question

a.To be considered traumatic, a person's response to the event must include ____, ____, _____, or _____ in children.

answer

intense fear, helplessness, or horror, or disorganized behavior in children. (p.7)

question

a. The DSM-IV lists several potentially traumatic events:

answer

combat, sexual/physical assault, robbery, kidnapped, taken hostage, terrorist attacks, torture, disasters, auto accidents, life-threatening illnesses/surgery, witnessing death or serious injury by violent assault, accidents, war, disaster, childhood sexual abuse (p.7)

question

a. Trauma must involve experiencing, witnessing, or being closely connected to an event that involves actual or threatened ________, ______, _____________.

answer

death, serious injury/harm, or threat to physical integrity of self or another close individual. (p.7)

question

a. The DSM-III also defined traumatic event as including threat to ______________ integrity.

answer

psychological integrity (p.7)

question

a. revictimization

answer

the increased likelihood that someone who has suffered childhood abuse and/or neglect will be sexually or physically assaulted later in life (p. 9)

question

a. Past interpersonal trauma creates statistically greater risk for

answer

future interpersonal trauma (p.17)

question

a. Rape

answer

Any non-consensual oral, anal, or vaginal sexual penetration of an adolescent or adult with any badoy part or object, through the use of threat or physical force, or when the victim is incapable of giving consent (drugs, alcohol, cognitive impairment, age) (p. 11)

question

a. Sexual assauly

answer

any forced sexual contact short of rape (p. 11)

question

a. Military Sexual Trauma (MST)

answer

sexual coercion, harassment, and assault against service members by their peers or superiors in the military (p.12) 15% of females, 1% of males

question

a. coyotes

answer

human traffickers

question

a.stranger physical assault

answer

motive is often robbery or expression of anger or to assert dominance (p.12) 64% against men 14% against women

question

a.Intimate Partner Violence (IPV)

answer

and adult against another in an intimate and often cohabiting relationship which generally involves emotional abuse, humiliation, degradation, criticism, stalking, threats of violence toward people or property the victim cares about (p.12)

question

a.sex trafficking

answer

the forced or coerced recruitment, transportation, transfer, harboring, or receipt of individuals for the purposes of commercial sexual exploitation (p.13) 14,500 -17,500 trafficked into the US every year

question

b. dissociative disorder NOS

answer

significant dissociative symptoms are present but cannot be classified into one of the preceding diagnostic categories.

question

b. risk factors for traumatic stress are variables associated with

answer

the specific extent and type of symptom expression for those exposed to a Criterion A trauma. (p.19)

question

b. Victim Variables refer to

answer

those aspects of the victim that were in place before the relevant trauma but that are risk factors for sustained post- traumatic difficulties. (p. 20)

question

b. Victim Variables examples

answer

female gender; race (black or Hispanic); poverty; low SES; prior traumatic history; pre/exisiting psychological disorder; family dysfunction; dysfunctional coping styles; age (youngest & oldest); genetic predisposition (epigenetic effects); peri-traumatic dissociation; greater peri-traumatic distress (p.20-1)

question

b. why are women and ethnic minorities at greater risk?

answer

they are more frequently exposed to events that produce post-traumatic disturbances (p. 22)

question

b. Three domains of risk factors for traumatic stress are

answer

1. victim variables 2. characteristics of the stressor, 3. social response to the victim

question

b. characteristics of the stressor include

answer

intentional interpersonal violence presence of life threat physical injury degree of combat exposure witnessing death, especially grotesque scenes loss of close friend/family due to trauma life threatening illness/painful medical treatments unpredictability & uncontrollability of event sexual victimization duration & frequency of trauma (p.22-3)

question

b. factors that associate childhood trauma to severe outcomes include

answer

most vulnerable developmental stage involve relational maltreatment generally prolonged exposure multiple, separate victimization experiences (p.23)

question

b. traumatic reactions more specific to childhood trauma include

answer

affect dysregulation identity disturbance difficulty forming positive & lasting attachments revictimization (p.23)

question

b. Studies show that this risk factor for traumatic stress is one of the most powerful determinant of traumatic outcome:

answer

social support.

question

b. Existential impacts of trauma include

answer

loss of meaning in life a sense of being alone in the world realization of the fragility of life reality of death loss of spirituality/trust/hope/empathy/self-compassion (p. 25)

question

b. depression-related disturbance & PTS

answer

overlapping symptoms arising from the same trauma grief & loss, abandonment, isolation, heightened suicidal ideation (p.25)

question

b. the proposed DSM-5 bereavement-related disorder is defined as

answer

persistent, frequent distressing thoughts, images, or feelings related to traumatic features of the death , following a death that occurred under traumatic circumstance (homicide, suicide, disaster, accident) (p. 25)

question

b. one of the most common co-morbid disorders for PTSD is

answer

Depression (p.26)

question

b. PTSD is four times more commonly co-morbid with major depression with _________ than without.

