Trauma and

stressor-related
Disorder
By: Laeh Mae Abugan
Angellette Alvarado
Djanisa

HISTORICAL AND
EPIDIOMIOLOGICAL DATA
Known throughout centuries as shell shock, battle
fatigue, accident neurosis and posttraumatic
neurosis.
TRAUMATIC NEUROSIS egos inability to master
the degree of disorganization brought about by a
traumatic experience.
PSTD is linked to psychological casualties of the
Vietnam war.
DSM-IV-TR- states trauma that precedes PSTD as
an event that is outside human experience.
The disorder appear to be more common in
women than in men.
Adjustment disorder- stress reaction from normal

APPLICATION OF THE POSTTRAUMATIC STRESS

DISORDER AND ACUTE STRESS DISORDER

BACKGROUND ASSESSMENT DATA

TRAUMA extremely distressing experience that
causes emotional shock and may have long
lasting psychological effects.
PSTD symptoms are not related to common
experiences such as uncomplicated bereavement,
marital conflict or chronic illness but with the
events that is markedly distressing to anyone.
DSM-5 describe another disorder that is ASD
(acute stress disorder) the symptoms are time
limited.

DIAGNOSTIC CRITERIA FOR POST

TRAUMATIC STRESS DISORDER
Note: the ff. apply to any age less than 6 years old.
A. Exposure to actual or threatened death, serous injury, or
sexual violence
B. Presence of one (or more) of the ff. intrusion symptoms
C. Persistent avoidance of stimuli associated w/ the traumatic
events.
D. Negative alterations in cognition and mood associated w/ the
traumatic events.
E. Marked alterations in arousal and reactivity asso. w/
traumatic events
F. Duration of the disturbance is more than 1month
G. the disturbance causes impairment in social, occupational
etc.
H. disturbance not attributed with physiological effect of
substance.

DIAGNOSTIC CRITERIA FOR

ACUTE DISORDER
A. Exposure to actual or threatened death, serous injury,
or sexual violence
B. Presence of nine (or more) of the ff. intrusion symptoms

Intrusion symptoms
Negative mood
Dissociative symptoms
Avoidance symptoms
Arousal symptoms

C. Duration of the disturbance is 3 days to1month

D. The disturbance causes impairment in social,
occupational etc.
E. Disturbance not attributed with physiological effect of
substance.

PREDISPOSING FACTORS TO
TRAUMA RELATED DISORDER
PSYCHOSOCIAL THERAPY
The Traumatic Experience
The Individual
The Recovery Environment

LEARNING THEORY theorist view negative

reinforcement as behavior that leads to reduction
in an aversive experience , thereby reinforcing
and repetition of the behavior.
COGNITIVE THEORY the cognitive appraisal of an
event and focus on assumption that an individual
makes about the world.

 BIOLOGICAL ASPECTS Studies suggest that

physiological arousal initiated by exposure to
trauma like situations enhances production of
endogenous opioid peptides and results in
increased feeling of comfort and control.

DIAGNOSIS/OTCOME IDENTIFICATION
Post-trauma syndrome related to
distressing event considered to be outside
the range of usual human experience
Complicated grieving related to loss of self
as perceived before the trauma

PLANNING/IMPLEMENTATION
Post-trauma Syndrome a sustained
maladaptive response to traumatic, overwhelming
event
Complicated grieving occurs after the death of
significant other in which the experience of distress
accompanying bereavement fail to and manifest in
functional impairment.
Client goals (short-term goal and long term goals)
Interventions
CONCEPT CARE MAPPING
An approach to planning and organizing nursing
care whereby the visualization between medical
diagnosis, nursing diagnosis, assessment data and
treatment are showed.

EVALUATION
REASSESMENT is conducted in order to
determine if the nursing actions have been
successful in achieving the objectives.

ADJUSTMENT DISORDERSBACKGROUND ASSESSMENT DATA

STREESS mental, motional or physical strain
experience by individual in response to stimuli from
internal or external environment.
ADJUSTMENT DISORDER is characterized by
maladaptive reaction to an identifiable stressor that
result in the devt. of clinically significant emotional
and behavioral symptoms.
ADJUSTMENT DISOREDR WITHH DEPRESSED
MOOD the most commonly diagnosed adjusted
disorder, symptoms include depressed mode,
tearfulness and feeling of hopelessness.
ADJUSTMENT DISORDER WITH ANXIETY this
category denotes a maladaptive response to a stressor
in which the predominant manifestation is anxiety,
symptoms include nervousness, worry and jitteriness.

