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Acute Stress Disorder and Post-Traumatic Stress Disorder –The Disorder Occurs Within a Month of a Traumatic Event

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Acute Stress Disorder and Post-Traumatic Stress Disorder –The Disorder Occurs Within a Month of a Traumatic Event ACUTE STRESS DISORDER AND POST -TRAUMATIC STRESS DISORDER • A traumatic experience is a disastrous or an extremely painful event that has severe psychological and physiological effects. Examples include: accidents, violence, war, riots, fires and earthquakes. • Acute stress disorder develops soon after a traumatic event. • The individual develops intense fear, helplessness or horror. • Most people are able to return to relatively normal functioning within days or weeks. • Others may not develop the disorder while others develop PTD when the symptoms persist for more than a month. Diagnostic features of Acute Stress Disorder and Post-Traumatic Stress Disorder –The disorder occurs within a month of a traumatic event. –It causes clinically significant distress or impairment that lasts up to 4 weeks. –They experience death or serious injury. –They also experience a physical threat to self or others. –They respond with intense fear, helplessness or horror. –Sense of detachment, numbing or lack of surrounding as in a trance (daze). –Feelings of unreality. –Inability to recall an important aspect of the trauma (dissociate amnesia). –Recurrent images, thoughts, dreams, illusions, flashback episodes, a sense of reliving the experience or the person feels intense distress when exposed to reminders of the event. –The individual avoids situations that evoke memories of trauma. –The individual experiences symptoms of anxiety, insomnia, irritability, poor concentration and restlessness. THEORIES 1. Biological Theory • Biological abnormalities are manifested in the individual nervous system or hypersensitive to possible danger in the future. 2. Psychological Perspectives • Trauma causes the flooding of the ego’s defences with uncontrollable anxiety. • Painful memories are triggered and inability to keep these memories repressed causes disturbance. 3. Behavioural Perspectives • The person with PTSD has acquired a learned fear to the stimuli that were present at the time of trauma. 4. Cognitive Perspective • People’s beliefs about traumatic events influence how people cope with it. Thoughts such as self blame for events beyond your control cause disturbance . 5. Social Cultural Perspective • This includes devastating wars. Lack of social support may contribute to the disorder. • In certain ethnic groups, stigma is associated with seeking professional psychological help. • This can aggravate the experience of PTSD. TREATMENT –Medication –Psychotherapy – supportive therapy and stress management –Systematic desensitization –Dispute irrational thinking • Behavioural therapy: - - Establish a rapport with the client - Dispute irrationality - Problem solving skills - Confront the feared situation in thoughts and all settings - Confront barriers in form of feelings e.g. fears, guilt, depression and distorted beliefs e.g. negative self image. Revision Questions • Define anxiety disorders • Identify any five categories of anxiety disorders • Discuss causes of specific phobia and social phobia • Differentiate between Acute Stress Disorder and Post- Traumatic Stress Disorder • Differentiate between Agoraphobia and Panic Disorder with Agoraphobia • Discuss the various intervention strategies you will use to help a client with Anxiety Disorders SCHIZOPHRENIA • By the end of the lesson, the learner should be able to: - – Define Schizophrenia – State the phases of Schizophrenia – Discuss the theories and treatment of Schizophrenia Meaning of Schizophrenia • Schizophrenia means a split personality. • It is a disorder with a range of symptoms involving disturbances in content of thought, perception and effect, sense of self, motivation, behaviour and interpersonal functioning. Characteristics of Schizophrenia • Four fundamental features include: - i. Association – evident incoherent speech. ii. Affect – inappropriate expression of emotions e.g. inappropriate laughter in a sad situation. iii. Ambivalence – inability to follow through a decision. iv. Autism. Phases of Schizophrenia • Schizophrenia marks disturbances lasting at least 6 months. 1.Prodromal Phase • Deterioration in social and interpersonal functioning. It is characterized by maladaptive behaviour such as social withdrawals, inability to work productively, poor grooming, inappropriate emotions, peculiar thoughts and speech, unusual beliefs and decreased energy and initiative. 2.Active Phase • Behaviour and negative symptoms such as speechlessness or lack of initiative. 