PYC 4802_EXAM_Qs_&_As. 100% CORRECT ANS.

QUESTION 1 (OCT/NOV 2011) ANSWER: A). Firstly, a person must have been exposed to actual or threatened death, serious injury, or sexual violence in one or more of the following ways: directly experiencing the traumatic event(s); witnessing in person the event(s) as it occurs to others; learning that the traumatic event(s) occurred to a close family member or close friend; experiencing repeated or extreme exposure to aversive details of the traumatic event(s). (Not including electronic media for people who don’t work in that profession). Secondly, The trauma is relived through intrusive and distressing recollections of the event, dissociative reactions such as flashbacks in which the individual feels or acts as if the traumatic event(s) were recurring, nightmares relating to the traumatic event(s), intense physiological reactivity or distress when exposed to reminders of the event. Thirdly, Persistence avoidance of stimuli associated with the traumatic event(s), beginning after traumatic event(s) occurred. People may withdraw emotionally and may avoid anything that might remind them of the event(s). Fourthly, Negative alterations in cognitions and mood associated with the traumatic event(s), as evidence by two or more of the following : inability to remember an important an important aspect of the traumatic event(s) (typically due to dissociative amnesia and not to other factors such as head injury, alcohol or drugs); persistent and exaggerated negative beliefs or expectations of oneself, others, or the world; persistent distorted cognitions about the cause or 4 consequences of the traumatic event(s) that lead the individual to blame him or herself or others; markedly diminished interest or participation in significant activities; persistent negative emotional state; feelings of detachment or estrangement from others; persistent inability to experience positive emotions. Fifthly, heightened autonomic arousal where this reaction can include two or more symptoms such as sleep disturbance, hypervigilance, irritability, reckless or self destructive behaviour, exaggerated startle response, problems concentrating, and poor control over aggressive impulses. The duration of disturbance is more than 1 month. The disturbance causes clinically significant distress or impairment in social, occupational, or other important areas of functioning. The disturbance is not attributable to the physiological effects of a substance or another medical condition. B). The diagnosis of PTSD Developmental stage The onset of PTSD starts after exposure to an extreme stressor such as one that is life-threatening. ASD can develop after at least 3 days and shouldn’t last for more than a month, otherwise a diagnosis of PTSD should be considered. If the symptoms develop within a period of six months and persist for a period for up to six months after the event, it is an indication of acute PTSD. If the disorder lasts longer, that is an indication of a diagnosis of chronic PTSD. Co-morbidity Individuals with PTSD often suffer from psychiatric conditions. Children with PTSD also have fairly high rates of psychiatric co-morbidity. Co-morbidity may include: Alcohol and Drug abuse, Personality Disorder, General Anxiety Disorder, Obsessive Compulsive Disorder, Schizophrenia etc. Occasionally it 5 might create a problem for clinicians to distinguish PTSD symptoms from symptoms of coexisting psychic disorders. Delayed onset The delayed onset of PTSD is a subtype of posttraumatic stress disorder where the full diagnosis of the disorder is made only after at least 6 months have passed since the exposure to the traumatic event(s) because the patient may display symptoms of PTSD, but not all which would constitute them a full diagnosis of PTSD. The onset and expression of some symptoms may be immediate. Socio-economic status Environmental demands may differ between groups such as that they are either variously more predisposed to, or more protected from, certain disorders than other groups. People in disadvantaged groups, who may be of lower socio-economic and educational status, are more likely to have a stressful environment such as an unsafe neighbourhood, and to experience chronic and pervasive anxiousness. Substance abuse Post-traumatic stress disorder has emerged as a common co-occurring diagnosis among substance abusers. In reference to PTSD as the co-existing disorder, it is hypothesised that PTSD develops first and that chemical substance are used as a means of achieving symptom of relief. An investigation of PTSD among substance users from the general population shows that the onset of substance use precedes the onset of PTSD symptoms. It may be that early substance abuse occurs in the context of other “high risk” behaviours (prostitution), which increase the likelihood of exposure to potentially traumatizing events (e.g. being seriously beaten or injured) and hence, the likelihood of developing PTSD following traumatic exposure because they have historically relied on alcohol and drugs as a way to combat stress and failed to develop more effective stress inoculations strategies