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NURS 663 Exam 3 with Verified Q&A’S | Latest Update
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NURS 663 Exam 3 with Verified Q&A’S | Latest Update
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NURS 663 Exam 3 with Verified Q&A’S |Latest Update
CBITS - ✔✔Cognitive Behavioral Interventions for Trauma in Schools
CBITS description - ✔✔intervention that administers treatment in the school setting for
children who screen positive for PTSD and whose parents agree to treatment in school.
CBITS elements - ✔✔Consists of 10 weekly group sessions
1-3 individual imaginal exposure sessions
2-4 optional sessions with parents
1 parent education session.
Similar to trauma-focused CBT, incorporates psychoeducation, relaxation, training, cognitive
coping skills, gradual exposure to traumatic memories
SPARCS - ✔✔Structured Psychotherapy for Adolescents Responding to Chronic Stress
SPARCS description - ✔✔-Consists of a group intervention,
-16 sessions
-focus on the needs of adolescents (12-19 years old) chronic trauma and PTSD.
-Utilizes cognitive behavioral techniques, and -incorporates many of the components of TF-CBT
-Includes mindfulness techniques and relaxation.
TARGET - ✔✔Trauma Affect Regulation:Guide for Education and Therapy
TARGET description - ✔✔-affect regulation therapy,
-combines CBT components, such as cognitive procession, with affect modulation.
,-adolescents (13-19) exposed to maltreatment and/or chronic traumatic exposure to such
things as community violence or domestic violence.
-12 sessions, which focuses on past or current situations.
TARGET efficacy - ✔✔--Like SPARCS treatment, gradual exposure may occur in the context of
recounting past trauma but is not a core component of treatment.
--Reduces anxiety, depression, and PTSD
--Promising treatment for girls with h/o delinquency, especially to reduce anger and to enhance
optimism and self efficacy.
Crisis intervention/Psychological Debriefing - ✔✔1. several sessions immediately after an
exposure to a traumatic event; encouraged to describe the traumatic event in the context of a
supportive environment.
2. Psychoeducation is provided and guidance about the management of initial emotional
reactions may be provided.
3. No controlled studies have yet provided evidence that this intervention leads to a more
positive outcome
PTSD criteria add'l info - ✔✔1. Over 6 years old
2. Sx over 1 month duration, or dx criteria may not have occurred until at least 6 months after
the trauma
3. Constricted emotions can show up suddenly after major life event, stressor, or accumulated
stressors that challenge defenses.
4. Can hide in somatic complaints or co-occur with depression, substance abuse, anxiety or
after head injury
PTSD differential diagnosis: Medical - ✔✔hyperthyroidism, caffeinism, migraine, asthma,
seizure disorder, and catecholamine or serotonin-secreting tumors. Some prescription
medications and even some OTC medications may have similar effects, such as antiasthmatics,
sympathomimetics, steroids, SSRIs, and antipsychotics, diet pills, antihistamines, and cold
medicines
,PTSD differential diagnosis - ✔✔anxiety disorders, such as separation anxiety disorder,
obsessive-compulsive disorder (OCD) or social phobia, depressive disorders, bereavement
trauma, disruptive behavior d/o
PTSD-associated psychosis - ✔✔does not respond well to neuroleptic (antipsychotic)
medication; may respond better to psychosocial interventions. The hallucinations and delusions
connect to the traumatic situation and perpetrators. Older kids show symptoms like adults.
PTSD criteria - ✔✔Trauma: occured, witnessed, learned about
Harm or threat of harm to self, loved one
1. Re-experiencing traumatic event
2. Sustained high level of anxiety, hyperarousal / hypervigilance / exaggerated startle
3. Avoid activities, people, places, situations, objects that arouse memories
4. A numbing of responsiveness, concentration
5. Re-exp. flashbacks, nightmares, intrusive memories
6. Inability to remember aspects of the trauma
7. Chronic negative emotional state, decreased interest / participation in significant activities
8. Depression, survivor's guilt, relationship problems, panic attacks
9. Substance abuse
10. Anger, aggressive, reckless, thrill-seeking, or self-destructive behavior
PTSD stats - ✔✔20 to 76% _________ children in inpt psych units endorse hallucinations.
Psychosis is present in up to 75 to 95% of those diagnosed with dissociative disorders.
Traumatized C/A - ✔✔1. Hear perpetrators frightening them, making derogatory remarks, or
announcing / threatening new victimization.
2. See the perpetrator, smell them, fear victimizer will follow them, or feel they will come hurt
them again.
, 3. Hear command hallucinations (by the perpetrator) telling them to harm themselves or
others.
4. Hallucinations (PTSD type) are frequently nocturnal. Occur in 9% of abused children.
5. Nightmares are frightening, recurrent
PTSD under 6 yo - ✔✔alterations in arousal and reactivity associated with the traumatic
event(s) including:
irritable behavior and anger outbursts, hypervigilance, exaggerated startle response, problems
with concentration, and sleep disturbance.
PTSD under 6 yo add'l - ✔✔1. May have enuresis after they were toilet trained
2. Developmental regression-Stop speaking or forget how to talk -
3. Become very clingy
4. Act out trauma through play or re-enactment
5. Egocentric theory of causality: blame self
ODD - ✔✔oppositional defiant disorder
ODD criteria - ✔✔A pattern of angry/irritable mood, argumentative/defiant behavior, or
vindictiveness lasting at least 6 months as evidenced by at least four symptoms from the
categories, and exhibited during interaction with at least one non-sibling
ODD categories - ✔✔Angry/Irritable Mood
1. Often loses temper.
2. Is often touchy or easily annoyed.
3. Is often angry and resentful. Argumentative/Defiant Behavior
4. Often argues with authority figures or, for children and adolescents, with adults.
5. Often actively defies or refuses to comply with requests from authority figures or with rules.
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