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Content text 05 AbPsy - Trauma- and Stressor-Related Disorders.pdf


● The restricted interests and repetitive behaviors characteristic of ASD are not a feature of RAD ● Only children with ASD exhibit selective impairments in social communicative behaviors, such as intentional communication Comorbidity ● Conditions associated with neglect, including cognitive delays, language delays, and stereotypies, often co-occur with RAD ● Medical conditions, such as severe malnutrition, may accompany signs of the disorder ● Depressive symptoms also may co-occur with RAD DISINHIBITED SOCIAL ENGAGEMENT DISORDER DEFINING DISINHIBITED SOCIAL ENGAGEMENT DISORDER Disinhibited Social Engagement Disorder – indiscriminately social disinhibited type ● Might engage in inappropriately intimate behavior by showing a willingness to immediately accompany an unfamiliar adult figure ● Occurs in a minority of children ● Conditions of social neglect are often present in the first months of life ● Indiscriminate social behavior and lack of reticence with unfamiliar adults in toddlerhood are accompanied by attention-seeking behaviors in preschoolers DIAGNOSTIC CRITERIA A. A pattern of behavior in which a child actively approaches and interacts with unfamiliar adults and exhibits at least two of the following: 1. Reduced or absent reticence in approaching and interacting with unfamiliar adults. 2. Overly familiar verbal or physical behavior. 3. Diminished or absent checking back with adult caregiver after venturing away, even in unfamiliar settings. 4. Willingness to go off with an unfamiliar adult with minimal or no hesitation. B. The behaviors in Criterion A are not limited to impulsivity (as in ADHD) but include socially disinhibited behavior. C. The child has experienced a pattern of extremes of insufficient care as evidenced by at least one of the following: 1. Social neglect or deprivation in the form of persistent lack of having basic emotional needs for comfort, stimulation, and affection met by caregiving adults. 2. Repeated changes of primary caregivers that limit opportunities to form stable attachments. 3. Rearing in unusual settings that severely limit opportunities to form selective attachments. D. The care in Criterion C is presumed to be responsible for the disturbed behavior in Criterion A. E. The child has a developmental age of at least 9 months. Specify if: Persistent: The disorder has been present for more than 12 months. Specify current severity: Specified as severe when the child exhibits all symptoms of the disorder, with each symptom manifesting at relatively high levels. CAUSES / RISK FACTORS Environmental Risks ● May be caused by early persistent harsh punishment ● Result in a pattern of behavior in which the child shows no inhibitions whatsoever to approaching adults Course Modifiers ● Caregiving quality ● Even after placement in normative caregiving environments, some children show persistent signs of the disorder, at least through adolescence POSTTRAUMATIC STRESS DISORDER DEFINING POSTTRAUMATIC STRESS DISORDER Posttraumatic Stress Disorder – indiscriminately social disinhibited type ● Symptoms usually begin within the first 3 months after the trauma ● There may be a delay of months, or even years, before criteria for the diagnosis are met ● DSM-IV called it "delayed onset" but is now called "delayed expression" ● Was first named in 1980 in DSM-III Prevalence ● Rates of PTSD are higher among veterans and others whose vocation increases the risk of traumatic exposure ● Highest rates are found among survivors of rape, military combat and captivity, and ethnically or politically motivated internment and genocide DIAGNOSTIC CRITERIA 2 | @studywithky

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