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Chapter19 Trauma and Stress Latest Updated 2021

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TRAUMA AND STRESS RELATED DISORDERS OBJECTIVES • Review historical aspects and epidemiological statistic related to trauma and stress related disorders. • Describe and identify symptoms of various types of trauma and stress disorders. • Identify predisposing factors • Formulate nursing diagnoses. • Describe appropriate nursing interventions. • Evaluation of nursing care. • Discuss treatment modalities. 2 HISTORICAL AND EPIDEMIOLOGICAL • Trauma – An extremely distressing experience that causes severe emotional stress and may have long lasting psychological effects. • Post trauma response was historically known as shell shock, battle fatigue, accident neurosis, or posttraumatic neurosis. • Renewed interest about the disorder began in the 1970s, in response to problems encountered by Vietnam veterans. 3 PTSD • More than half of all individuals will experience a traumatic event in their lifetime, but less than 10% will develop PTSD. • The traumatic event is described as one that is “outside the range of usual human experience.” • PTSD is more common in women than in men. 4 PTSD Posttraumatic Stress Disorder • A reaction to an extreme trauma, which is likely to cause pervasive distress to almost anyone, such as: • natural or man-made disasters • combat • serious accidents, • witnessing the violent death of others • being the victim of torture, terrorism, rape, or other crimes 5 PTSD Characteristics • Re-experiencing the traumatic event • A sustained high level of anxiety or arousal (hypervigilance) • Inability to experience happiness, satisfaction or loving feelings. • A general numbing of responsiveness • Intrusive recollections or nightmares • Amnesia to certain aspects of the trauma • Difficulty with concentration • Depression; survivor’s guilt • Reckless or self-destructive behavior i.e. Substance abuse • Anger and aggression – irritable behavior, angry outbursts may be verbal or physical. • Relationship problems – **Feels psychologically numb and detached from others Symptoms may begin within the first 3 months after the trauma, or there may be a delay of several months or even years 6 REVIEW OF PTSD SYMPTOMS, FLASHBACKS VS NIGHTMARES & DISSOCIATION • https:// www.youtube.com/watch?v=GZxs0uSGhM8 • https:// www.youtube.com/watch?v=dwzCHv72hmU • https:// www.youtube.com/watch?v=CWoGOa6WSKA 7 ACUTE STRESS DISORDER • Similar to PTSD in terms of precipitating traumatic events and symptomatology • Symptoms are time limited: up to 1 month following the trauma • If the symptoms last longer than 1 month, the diagnosis would be PTSD Characteristics • development of severe anxiety, • dissociative, and other symptoms that occurs within one month after exposure to an extreme traumatic stressor • difficulty concentrating, • feel detached from their bodies, • experience the world as unreal or dreamlike, or • have increasing difficulty recalling specific details of the traumatic event (dissociative amnesia). • recurrent recollections, images, thoughts, dreams, illusions, flashback episodes, a sense of reliving the event, or distress on exposure to

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