课件10级大5上精神病学42stress related disorder.pptxVIP

Stress Related Disorder ;; Traumatic stressor;Natural disasters;;Torture;Political violence;Terrorism;Accidental disasters; sexual or physical assault; Subtypes of SRD ;A 35-year-old man is brought to see a psychiatrist by his friend because “ever since the disaster that killed his wife, he has been out of it?.” The patient states that 1 week previously the town in which he lived was hit by a tornado. His house was destroyed, and his wife of 2 years was killed. ;;;;16;17;18;Summary:;Dictionary;Definitions;Summary:;23;24;Acute stress disorder;DSM-Ⅳ diagnostic criteria ;(2) The person experiences at least three of the following dissociative symptoms during or after the traumatic event: Numbing, detachment, or absence of emotional responsiveness Being in a daze Derealization Depersonalization Dissociative amnesia;Definitions; (3) Psychomotor excitement (4) Psychomotor inhibition (5) Others:;DSM-Ⅳ diagnostic criteria;DSM-Ⅳ diagnostic criteria;Criterion D: Differential Diagnosis:;Differential diagnosis;34; ;Clinical approach;The fear response is activated via the hypothalamic-pituitary-adrenal axis（下丘脑-垂体-肾上腺）and locus ceruleus (蓝斑核）/ norepinephrine（去甲肾上腺素）system, resulting in cascade（串联的） of further physical events. ASD is defined as occurring within the first 4 weeks after a traumatic event because research indicates that in many individuals this syndrome can resolve without progressing to posttraumatic stress disorder (PTSD). ;Treatment ;Clinical pearls ;Clinical pearls ;Case II;She notes that she become irritable and angry with her husband for no apparent reason and feels disconnected from him emotionally. Her sleep is restless, and she is having trouble concentrating on her work as laboratory technician. She has nightmares about the rape in which the event is replayed. The patient states that she has told very few people about the rape and tries “ not to think about it” as much as possible. She avoids going anywhere near the location where the event o