Psych 101: Responses to Stressors

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Psych 101Responses to Stressors

• Terri J. Farmer, PhD, PMHNP
• Clinical Associate Professor
• University of Arizona College of Nursing
• June 4, 2008

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Overview

• At the end of this session the learner will
• Be able to list major responses to an acute
  event.
• Have increased understanding of the bases of
  these responses
• List basic guidelines for interacting with
  traumatized individuals

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Trauma vs Disaster

• Trauma threatens individual health and
  well-being (assault). Time length variable
• Disaster sudden or time-limited public event
  (earthquake). May cause systemic disruption

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Death Panic

• The initial responses of an individual during a
  traumatic event
• Wish to avoid harm, injury, death
• Instinctual
• May be discordant with individuals normal
  behaviors

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What Do We See?

• Physical Responses
• Behaviors
• Psychological symptoms

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Physical Responses

• Fight or flight
• Numbness
• Tightness in chest
• Nausea
• Pounding heart
• Apprehension
• Headache
• Narrow focus

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Physical Responses

• May be difficult to differentiate from injury
• When in doubt, consider physical injury first!
• Physical injuries take priority for care.
• ABCs (airway, breathing, circulation) first!

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Behaviors

• You may see
• Crying
• Calmness
• Agitation
• Withdrawal
• Disorganization
• Clinging, dependency
• Retelling of story

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Psychological Responses

• What affected individuals may tell you
• Feelings of fear, anxiety, panic
• Dissociation, amnesia
• Guilt
• Anger
• Denial
• Confusion

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A Word About Children

• Children experience similar responses
• Regression may occur
• Children take cues from adults around them

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A Word About Guilt and Anger

• Those who survive may feel guilty about those who
  died
• Anger that they could have done more
• Anger at God
• Angry about losses

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Emergency Response Personnel

• We are the sources of both comfort and further
  trauma
• Delivering care
• Delivering bad news
• Appearance may be indimidating

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Factors Affecting Responses

• Type or dose of exposure
• History of other traumatic events
• Presence of others who care
• Underlying psychopathology
• Coping style
• Type of loss
• Culture and community

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Stress Disorders

• Acute Stress Disorder
• The anxiety based responses that occur up to 3
  months after the traumatic event
• Post-Traumatic Stress Disorder
• Continued anxiety based symptoms consisting of
  re-experiencing of the event, avoidance of
  reminders, numbing, and vigilance

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Long Term Mental Health Issues

• Depressive disorders
• Complicated bereavement
• Anxiety disorders PTSD, generalized anxiety,
  insomnia
• Worsening of pre-existing conditions, such as
  bipolar disorder, psychotic disorders
• Tucson does not have adequate mental health
  resources for long-term illness

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Basic Guidelines

• REMEMBER THAT ALL BEHAVIOR IS FEAR BASED
• Speak slowly and clearly
• Use short sentences
• Simple commands
• Acknowledge the trauma
• This has been terrible for you but you are safe
  now. I need you to come over here. We will take
  care of you.

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• Any questions?