Deck 8: Trauma- and Stressor-Related Disorders

Question 1

When considering the diagnosis between posttraumatic disorder and generalized anxiety disorder GAD), one distinction includes:

A)The individual experiences sleep disturbances
B)The individual shows irritability
C)The individual persistently re-experiences "the event"
D)The individual experiences impairment in social and/or occupational functioning

Answer 1

C

Question 2

Cindy Baxter is a 6 year-old little girl who witnessed a traumatic episode where her babysitter was raped by an intruder. Cindy's mother is relieved that her daughter was unharmed. Which of the following behaviors would suggest that Cindy might be experiencing posttraumatic stress disorder?

A)Plays normally with her toys
B)Expresses no fear when talking about the event
C)Takes the clothes off her dolls when playing
D)Has recurrent dreams about castles and being a princess

Answer 2

C

Question 3

Posttraumatic stress disorder PTSD) may arise after all the following except:

A)Loss of one's home through a devastating flood
B)Witnessing a catastrophic train accident
C)A combat war experience
D)Losing one's job

Answer 3

D

Question 4

Persistent complex bereavement disorder is a proposed diagnosis which appears in Section III, Conditions for Further Study, of the DSM-5.

Question 5

Experiencing repeated or extreme exposure to aversive details of traumatic events) supports the diagnosis of posttraumatic stress disorder.

Question 6

Sarah Ackley was 6 years old when her mother and step-father brought her to the Children's Center for an evaluation. Her mother, Dianna Hamilton, described her daughter's childhood as filled with frequent changes in primary caregivers. When Sarah was 2 years old her parents divorced. Mrs. Hamilton stated, "I was in the Army at the time serving in Afghanistan so her father was granted custody. Looking back, I don't think it was a good idea. Seems he had a steady stream of girlfriends coming and going but being stationed so far away I never really got the full story. Anyway, somebody put in an anonymous complaint to child protective services and Sarah was removed from his care. She was subsequently placed with my parents. They were in their late sixties at the time so I'm not really sure they were ready to be parents again but I do know they were concerned about Sarah." According to the family physician, Sarah's physical development was seen as normal. However, socially she appeared immature and inappropriate. Her interactions were described as "dominated by indiscriminate sociability." Mrs. Hamilton explained Sarah's behavior as follows, "I don't know how many times I have been so embarrassed by that child. I mean Sarah will talk to anybody. If we are in the supermarket and she sees a woman wearing a bracelet that she likes, Sarah will go right over and ask if she could have it. I thought this was a phase she was going though and that she would outgrow it but that's not happening." What is the most likely diagnosis for Sarah Ackley?

A)Posttraumatic Stress disorder
B)Acute stress disorder
C)Reactive attachment disorder
D)Disinhibited social engagement disorder

Question 7

Practitioners should be aware of fears and anxieties that develop a result of traumatic events in order to distinguish these from generalized anxiety disorder.

Question 8

Six months after the death of her husband, 70 year-old Emma Davis has not been able to move out of her home because she is unable to sort through and dispose of her husband's belongings. Emma can longer afford to keep what is now a large house and yearns for her husband to come back. Emma's family doctor referred her to the social worker for counseling to address symptoms of overwhelming sadness and anger regarding her husband's sudden death from a heart attack. What would be the appropriate diagnosis for Emma Davis?

A)Major depressive episode
B)Posttraumatic stress disorder
C)Adjustment disorder
D)Normal grief and bereavement
True/False Questions:

Question 9

Of the following statements, which is most indicative of developing posttraumatic stress disorder?

A)Experiencing a personal injury
B)Having a prior mental disorder
C)Perception of the event as something that is a life threat
D)Severity of the trauma

Question 10

Ms. Holley is a first grade teacher who is concerned about one of her students, 6 year-old Kara Steel. Each time the class goes on a field trip, Kara leaves the class group and approaches strangers. It seems that Kara has a history of being placed in several different foster homes over the past 3 years. Which of the following diagnoses best explains Kara's behavior?

A)Reactive attachment disorder
B)Disinhibited social engagement disorder
C)Acute stress disorder
D)Attention-deficit/hyperactivity disorder

Question 11

Adjustment disorder is a reaction to a stressor, such as learning one has a serious medical illness.

Question 12

Reactive attachment disorder occurs only in children who have impaired communication.

Question 13

Duc Tran Dong, a forty-two year-old Vietnamese immigrant was held up at gunpoint and shot in the arm one year ago working as a clerk in the neighborhood convenience store. Within the last two weeks he has begun experiencing symptoms of posttraumatic stress disorder. You are his social worker. What would help you to decide whether his diagnosis posttraumatic stress disorder could be characterized as acute, chronic, delayed onset or residual?

A)Time
B)Nature of the event alone
C)Severity and intensity of the incident
D)Family history of anxiety

Question 14

Jamie Richards is a freshman at a near-by community college. Normally a good student, she contacted student counselling services for some help when her grades started to slip. She always loved school and now found it harder and harder to find the energy to devote to her classes. Jamie begins, "Well, it all started when my step-dad raped my sister when she was 11 years old. She's now 14 but only told me about it last month. Of course I told my mom right away. It broke her heart. I felt so bad. Anyway, from that moment on my whole life changed. First off, I f_ _ ked up things with my boyfriend." Jamie admits that she had flirted with her boyfriend's best friend. "I know I broke my boyfriend's heart. I feel so miserable and I hate knowing that I broke somebody else's heart just like my step-dad broke mine, my mom's, and my little sister's," said Jamie." She continues, "Anyway, this has been going on for the past 3 months and I just feel so down. I cry at the drop of a hat and feel so hopeless about ever getting back to 'normal'." What is the likely diagnosis for Jamie Richards?