 ADJUSTMENT DISOREDER W/ MIXED ANXIETY AND

DEPRESSED MOOD the predominant feature of
this category include disturbance in mood and
manifestation of anxiety that are more intense
than normal.
ADJUSTMENT DISORDER WITH DISTUBANCE OF
CONDUCT is characterized y conduct in which there is
a violation of the right of others or major ageappropriate social norms and rules.
ADJUSTMENT DISORDER WITH MIXED
DISTURBANCE OF EMOTIONS AND CODUCT - the
predominant include motional disturbance as well as
disturbance of conduct.
ADJUSTMENT DISORDERUNSPEFIED the individual
may have physical complaints, withdraw form
relationship or exhibit impaired work or academic but
w/out disturbance in emotion or conduct.

PREDISPOSING FACTORS TO
ADJUSTMENT DISORDER
BIOLOGICAL THEORY chronic disorder are thought
t impair the ability of an individual to adapt a
stress causing vulnerability to adjustment
disorder.
PSYCHOSOCIAL THEORIES views adjustment
disorder a as maladaptive response to stress that
it is caused by early childhood trauma, increased
dependency and retarded ego devt.
TRANSACTIONAL MODEL OF STRESS/ADAPTATION
takes into consideration the interaction between
the individual and the environment.

DIAGNOSIS/OTCOME IDENTIFICATION
Complicated grieving related to real or
perceived loss of any concept of value of the
individual
Risk prone health behavior related to
change in health status requiring in
modification in lifestyle
Anxiety related to situational/maturational
crisis
PLANNNG/IMPLEMENTATION
CLIENT GOALS
INTERVENTONS
CONCEPT CARRE MAPPING
EVALUATON

TREATMENT MODALITIES
TRAUMA REALATED DISORDER
COGNITIVE THERAPY- individuals learns to modify he
relationship between thoughts and feelings
PRLONGED THERAPY- it can be conducted in
imagined or vivo situation
Imagined situation- individual is exposed in
repeated and prolonged mental recounting of the
traumatic experience
Vivo situation involves systematic confrontation
within safe limits, of trauma related that are
feared and avoided.
GROUP/FAMIY THERAPY able to share their

EYE MOVEMENT
DESENSITIZATIONAND REPROCESSING

Phase
Phase
Phase
Phase
Phase
Phase
Phase
Phase

I: HX ANND TX PLANNING
II: PREPARATION
III: ASSESSMENT
IV: DESENSITIZATION
V: INSTALLATION
VI: BODY SCAN
VII: CLOSURE
VIII: REEVALUATION

PHRMACOLOGY
ANTIDEEPRSANTS: Tricyclic antidepressants,
MAOI, trazodone
ANXIOLYTICS: Alprazolam, Benzodiazepines,
Buspirone
ANTIHPERTENSIVES: Propanolol, alpha2-receptor
agonist
OTHER MEDICATIONS: Carbazepine, Valproic acid,
lithium carbonate

ADJUSTMENT DISORDER
INDIVIDUAL PSYCHOTHERAPY- Allows the client to
examine the stressor that is casing the problem,
personal meaning to he stressor and confront
unresolved issue.
FAMILY THERAPY- Focus of this treatment is shifted
from the individual to the system of the
relationship in which the individual is involved.
BEHAVIOR THERAPY- To replace ineffective
response patterns with more adaptive ones.
SELF HELP GROUPS- w/ or w/out professional
facilitator, provide arena in which the embers may
consider and compare themselves wit similar life
experience.

 CRISIS INTERVENTION- the therapist or other

intervener becomes part of the individuals lifes
situation.

PSYCHOPHARMACOLOGY
adjustment disorder is not commonly treated
with medications for the ff. reasons: their effect
may be temporary and only mask the real problem,
and psychoactive drugs may carry the potential for
physiological and psychological dependence.