3.Residual Phase • There are serious problems at work, relationship and self care. 1.Disturbance of thought content – Delusions deeply entrenched false beliefs are the most common disturbance of thought at this time. The false beliefs are not consistent with the client’s intelligence or background. – The person imagines that people want to harm them or prevent them from fulfilling their mission. 2. Disturbance in perception hallucinations . - These are false perception involving one of the fie senses the false perceptions do not correspond with the objective stimuli present in the environment e.g. hearing of sounds, seeing things that others don’t e.t.c. 3. Disturbance of thinking. • Language and communication: Disorganized speech. The persons thinking may lack cohesiveness and logic. Their language may be distorted to the point of incomprehensibility. 4. Disturbed Behaviour • The person may move in odd and disturbing ways. They may not respond to external stimuli. They at times portray repetitive bodily movements. 5. Negative symptoms such as: - – Affective flattening – unresponsive with minimum eye contact – Alogia – loss of words and unresponsiveness in conversation. – Avolitian – unwillingness to act – Anhedonia – loss of interest in experiencing pleasure from activities that others find pleasurable. 6. Social and occupational dysfunctions - They have difficulty interacting with others. Diagnostic Features of Schizophrenia • Delusions • Hallucinations • Disorganized speech. • Catatonic stupor (a state of being unresponsive to eternal stimuli) severe lack of motivation. Types of Schizophrenia 1.Catatonic Schizophrenia • It is characterized by psychomotor disturbance such as excessive purposeless motor activity. 2.Disorganized Schizophrenia • Characterized by disorganized speech, and inappropriate affect. 3.Paranoid Schizophrenia • They are pre-occupied with auditory hallucination related to a theme of being persecuted or harassed. They have tremendous interpersonal problems because of their suspicions and argumentative style. 4. Undifferentiated Schizophrenia • The person manifests delusions, hallucinations, incoherence and disturbed behaviour. 5. Residual Schizophrenia • They retain symptoms such as emotional dullness, social withdrawal and illogical thinking. Theories of Schizophrenia 1. Biological Perspective • The brain structure and genetics are recognized as contributing to an individual’s illogical vulnerability and Schizophrenia. 2. Physiological Perspectives • Caused by an over activity of neurons that communicate with each other via the transmission of dopamine. 3. Environmental Perspectives • Pre-natal infection, birth complications may disrupt the brain development of the fetal and potential period through infection or injury. 4. Diathesis Stress Model • Diathesis means physical vulnerability to a particular disorder, especially if the individual lives in a stressful environment . Treatment of Schizophrenia (i) Biological/Pharmacotherapy Treatment • - Giving effective medication (ii) Psychological treatment – Reward a person who acts in a socially acceptable manner. – Reinforce appropriate behaviour especially in interpersonal situations – Helps the client to develop a more positive approach and evaluating the ability to cope with daily problems. (iii) A family and friends therapy (iv) Use core conditions to create rapport. Revision Questions • Define the term schizophrenia • Identify the three phase of schizophrenia • Discuss any five symptoms of schizophrenia • Describe the diagnostic features of schizophrenia • Discuss catatonic and disorganized types of schizophrenia • Discuss any three major treatment for schizophrenia patents PERSONALITY DISORDER • By the end of the lesson, the learner should be able to • Define personality and personality disorder. • Identify the various categories of personality disorder. • Describe the diagnostic features of each personality disorder. • Describe causes and treatment of each personality disorders. • Differentiate the personality disorder. Introduction • Personality disorder are classified under axis 2 unlike the disorders we have already looked at, classified under axis 1 • A personality trait is an enduring pattern of perceiving, relating to and thinking about the environment and others, a pattern that is ingrained in the matrix of the individuals psychological make-ups. • A personality disorder involves a long lasting maladaptive pattern of inner experience and behaviour, dating back the adolescence of young adulthood that is manifested in at least two of the following areas: i. Cognition – (ways f perceiving self, other people and events. ii. Affectively – rage, intensity and appropriate of emotional expression iii. Interpersonal functioning iv. Impulse control. • The pattern is inflexible and pervasive across a range of personal and social situations. The pattern causes distress or impairment. • The present system in the DSM-IV includes a set of separate diagnoses grouped into two cluster based on shared characteristics. CLUSTER A • It comprises paranoid, schizoid and
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