answer

psychosis (p. 26)

question

b. Three clusters of anxiety associated with post-traumatic outcomes include

answer

generalized anxiety (nonspecific) panic, phobic anxiety (irrational fears) (p. 27-28)

question

b. PTSD Criterion clusters

answer

Criteria A event & response Criteria B re-experiencing Criteria C avoidance Criteria D persistent increased arousal Criteria E duration over 1 month Criteria F causes clinical dysfunction

question

b. what change is made in the DSM-5 for PTSD?

answer

A2 response to event (peri-traumatic distress) is removed Criterion C is split into two clusters: numbing and effortful avoidance dysphoric mood (self-blame, low self-esteem, anger, fear) is added to the numbing cluster (p. 31).

question

b. ASD differs from PTSD by

answer

acute diagnosis (< 1 month), fewer effortful avoidance and hyperarousal, increased dissociative symptoms (p. 33)

question

b. There is not a one-to-one relationship between ASD and PTSD. True of false.

answer

true (p.33)

question

b. two symptoms ASD creates that are not DSM criteria are

answer

labile affect and psychomotor agitation of retardation (p. 33)

question

b. Psychotic or near-psychotic symptoms found in ASD include

answer

transient cognitive loosening briefly overvalued ideas involving persecution or outside control auditory hallucinations with trauma-related content (p.33)

question

b. Studies indicate that these three symptoms are more powerful predictors of PTSD than dissociative symptoms:

answer

hypervigilance, sleep disturbances, and intrusive re-experiencing

question

b. Complex post-traumatic presentations

answer

accumulation and summation of trauma effects over the lifespan & the tendency for earlier trauma to exacerbate subsequent responses to later traumas

question

b. Peri-traumatic distress

answer

is a major predictor of PTSD & indicator of perceived trauma severity, includes feelings of horror, shame, fear, helplessness, anger, guilt

question

b. dissociation

answer

a disruption in the usually integrated functions of consciousness, memory, identity, or perception of the environment (APA) reduced or altered access to one's thoughts, feelings, perceptions, and/or memories, often in response to a traumatic event & is not attributable to an underlying medical disorder significant co-morbidity with PTSD (p. 34)

question

b. peri-traumatic dissociation

answer

includes derealization, depersonalization or cognitive disengagement at the time of the traumatic event

question

b. depersonalization disorder

answer

involves perceptual alienation and separation from one's body (p. 34)

question

b. dissociative fugue

answer

is characterized by extended travel with associated identity disturbance (p.35)

question

Dissociative identity disorder

answer

involves the experience of 2 or more personalities within oneself (p.35)

question

b. dissociative amnesia

answer

consists of psychogenic, clinically significant inability to access memory (p. 34)

question

b. rather than viewing dissociation on a continuum, some clinicians argue that dissociative symptoms all point to the same outcome:

answer

mental avoidance of emotional distress (p.35)

question

b. disorganized attachment to caregivers is characterized by

answer

chaotic, shifting, and intrusive responses to grossly confusing, fear-inducing, and/or painful parental behaviors, & is itself potentially a trauma syndrome (p. 36)

question

b. what year did PTSD come into the DSM?

answer

it was added to the DSM-III, published in 1980

question

b. somatoform responses

answer

physical or bodily symptoms that are strongly influenced by psychological factors (p. 36)

question

b. somatization disorder

answer

patients exhibit a wide variety of symptoms whose only commonality is their somatic focus & the fact that they can't be explained by medical phenomena alone (p.36)

question

b. undifferentiated somatoform disorder

answer

requires only one physical complaint with no medical explanation and symptom exceeds its expected intensity (p. 36)

question

b. conversion disorder

answer

when symptoms or deficits affect voluntary motor or sensory function (paralysis, blindness, seizures, deafness, mute) but psychological factors are judged to be the cause because initiation or exacerbation is preceded by stressors child abuse, combat, witnessing or experiencing torture (p. 37)

question

b. psychosis & trauma

answer

psychotic symptoms like hallucinations, delusions, tangential or loosened mental associations, catatonic behaviors that follow exposure to trauma common traumatic exposure types: childhood abuse, sexual abuse, combat BPDMS brief psychotic disorder with marked stressor(p.39)

question

b. brief psychotic disorder with marked stressor (BPDMS)

answer

< 1 month 1 of 4: hallucinations, delusions, disorganized speech, grossly disorganized or catatonic behaviors (p.39)

question

b. extended psychotic responses to trauma may indicate what two things?

