NUR 253
EXAM 3 STUDY GUIDE
Concepts of Mental Health Nursing
Galen College of Nursing
, lOMoARcPSD|51648332
Mental Health Exam 3 Study Guide
Trauma/Stress/Dissociative Disorders
Trauma – subjective (Diathesis Stress Model) – war, interpersonal trauma,
witnessing something
Trauma-informed care- framework for tx (realize, recognize, respond, resist)
Post-Traumatic Stress Disorder:
Exposure to traumatic event (children may blame themselves)
Intrusion
o Flashbacks are dissociative (adults)
o Children may have reduced play, may act out trauma in play,
nightmares
Avoidance of stimuli associated with trauma
Negative change in cognition/mood – children have somatic symptoms
(GI upset, HA)
Change in arousal/activity – hypervigilant
Interventions:
o Psychoeducation – relaxation
o Pharm – antidepressants, antianxiety (clonidine given for
hyperarousal)
Goals:
o Manage anxiety, increase self-esteem, improve coping
Tx Effective if: Adults
o Recognize s/s r/t trauma
o Use new coping skills
o No flashbacks
o Adequate sleep with no nightmares
o Assume usual roles
Downloaded by Benjamin Luca ()
, lOMoARcPSD|51648332
Tx Effective if: Kids
o Safety maintained
o Decreased anxiety
o Appropriate behavior
o Normal milestones
o Seek out help from adults
Acute Stress Disorder: Dx 3 days to 1 month after trauma, will improve or
progress to PTSD, tx - therapy
Reactive Attachment Disorder: No comfort from caregivers
Disinhibited Social Engagement Disorder: Will seek care from anyone
for comfort (no fear of strangers)
Adjustment Disorder: Precipitated by stressful event, s/s negatively impact
functioning, dx immediately or within 3 months of exposure
Dissociative Disorders:
Occurs after adverse event = severe interruption of consciousness
Is an UNCONSCIOUS defense mechanism
Can be protective for a child
Risk Factors: ACEs, traumatic events
Depersonalization: Focus on self, feels like observing own body
Derealization: Outside world-surroundings seem
unreal/distant/dream-like
Dissociative Fugue: Sudden, unexpected travel and inability to recall
one’s identity and information about past. May assume new identity.
After a few weeks/months, may remember former identity
Dissociative Identity Disorder
o 2 or more distinct personality traits
o Host often unaware of alters
o Switching during times of stress - may be dramatic or subtle
o Severe trauma in childhood
o Priority = SAFETY
Downloaded by Benjamin Luca ()
EXAM 3 STUDY GUIDE
Concepts of Mental Health Nursing
Galen College of Nursing
, lOMoARcPSD|51648332
Mental Health Exam 3 Study Guide
Trauma/Stress/Dissociative Disorders
Trauma – subjective (Diathesis Stress Model) – war, interpersonal trauma,
witnessing something
Trauma-informed care- framework for tx (realize, recognize, respond, resist)
Post-Traumatic Stress Disorder:
Exposure to traumatic event (children may blame themselves)
Intrusion
o Flashbacks are dissociative (adults)
o Children may have reduced play, may act out trauma in play,
nightmares
Avoidance of stimuli associated with trauma
Negative change in cognition/mood – children have somatic symptoms
(GI upset, HA)
Change in arousal/activity – hypervigilant
Interventions:
o Psychoeducation – relaxation
o Pharm – antidepressants, antianxiety (clonidine given for
hyperarousal)
Goals:
o Manage anxiety, increase self-esteem, improve coping
Tx Effective if: Adults
o Recognize s/s r/t trauma
o Use new coping skills
o No flashbacks
o Adequate sleep with no nightmares
o Assume usual roles
Downloaded by Benjamin Luca ()
, lOMoARcPSD|51648332
Tx Effective if: Kids
o Safety maintained
o Decreased anxiety
o Appropriate behavior
o Normal milestones
o Seek out help from adults
Acute Stress Disorder: Dx 3 days to 1 month after trauma, will improve or
progress to PTSD, tx - therapy
Reactive Attachment Disorder: No comfort from caregivers
Disinhibited Social Engagement Disorder: Will seek care from anyone
for comfort (no fear of strangers)
Adjustment Disorder: Precipitated by stressful event, s/s negatively impact
functioning, dx immediately or within 3 months of exposure
Dissociative Disorders:
Occurs after adverse event = severe interruption of consciousness
Is an UNCONSCIOUS defense mechanism
Can be protective for a child
Risk Factors: ACEs, traumatic events
Depersonalization: Focus on self, feels like observing own body
Derealization: Outside world-surroundings seem
unreal/distant/dream-like
Dissociative Fugue: Sudden, unexpected travel and inability to recall
one’s identity and information about past. May assume new identity.
After a few weeks/months, may remember former identity
Dissociative Identity Disorder
o 2 or more distinct personality traits
o Host often unaware of alters
o Switching during times of stress - may be dramatic or subtle
o Severe trauma in childhood
o Priority = SAFETY
Downloaded by Benjamin Luca ()
