CC March 2016 Acute Stress Disorder

echoecho's version from 2016-05-31 02:48


Question Answer
According to the Diagnostic and Statistical Manual 5th edition (DSM-5), acute stress disorder (ASD) must first involve what?"exposure to actual or threatened death, serious injury or sexual violation"
The individual may?1) have direct exposure 2) witness an event suffered by another person 3) learn about the event affecting a close friend or family member 4) have repeated or extreme exposure to aversive details of the events
Additionally, the individual must exhibit at least ____ symptoms in any of the 5 symptom categories?9
List the 5 symptom categories?1) Dissociative symptoms 2) Intrusion symptoms 3) Avoidance symptoms 4) Arousal symptoms 5) Negative mood
Define dissociative symptoms?amnesia for important events related to trauma, altered sense of reality
Define intrusion symptoms?recurrent intrusive memories or dreams of or related to the event, flashbacks, intense psychological or physiological distress or reactions to cues that symbolize or resemble trauma aspects
Define avoidance symptoms?avoiding memories or thoughts, avoiding external reminders
Define arousal symptoms?sleep disturbance, hype vigilance, exaggerated startle, irrational behaviors or outburst, difficulty concentrating
These s/s must develop within ____ weeks of a traumatic experience and must be present for at least ___ days for the dx of ASD to be made4; 2
There are tools to help assess ASD. These include what scales?1) acute stress disorder interview (ASDI) and 2)Acute Stress Disorder Scale
ASD is believed to affect between ___ % and ____% of individuals who experience a severe trauma in their lieves?14; 33
ASD places patients at an increased risk of progressing to what disorder?PTSD
What is the key difference between ASD and PTSD?the duration of symptoms (PTSD s/s must be present for > 1 month) and the dissociate s/s associated with ASD
*** What is the most effective mthod usied in the treatment of ASD?TF-CBT (trauma-focused cognitive behavioral therapy)
Describe TF-CBT?1) it is an intervention that focuses on educating patients about their feelings and reactions to their individual traumas, as well as attempting to reform the beliefs regarding those traumas 2) there are also components of muscle relaxation and development of tolerance w/ gradual introduction to the avoided stimuli
CBT has also been shown to be more effective than what type of counseling?supportive
*** List the interventions that have not been proven helpful for ASD?1) CISD (critical incident stress debriefing) 2) use of pharmacological therapies
Describe CISD (critical incident stress debriefing)?1) a group intervention initiated soon after a shared traumatic experience, typically w/in the first week 2) focus is to alleviate emotional distress through discussion and sharing emotions related to the event 3) pts are given info about their situation as well as methods of coping 4) CISD offers no benefit and may be detrimental to the natural revocer process
List the 3 medications that have been used in ASD but there is no evidence to support their routine use?1) Fluoxetine (Prozac) 2) Imipramine (Tofranil) 3) propranolol (Inderal)
What other drug has had some benefit for controlling acute ASD s/s and can be considered in pts unable to participate in CBT?Risperidone (Risperidal)
Limited evidence suggests that propranolol may lessen the potential progression of ASD to ____?PTSD
*** SUMMARY = How is ASD distinguished from PTSD?by the shorter duration of symptoms, the proximity of onset to a specific traumatic event and the presence of dissociative and avoidance symptoms
*** SUMMARY = What is the treatment of choice for ASD? Trauma-focused cognitive behavioral therapy
*** SUMMARY = Is medication treatment for ASD generally recommended?no