answer

trauma-activated latent predisposition for psychosis or acute exacerbation of previously undetected psychosis (p.38)

question

b. the trauma & schizophrenia controversy

answer

schizophrenia is historically explained genetically, new evidence implicates trauma, especially severe childhood abuse possible that a later diagnosis of schizophrenia reflects a neurodevelopmental interaction between biological PTS alterations (hypothalamic-petuitary-adrenal axis) and biological schizophrenic substrates (p.40)

question

b. drugs & alcohol & trauma

answer

abuse & dependence co-morbid with PTSD and trauma histories 1. post trauma self-medication 2. pre trauma become easy prey for victimization 3. abuse & dependence ^ PTSD symptomology (p. 40)

question

b. drug & alcohol vicious cycle

answer

early trauma > revictimization > accumulation of traumatic responses > PTS & dysphoria > decreased affect regulation > self-medication > decreased awareness and ^ risky behaviors > revictimization > ^ distress > self-medication (p.41)

question

b. Complex stress effects

answer

arise from severe, prolonged, and repeated trauma, almost always of an interpersonal nature, often beginning early in life Complex PTSD, disorder of extreme stress not otherwise specified, or self-trauma disturbance - somatic & dissociative disorders; difficulties in identity and boundary awareness, interpersonal relatedness, and affect regulation (p. 41)

question

b. tension reduction behaviors

answer

external ways of reducing activated abuse-related distress risky sexual behaviors; eating disorders, self-mutilation, other impulse control problems (p.42)

question

b. dysfunctional avoidance strategies such as _____, and __________ may result from _______.

answer

substance abuse dissociation inadequate affect regulation (p.42)

question

b. disrupted or inadequate parent-child attachment leads to:

answer

traumatic relational and identity disturbances -include the tendency toward chaotic/maladaptive relationships -difficulty negotiating interpersonal boundaries - reduced awareness of entitlements & needs in the presence of compelling others (p.42)

question

b. Borderline personality disorder (BPD)

answer

chronic disturbance with pervasive pattern of instability of interpersonal relationship, self-image, and affects with marked impulsivity across a variety of contexts (p.42)

question

b. BPD is generally associated with

answer

severe and extended childhood trauma and/or neglect, perhaps especially sexual abuse (p.43)

question

b. TBI symptoms

answer

history of head trauma difficulty in attention or memory 3 or more: irritability, easily fatigued, disordered sleep, headache, anxiety/depression/affect lability, changes in personality, apathy or lack of spontaneity (p.46)

question

b. cultural variables & traumatic symptoms

answer

PTSD symptoms are found world-wide, but cultural variables can impact the presentation of PTS symptoms (p.47)

question

G5. The False Memory Syndrome Foundation (FMSF)

answer

founded in 1992 by Elisabeth Loftus, a theory that therapists can implant false memories, and that discovery of repressed memories cannot be trusted. +ve: taught therapists to guard against suggestibility; increased research in memory function/process

question

DV. what are the stages of the Cycle of Violence

answer

tension building: phase I > explosion/battering: phase II > honeymoon: phase III > (spins around denial in the center)

question

DV. The Violence Model

answer

(family of origin + socialization + biology) + social permission + impetus & actions = VIOLENCE violence + reinforcement or no consequences = REPEATED VIOLENCE remove permission through consequences + (improved personal skills in communication + conflict resolution) + limited conflict + remove opportunity = NO VIOLENCE

question

DV. Power & Control wheel:

answer

Came from Deluth Model coercion & threats intimidation emotional abuse isolation minimizing/denying/blaming using children economic abuse male privilege

question

DV. Equality Wheel

answer

Came from Duluth Model Negotiation & fairness (mutual terms) non-threatening behavior (safe) respect and value trust and support honesty and accountability responsible parenting shared responsibility (fair distribution) economic partnership

question

DV. Effectiveness of Duluth Model batterer's training:

answer

70 % who complete the training do not re-enter the criminal justice system; 70% of drop-outs from the program become repeat offenders

question

DV. What is battering?

answer

A pattern of behavior with the effect of establishing power and control over another person through fear and intimidation, often including the threat or use of violence.

question

DV. What does a batterer believe about battering?

answer

-believes they are entitled -believe violence is permissible -believe it will produce the desired effect or prevent a worse one -believes the benefits outweigh the consequences

question

DV. Describe the Tension Building Phase of DV.

answer

minor incidents; victim claims responsibility for the abuse, makes it her fault, denial, rationalization, -tension and intensity of incidents escalate

question

DV. Describe the Acute Battering Phase.

answer

-characterized by uncontrollable discharge of tensions -batterer wants to 'teach her a lesson' and doesn't stop beating until he thinks she has got it -only batterers can stop phase II -usually an external even or internal state of male that initiates phase II -generally 2-24 hours -victim feels shock and disbelief

question

DV. Describe Honeymoon Phase, Phase III

answer

-welcomes by both parties -extremely loving, contrite, kind behavior -her victimization is made complete because he makes her feel guilty for wanting to leave, and he promises he will never do it again this is the phase most women are likely to leave

question

DV. Higher in the Protestant Christian home.

