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Trauma, Stressor-related, and Dissociative Disorders

Robert M. Millay RN MSN Ed

Napa Valley College

Psychiatric Technician Program

Copyright © 2014, 2010, 2006 by Saunders, an imprint of Elsevier Inc.

Clinical Picture Posttraumatic stress disorder in preschool children

Reactive attachment disorder

Disinhibited social engagement disorder

Trauma-Related Disorders in Children

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Epidemiology

Comorbidity

Biological factors Genetic

Neurobiological

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Trauma-related Disorders in Children (Cont.)

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Psychological factors Attachment theory

Environmental factors

Cultural considerations

Trauma-related Disorders in Children (Cont.)

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Assessment Developmental assessment

Nursing diagnoses

Outcomes identification

Implementation

Application of the Nursing Process

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A child has been traumatized by a history of violence. The nurse plans to assess the child’s mental health.

What are some things that should be assessed?

Case Study

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Interventions

Advanced practice interventions

Psychopharmacology

Evaluation

Application of the Nursing Process (Cont.)

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What are some interventions the nurse could use with this child who has been traumatized?

Case Study (Cont.)

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Posttraumatic stress disorder (PTSD) 1.

2

3

4.

Trauma-Related Disordersin Adults

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Epidemiology

Comorbidity

Psychological factors Polyvagal theory

Treatment

Trauma-Related Disordersin Adults (Cont.)

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Acute Stress Disorder Diagnosis/criteria

Outcomes

Implementation

Trauma-Related Disordersin Adults (cont’d)

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Adjustment disorder 1.

2.

3.

Trauma-Related Disordersin Adults (Cont.)

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Occur after…

Individuals respond to…

Unconscious defense mechanism

Protects individual against…

Dissociative Disorders

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Depersonalization/derealization disorder

Dissociative amnesia

Dissociative identity disorder

Dissociative Disorders (Cont.)

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Epidemiology

Comorbidity

Etiology

Biological factors Genetic

Neurobiological

Dissociative Disorders (Cont.)

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Psychological factors

Environmental factors

Cultural considerations

Dissociative Disorders (Cont.)

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Depersonalization—focus on…

Derealization—focus on…

Depersonalization/Derealization Disorder

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Inability to recall…

Often of traumatic or stressful nature Dissociative fugue

Dissociative Amnesia

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Presence of two or more distinct…

Each alternate personality (alter) has own pattern of Perceiving

Relating to and

Thinking about the self and environment

Dissociative Identity Disorder

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History

Moods

Impact on patient and family

Suicide risk

Self-assessment

Dissociative DisordersAssessment

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Interventions Psychoeducation

Pharmacological interventions

Advanced practice interventions Somatic therapy

Evaluation

Dissociative DisordersImplementation

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1. A nurse assesses a patient diagnosed with dissociative identity disorder. Which finding would likely be part of the patient’s history?

A. Travel to a foreign country

B. Physical or sexual abuse

C. Thyroid dysfunction

D. Eating disorder

Audience Response Questions

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