Review of DSM5 Mental Disorders for NCMHCE Study

1. Post-Traumatic Stress Disorder2. Acute Stress Disorder3. Adjustment Disorders4. Reactive Attachment Disorder5. Disinhibited Social Engagement Disorder

S2. Assess or ReferTests DAPS Impact of Events Scale Beck Anxiety Inventory Clinician Administered PTSD Scale PTSD ChecklistChildren K-SADS PTSD, of Child Behavior

Checklist CBC Childhood Trauma Questionnaire Psychometric Evaluation, of Children’s

Impact of Traumatic Events Scale Revised CITES-R

Medical evaluation

S4. Treatments1. Medication Antidepressant Anxiolytics Anti-convulsants

2. Therapies Prolonged Exposure Therapy PET Cognitive-Processing Therapy CPT Multiple-Channel Exposure Therapy

M-CET Stress Inoculation Training SIT Eye Movement Desensitization and

Reprocessing therapy EMDR Relaxation Training Imaginal Exposure & In Vivo Exposure Trauma-focused Psychological Therapy Anxiety Management Training

Difference is timing

Post-Traumatic Stress Disorder Begins over 4 weeks

after the event

Acute Stress Disorder Occurs and ends within 4

weeks of the event Symptoms last at least 2

days and less than 1 month

Diagnosis ISymptom following the direct experience or indirect experience (hearing about) of a traumatic eventA. One symptom in each category 1. Re-experiencing the trauma Recurring flashbacks, bad dreams or

frightening thoughts2. Altered cognitions and mood Forgetting details Irrational beliefs or thoughts about the

cause of the trauma Negative emotions: guilt, worry,

depression

3. Avoidance or numbing Shunning any reminders Feeling emotionally

numb Detachment from people

4. Increased arousal or reactivity

Hypervigilance, sleep problems

Irritability, recklessness Impaired concentration

Diagnosis II2. Onset or duration Begins over a month after the traumatic

event Acute if lasting less than 3 months Chronic if persisting 3 months or more Delayed onset if the symptoms first occur

after 6 months or some years late

Diagnosis IIICo-occurring: Anxiety Substance abuse Bipolar Disorders

Rule Out Schizophrenia &

Psychotic Disorders Dissociative Disorders

S1. Find Out More1. Details about any disturbing episode2. Frequency, duration and intensity and specifics of

symptoms 3. Affective history4. Cognitive functioning5. Anxiety history6. Drug and alcohol history7. Medical history (related to trauma)8. Trauma and loss history9. Potential for violence10. Potential for suicide

S2. Assess or ReferTests DAPS Impact of Events Scale Beck Anxiety Inventory Clinician Administered PTSD Scale PTSD ChecklistChildren K-SADS PTSD, of Child Behavior

Checklist CBC Childhood Trauma Questionnaire Psychometric Evaluation, of Children’s

Impact of Traumatic Events Scale Revised CITES-R

Medical evaluation

S4. Treatments1. Medication Antidepressant Anxiolytics Anti-convulsants

2. Therapies Prolonged Exposure Therapy PET Cognitive-Processing Therapy CPT Multiple-Channel Exposure Therapy

M-CET Stress Inoculation Training SIT Eye Movement Desensitization and

Reprocessing therapy EMDR Relaxation Training Imaginal Exposure & In Vivo Exposure Trauma-focused Psychological Therapy Anxiety Management Training

S5. Monitoring Progress Quality of sleep Proper use of medications Trauma symptom

assessment Affective functioning Capacity to concentrate,

etc.

S6. After Termination Medication monitoring for

compliance, to reduce high rate of relapse

Medication monitoring for side effects

Psychotherapies Support group

Diagnosis ISymptom following the direct experience or indirect experience of(hearing about) a traumatic event1. One symptom in each category 1. Re-experiencing the trauma Recurring flashbacks, bad dreams or

frightening thoughts2. Altered cognitions and mood Forgetting details Irrational beliefs or thoughts about

the cause of the trauma Negative emotions: guilt, worry,

depression

3. Avoidance or numbing Shunning any

reminders Feeling emotionally

numb Detachment from

people4. Increased arousal or

reactivity Hypervigilance, sleep

problems Irritability, recklessness Impaired

concentration

Diagnosis II2. Onset or duration Symptoms last at least 2 days and

less than 1 month Occur within 4 weeks of the event

Diagnosis IIICo-occurring: Anxiety Substance abuse Bipolar Disorders

Rule Out Psychotic Disorders

S1. Find Out Details of any disturbing episodes Medical evaluation Cognitive functioning Affective functioning Substance use history Violence and aggression history Military history Sleep disturbance

S4. Treatments1. Medication 2. Therapies

Cognitive Behavioral Therapy

Exposure and REBT Relaxation, REBT, Imaginal Exposure and

In Vivo Exposure (can prevent PTSD)

Diagnosis I1. Emotional or behavioral

symptoms in response to an identifiable stressor

Occurs within 3 months of the onset of the stressor

Ends 6 months after stressor gone

2. Sufficient intensity of episode

Distress is out of proportion to the severity or intensity of the stressor

Impairment is significant

S1. Find Out Details of symptoms Work functioning Trauma history Substance abuse history Destructiveness or self-

destructiveness, suicide history Affective functioning Cognitive functioning

S2. Refer & AssessTests SCAD

S4. TreatmentsRelieve acute symptoms Stress reduction techniques

Therapies

Psychoeducation

Brief psychodynamic therapy

CBT

S5. Monitoring Progress Mood charting Level of re-involvement

and concern about daily activities and environment

Affective functioning

S6. Termination Return to therapy if relapse Support group Hobbies and stress

reduction activities