answer

the more rigid a structure within a marriage, the more the partner will try to control that structure.

question

DV. Characteristics of Abuse Victim

answer

-low self-esteem -believes the myths about D.V. -traditionalist about the home -accepts responsibility for the batterer's actions -suffers from guilt but denies terror and anger -presents a passive face to the world, uses her passivity in the relaionship to try to manipulate safety -has severe stress reactions with psychological complaints -uses sex to establish intimacy -believes that no one will be bale to help her resolve her predicament

question

DV. Belief System of Abusive/violent Me

answer

-the world is a dangerous place -I will survive -I can trust only myself -I will get what I want when I want it -I'm doing nothing wrong -I won't get caught but If I get caught, I can talk my way out of the situation -If I can't get out of it, the consequences will be light

question

DV. Who is battered?

answer

rural and urban women of all religions, ethnic, racial, economic and educational backgrounds; of various ages; physical abilities and lifestyles.

question

D.V. What percentage of IPV is ongoing?

answer

24-30%

question

D.V. Characteristics of the Violet Partner

answer

-low self-esteem -believes the myths about D.V. -traditionalist about the home -blames others for their actions/violence -is pathologically jealous -has severe stress reactions, uses drinking and violence to cope -uses sex as manipulation -does not believe their behavior should have negative consequences

question

D.V. Myths & Misconceptions include:

answer

-domestic violence affects only a small percentage of the population -victims are masochistic or crazy -minority groups suffer more - D.V. is less frequent and less severe as economic levels increase

question

D.V. Does a spouse abuser always beat the children?

answer

Not always, abusers are not violent in all their relationships.

question

D.V. Does battering sometimes just fade away?

answer

Battering always escalates unless there is some kind of intervention.

question

D.V. DO children fare better with any father, even abusive, rather than having no father.

answer

Statistics say NO.

question

D.V. Alcohol & drugs are involved in what percentage of violent homes?

answer

60%; chemicals make it easier for the batterer to be abusive, and to be more lethal.

question

D.V. Two main reasons for male violence:

answer

Men are trained/socialized to be violent; They lack the means to determine acceptable boundaries for violence or to resolve conflict without coercion.

question

D.V. Two main ways men use violence:

answer

Men use violence to reduce stress' and to control/punish others

question

FS. Describe Dysfunctional families.

answer

-little/no respect/empathy for growing child -unreasonable rules/expectations prevail -inconsistently applied/enforced rules -criticism; rejection

question

FS. Describe functional families

answer

-respect for child's development & individuation -responds appropriately to needs -healthy concern for child's welfare -sets reasonable rules/expectations

question

FS. Family health can be located on a _______ from isoloation to enmeshment

answer

continuum

question

FS. dysfunctional extreme of isolation

answer

neglect abandonment physical/sexual/emotional abuse maltreatment

question

FS. dysfunctional extreme of enmeshment

answer

over protection intrusion physical/sexual/emotional abuse maltreatment

question

FS. how does dysfunction contribute to sexual abuse inside/outside family

answer

multiple problems generational issue rigidity lack of respect dependency parental family of origin parentification negative rules

question

TSA. What 4 feelings/dynamics make sexual abuse/incest traumatic for the child?

answer

traumatic sexualization betrayal powerlessness stigma

question

TSA. What are some coping skills counselor need to handle sexual abuse clients

answer

^ client's self-sufficiency ^ client's awareness of needs/emotions of others -develop specialized skills ^ your persistence and tolerance ^ your sense of humor ^ your creativity

question

TSA. Client physical coping mechanisms (dysfunctional)

answer

personal neglect/self harm control of self & environment escape addictions/compulsions delinquency/deviant activities/behaviors

question

TSA. Client relational Coping Mechanisms (dysfunctional)

answer

other-directedness & codependence withdrawal & isolation relational addictions & dependence on others repeating abuse or abusing others

question

TSA. List some distorted self-image and negative perceptions of SA victims.

answer

feel isolated defective and worthless shameful and bad deserving of the abuse undeserving of assistance/intervention undeserving of care crazy helpless/powerless/out of control guilty, sometimes powerful

question

F.S. What is the definition of family role?

answer

can be described as the way a person behaves according to his or her position in the family system

question

F.S. List common roles in unhealthy families

answer

parentified child/caretaker/hero plactor/rescuer/peacemaker/enabler adaptor/lost child/mascot/indifferent scapegoat/victim/martyr acting out/class clown/delinquent controller/decision-maker/provider confidant/helper baby/protected one

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