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Reactive attachment Dx
Before age 5!
A) emotionally withdrawn from adult caregivers 1.doesnt seek comfort 2. Doesn’t respond to comfort
B) social/emotional disturbance (need 2) 1. Minimal response to other 2. No affect 3. Unexplained sad/anger/fear
C) pattern of lack or inconsistent care (need 1) 1. Social neglect 2. Changes in care 3. Unusual setting (institutes)
Disinhibited social engagement dx
Travers and no regard to safety
A) child approaches all adults (needs 2) 1. Absent fear when approaching other 2) overly familiar 3) no safety awareness when left 4) will go off with another adult
B) not from impulsive adhd
C) due to extreme inconsistencies in care
PTSD
-older than 6
-1 month!
A) exposure to threat or death, injury or sexual violence in one or more of the following
1.direct experience
2.witness
3. Learned happen to close family or friends
4. Repeated expose (first responser)
B) intrusive sx (one or more)
1) memories
2) dreams
3) flashbacks
C) avoid of stimuli through thoughts, places, activities,
D) Change in mood or cognitions
E) changes in arousal and reactivity (need 2)
-irritable, reckless, exaggeration, lack of concentration, sleep
Acute Stress Dx
-3 days to 1 month
A)same expose to PTSD
B) has 9 or more from the follow 5 categories: intrusion, neg mood, dissociation, avoid, arousal
Adjustment dx
A)Emotional or behavioral sx I’m response to stressor
-within 3 months of stressor
B) symptoms/behaviors are significant
1)out of proportion to severity
2)impairment to social/ occupation
Reactive attachment dx treatment
Family therapy, dyadic therapy, trauma focused CBT,
Disinhibited social engagement treatment
Interpersonal, expressive, play, psychoed
PTSD treatment
Trauma CBT, exposure therapy, cognitive process, EMDR, antidepressants
Acute- CBT trauma, exposure, cognitive restructuring, psyched
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