80 %
of people with ASR develop PTSD 6 months later
ASR (acute
stress reaction)
Also called acute stress disorder, ASR can appear quickly after an exceptional physical or mental stressor such as a bereavement, a road traffic incident, or an assault, but does not usually last long.
REGULAR MEDITATION can benefit the relationship that those with ASR have with uncomfortable mental experiences and calm the fight-or- flight response.
US_062-063_Post_Traumatic_Stress_Disorder.indd 63 09/01/2018 17:00
❯
❯Psychotherapies such as cognitive behavioral therapy (p.125) and/or family or group therapies (pp.138−141) to help identify and respond to stressors.
❯
❯Antidepressants (pp.142–143) to lessen symptoms of depression, anxiety, and insomnia, along with a psychotherapy.
TREATMENT
What is it?
Any stressful event can trigger anxiety, difficulty sleeping, sadness, tension, and inability to focus.
However, if an individual finds an event especially hard, their reaction can be stronger and persist for months. In a child, the disorder can follow family conflicts, problems at school, and hospitalization. The child may become withdrawn and/or disruptive, and complain of unexplained pain or illness.
Adjustment disorder is not the same as PTSD or ASR (pp.62–63)
Adjustment disorder
This is a short-term, stress-related psychological disorder that can follow a significant life event. Typically, a person’s reaction is stronger, or more prolonged, than expected for the type of event.
SOLD
because the stress trigger is not as severe. It normally resolves within months as a person learns how to adapt to a situation and/or the stressor is removed. There is no way to predict whether one person is more likely to develop adjustment disorder than another. It comes down to how they respond to an event and their personal history.
A GP initially assesses whether an individual’s symptoms may be due to another condition, such as ASR, before referring them for a psychological assessment.
3 MONTHS WITH HELP
SYMPTOMS RESOLVE IN 6 MONTHS With therapy and
removal of the stressor, a person
can learn to turn negative thoughts into healthy actions to change how they respond to stress.
SYMPTOMS BEGIN WITHIN 3 MONTHS The onset can be traced to an event and symptoms are more severe than
expected. They include defiant, impulsive behavior;
sleeplessness; crying;
feeling sad and hopeless; anxiety;
and muscle tension.
Causes and outcome
Some life events are known to lead to adjustment difficulties of varying severity.
Examples are the death of a friend or family member, divorce or relationship breakdown, moving, illness or injury, financial worries, or job stress.
3 MONTHS
DEATHMOVINGINJURYJOB STRESSDIVORCE
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65
Reactive 64
attachment disorder
This disorder can result in children who do not bond with a caregiver in infancy. Unidentified reactive attachment disorder can be a precursor to lifelong impaired personal development.
What is it?
Attachment theory (pp.154–157) states that developing a strong emotional and physical bond with a primary caregiver is key to a child’s healthy personal development.
Without such a bond a child can become increasingly detached, withdrawn, and distressed, and the physical symptoms relating to stress become obvious.
Persistent disregard of a child’s basic physical needs, frequent changes of primary caregivers, and childhood abuse can disrupt a child’s ability to form social and emotional bonds. The child can develop markedly disturbed ways of relating socially, and may be unable to initiate or respond to social interactions.
Disinhibited responses, such as a disregard for convention and impulsive behavior, used to be included in the assessment of this disorder, but these are now considered as a separate diagnosis of disinhibited social engagement disorder.
Associated disorders
Undiagnosed reactive attachment disorder is an underlying factor in a number of psychological problems that emerge in childhood or adulthood under clinical assessment.
DEPRESSION This can develop
because a person with reactive
attachment disorder sees a constant disparity
between expectation
and reality.
SOCIA L DIF
FICU LTIES If a p
erson feels differe
nt from their peers
, they can be d
isrup tive and are m
ore susc
eptib le to isolation
or bullyin
g.
LOW SE
LF-ESTEEM Without any positivinterace reciptionsrocal infancy, neutra in l or negative on can prelater, wdominate es
hich can affect self-esteem.
LEARNING DIFFICULTIES Social isolation creates a hostile environment that
can make an individual more
likely to have developmental
disorders.
SUBSTANCE ABUSEIndividuals who have suffered a disrupted infancy or childhood commonly seek support through drugs.
RELA TIONSH
IP ISSUES Not d
evelopi ng healthy attac
hments in childhood m
akes it diffic
ult to form m
eaning ful relationsh
ips in adulthoo
d.
❯
❯Cognitive and behavioral therapies including cognitive behavioral therapy (p.125) to examine habitual appraisals, dialectical behavior therapy (p.126) to help severely affected adults, family therapy (pp.138−141) to promote good communication, anxiety management, and positive behavior support.
TREATMENT
Long-term impact
Early neutral, negative, or even hostile environments are likely to have a long-term negative impact and affect a person right through to adulthood. An individual’s ability to make and maintain healthy relationships in later life is seriously compromised. Reactive attachment disorder can develop in early infancy, and the vulnerability it creates is associated with a wide range of disorders that affect both children and adults (below).
CHILD ADULT
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Identifying ADHD
A GP cannot officially diagnose ADHD, but if they suspect a child has the disorder they refer them for specialist assessment. The child’s patterns of hyperactivity, inattention, and impulsive behavior are observed over a six-month period before a treatment plan is prepared.