TRAUMA AND STRESSOR

RELATED DISORDERS
(DSM-5)

PRESENTED BY: Ms Mamta Bisht

Lecturer
(Psychiatric Nursing)
 INTRODUCTION
Trauma and stressor-related disorders are a
group of emotional and behavioral problems
that may result from childhood traumatic
and stressful experiences.

These traumatic and stressful experiences

can include exposure to physical or
emotional violence or pain, including abuse,
neglect or family conflict. Presented By Ms Mamta Bisht
 TRAUMA AND STRESSOR RELATED
DISORDERS (DSM-5)
• Reactive attachment disorder
• Disinhibited social engagement disorder
• Post traumatic stress disorder (PTSD)
• Acute stress disorder
• Adjustment disorder
• Other specified trauma and stressor related
disorders
• Unspecified trauma and stressor related
disorders Presented By Ms Mamta Bisht
 REACTIVE ATTACHMENT
DISORDER

It is a rare condition of emotional

dysfunction in which infant or child has
difficulty forming a healthy bond or
attachment with parent or caregivers due
to early neglect or mistreatment

Presented By Ms Mamta Bisht

 REACTIVE ATTACHMENT DISORDER contd....

• Child shows emotionally withdrawn

behavior towards the caregivers
• Occasional or minimal signs of
seeking or responding to comfort
when distressed.
• Unexplained sadness, fear and
irritability

Presented By Ms Mamta Bisht

DISINHIBITED SOCIAL ENGAGEMENT
DISORDER

Disinhibited social engagement

disorder is characterized by patterns of
behavior in which the child is not closely
bonded to parents and is comfortable
with thee strangers as they are with their
primary caregivers.

Presented By Ms Mamta Bisht

 REACTIVE ATTACHMENT DISORDER contd....

• There is no fear, hesitations or

shyness on meeting strangers.
• Over friendly and over talkative
behavior towards strangers.
• Hugging or cuddling unknown adults.

Presented By Ms Mamta Bisht

POST TRAUMATIC STRESS
DISORDER (PTSD)
 POST TRAUMATIC STRESS
DISORDER (PTSD)
Definition:
Post traumatic disorder is a reaction to
an extreme trauma , which causes
pervasive distress to the individual.
The traumatic events may include,
disasters (natural or man made),
combat, war, rape, torture, terrorism, or
other crimes.
Presented By Ms Mamta Bisht
 ETIOLOGY FOR PTSD
Traumatic experience
• Exposure to actual or threatened death
• Experiencing serious injury, or sexual
violence.
• Witnessing life
threatening events
like crime, murder
or disaster.
 CLINICAL FEATURES OF PTSD
1.Intrusive memories of the traumatic
event
• Recurrent, unwanted and
distressing memories
of the event

• Flashbacks and nightmare

 CLINICAL FEATURES OF PTSD contd....

2.Avoidance
• Avoiding places and activities or
peoples that remind of the traumatic
event.
• Keeping excessively busy to avoid
thinking about the traumatic event.

Presented By Ms Mamta Bisht

 CLINICAL FEATURES OF PTSD contd....

3.Negative thoughts and

beliefs about self ,
people or world:
• Hopelessness
• worthlessness
• Loss of interest in once important and
positive activities.
• Being jumpy

Presented By Ms Mamta Bisht

 CLINICAL FEATURES OF PTSD contd....

4.Changes in physical and emotional

reaction:
• Difficulty maintaining close
relationships
• Detached from family and friends
• Easily frightened
• Self destructive behavior
• Trouble sleeping
• Irritability, anger outbursts
Presented By Ms Mamta Bisht
 MANAGEMENT OF PTSD
1. psychosocial therapies

• Cognitive behavior therapy

• Systematic Desensitization

• Thought stopping

Presented By Ms Mamta Bisht

 MANAGEMENT OF PTSD contd....

2.Stress management
• Relaxation training and hypnotherapy
• Assertiveness training (promoting
positive thinking)

3.Supportive therapy

Presented By Ms Mamta Bisht

 MANAGEMENT OF PTSD contd....

4.pharmacological treatment

• SSRIs (First line treatment)-Paroxetine

• MAOIs - Phenelzine
• TCAs – Amitriptyline
• Benzodiazepines

Presented By Ms Mamta Bisht

 ADJUSTMENT DISORDER
Adjustment disorder refers to the
psychological reaction arising in
relation to adapting to new
circumstances such as :
• Major change of work
• Divorce and separation.
• Transition from school to university
• Migration
• Birth of handicapped child Presented By Ms Mamta Bisht
 ADJUSTMENT DISORDER
Definition:
An adjustment disorder is characterized
by a maladaptive reaction to an
identifiable stressor that results in
clinically significant emotional or
behavioral symptoms.
 CLINICAL FEATURES
1.Psychological symptoms

• Depression
• Anxiety
• Irritability
• Worry
• Poor Concentration

Presented By Ms Mamta Bisht

 CLINICAL FEATURES
2.Physical symptoms:
Palpitations, rapid breathing, tremors,
GI symptoms

3.Behavioral disturbance: anger, self

harm, substance use, social difficulties,
occupational problems, poor
performance.
Presented By Ms Mamta Bisht
MANAGING ADJUSTMENT DISORDER

• Talk therapy
• Teach & assist the client to face his
fears and accept the challenges
• Provide emotional support
• Stress management techniques
• Encourage positive thinking and
optimism.
Presented By Ms Mamta Bisht
MANAGING ADJUSTMENT DISORDER

• Help the person to get back to the

normal routine
• Help the person develop support
system (family and friends)
• Lifestyle modifications : good sleep,
healthy diet and regular physical
exercise
Presented By Ms Mamta Bisht
Thank you