A)Posttraumatic Stress disorder
B)Acute stress disorder
C)Reactive attachment disorder
D)Adjustment disorder

Question 15

Jeannie Koch has been known to child protective services since she was 2 years old. Her mother, Carmen, never married. Jeannie's father lost touch with the family after his last incarceration for selling drugs. The case notes describe Jeannie's mother as struggling with depression indicating that she was often "unavailable" due to recurring bouts of depression. During episodes of feeling "down," Carmen would leave Jeannie in the care of various sitters or relatives. While there was no history of serious abuse or neglect, Jeannie's mother was often not able to attend to her daughter's needs. Carmen has just been hospitalized for a major depressive episode and this time around the caseworker was unable to locate relatives who could take care of Jeannie - now 4 years of age - for an extended period of time and so the youngster was placed in temporary foster care. Soon after placement, the foster mother reports, "She keeps to herself and hardly talks to any of us. I can hear that child sobbing when she is alone in her room. And when I ask Jeannie if she's worried about her mother, she insists that her mom is on vacation and will be back soon." Further, Jeannie seems unresponsive to any efforts to comfort her. What do you think is the appropriate diagnosis for Jeannie Koch?

A)Posttraumatic Stress disorder
B)Acute stress disorder
C)Reactive attachment disorder
D)Disinhibited social engagement disorder

Question 16

The establishment of a separate chapter for trauma- and stressor-related disorders in the DSM-5 is based on strong evidence that the clinical expression of psychological distress following exposure to a traumatic or stressful event is quite variable.

Question 17

DSM-5 diagnostic criteria for acute stress disorder ASD) require the presence of symptoms from 5 different categories: intrusion, negative mood, dissociative, avoidance, and arousal.

Question 18

Skip Bradeen spent 27 months in Iraq dodging roadside bombs, rocket-propelled grenades, mortars and snipers, and seeing his friends die. One memory especially stands out for Skip. It was when he saw one of his best friends die. After his first tour in Iraq, Skip's wife noticed how much he had changed. According to his wife, Pat, "When he came back, Skip would never talk about what he had done in Iraq. He was always an easy going kind of guy but now he seemed so negative. He would say things like 'The world is so dangerous. You can't trust anybody. That was so unlike him. Worse yet, my living room became a battlefield. If one of our kids would misbehave, Skip would go through the ceiling. I remember one night he grabbed our 8 year-old by the throat and threw him against the wall. It was like Skip was angry all the time." Pat added, "Our bedroom was a battleground, too. At first, Skip would wake up every single night screaming at the top of his lungs. Then came the nightmares. Another thing I noticed was that he spent a great deal of time shaking and crying when he thought nobody was looking. I don't know how many times I would come home after work and find Skip huddled in the corner of our bed, sheets over his head." The Army doctors noted Skip's severe migraines, frequent nightmares, sleep disturbance, memory lapses, hyper-vigilance, and anxiety and recommended him for a medical discharge. What is Skip's most likely diagnosis?

A)Posttraumatic Stress disorder
B)Acute stress disorder
C)Reactive attachment disorder
D)Adjustment disorder

Question 19

The experience of a college student at a film festival watching a series of violent movies that contain graphic rape scenes would qualify as a traumatic event supporting diagnostic criteria for posttraumatic stress disorder.

Question 20

For a child to be considered for the diagnosis of reactive attachment disorder, he or she must have a history of being placed in 5 foster homes, at a minimum.

Question 21

Use the following terms to complete the answer.

__________ disorder is distinguished from posttraumatic stress disorder by a symptom pattern restricted to a duration of 3 days to one month following exposure to the traumatic event.

Question 22

Use the following terms to complete the answer.

Spontaneous and intrusive memories may not necessarily appear as distressing but may be expressed as play reenactment is a diagnostic criterion that may be seen in children 6 years and younger with _______ disorder.

Question 23

The presence of emotional or behavioral symptoms in response to an identifiable stressor is the essential feature of adjustment disorders.

Question 24

Use the following terms to complete the answer.

Because of its association with social neglect __________ disorder may co-occur with developmental delays.

Question 25

Use the following terms to complete the answer.

The only known risk factor for __________ disorder is serious social neglect.

Question 26

With depressed mood is a specifier for the adjustment disorders.

Question 27

Use the following terms to complete the answer.

The essential feature of __________ disorder is absence or grossly underdeveloped attachment between the child and acknowledged caregiving adults.

Question 28

Use the following terms to complete the answer.
-Acurte stress
-Adjustment
-Disinhibted social engagment
-Posttraumatic stress
-Reactive attachment

-The key feature of __________ disorders is the presence of emotional or behavioral symptoms in response to an identifiable stressor.

Question 29

Use the following terms to complete the answer.

Indiscriminate social behavior and a lack of reticence with unfamiliar adults in toddlerhood accompanied by attention-seeking behaviors in preschoolers are commonly seen in __________ disorder.