Trauma and stressor related disorders

Two types:1. Post traumatic stress disorder

and 2. acute stress disorders

• Trauma: an extremely distressing experience that causes severe emotional shock and may have long lasting psychological effects.

• Trauma could be caused by natural or man related disaster e.g: accidents, deaths or rape,,,,,

S&S

• Nightmares • High level of anxiety• Not remembering certain aspect of the event• Depression• Painful guilt feeling• Anger • Substance abuse• Interference with social or occupational areas

Predisposing Factors:

1. Psychosocial theory: it is related to three variables which: a) the traumatic experiences b) the individual c) the recovery environment

a) The traumatic experience: • severity and duration of stressor• Extent of preparation of event• Exposure to death• Numbers affected by life threat• Amount of control over recurrence

b) The individual: • Degree of ego strength• Effectiveness of coping resources• Presence of preexisting psychopathology• Outcomes of previous experience of trauma• Behavioral tendencies (temperament)• Current psychosocial developmental age• Demographic factors ( age, education,,,,

3. The recovery environment: • Availability of social support • The protectiveness of family and friends• the attitudes of society regarding the

experiences • Cultural and subcultural influence

2. Learning theory: Negative reinforcement leads to the reduction in an aversive experience, thereby reinforcing and resulting in repetition of the behavior.

• - Avoidance may result . Ex. Blown up in car, will not get into a car again

3. Cognitive theory: it is a cognitive appraisal about the world. A person is vulnerable to posttraumatic stress disorder when fundamental beliefs are invalidated by experiencing trauma that cannot be comprehended and when a sense of helplessness and hopelessness succeed e.g

- For example: belief of.- I will be successful, I am a good person, etc.If those beliefs shaken by an experience, they will reinforce the negative experience thinking it will always be (ex. always be lonely b/c friends died in situation)

• this reflect If trauma occur there will be dis-equilibrium until accommodation for the change would occur. If a person does not comprehend the situation helplessness and hopelessness would occur.

4. Biological aspect: if individual exposed to trauma and he has been exposed to previous trauma this individual is more likely to develop symptoms. Because they will activate the behaviors associated with original trauma.

• There are studies suggest that when endogenous opioids increase at the beginning of the trauma leading to feeling comfort and control but when the stressor terminates the client will suffer from opioids withdrawal symptoms and they will express strong trauma symptoms

Extra information related to biological aspect of trauma

• Genetics ?

• Neuroanatomical: Brain areas involved in the stress response include the amygdala, hippocampus, and prefrontal cortex. Traumatic stress can be associated with lasting changes in these brain areas. Traumatic stress is associated with increased cortisol and norepinephrine responses to subsequent stressors.

• Biochemical: abnormal secretions of stress hormones such as cortizole

• Neurochemical:

Nursing Care Plan page 497

Treatment Modalities

• Trauma Related Disorders:1. Cognitive therapy: the individual learns to

modify the relationship between thoughts and feeling and to replace these negative thoughts with more accurate and less distressing thoughts and to gain hope and optimism about safety, trust and power.

2. Prolonged exposure therapy: It has four main parts: a) education about the treatment b) breathing retraining for relaxationc) Imagined exposure through repeated discussion with therapist d) exposure to real world situations related to the trauma.• it is confronting a client with traumatic situation

in safe limit till the client feel the event is not traumatic.

• What is Prolonged Exposure for Posttraumatic Stress Disorder (PTSD)?

• https://www.youtube.com/watch?v=n5C2ruCzj_4

3. Group/ Family Therapy: it is taking and expressions of feeling and finding options to manage their stresses and facilitate therapeutic change. It could be done with support group or individuals with experiences or with family members.

• PTSD Group Therapy• https://

www.youtube.com/watch?v=eAMPuWg4ISA

4. Eye movement desensitization and reprocessing https://www.youtube.com/watch?v=1f7oHNKNQNY• Psychotherapist is explaining it. https://www.youtube.com/watch?v=SQ_TnyknP5I

• محمد للدكتور مؤثّرة قصة ؟؟ الخوف لماذاالنابلسي راتب

• https://www.youtube.com/watch?v=hvyj-9wCpqA

Extra information:

• How Childhood Trauma Can Make You A Sick Adult

https://www.youtube.com/watch?v=y3cCAcGeG8E

5. Psychopharmacology: • Antidepressant • Anxiolytics• Anti- hypertensives• Other medications: carbamazepine, valproic

acid, lithium carbonate

Thank You