Mock exam sent out by UNISA in 2021 as a means of providing assistance and guidance for the actual exam in October/November. The questions were provided by UNISA, the answers were provided by the author. Please do not copy, use as a GUIDELINE and PREPARATION for the exam.
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Discuss how Post Traumatic (PTSD) develops in adults living in South Africa. Your
discussion should refer to the DSM 5 criteria of PTSD, and the development of
PTSD with respect to biological processes, and psychosocial stressors.
PTSD and the DSM-5 diagnostic criteria:
Post Traumatic Stress Disorder (PTSD) is a psychological disorder where the actual
aetiology is known – the traumatic event. These symptoms that will be discussed
below has the power to cause an individual clinically significant distress, while also
resulting in impairment in social, occupational, or other important areas of
functioning. There are eight criteria (A-H) that should be met for a diagnosis of PTSD
to be given. These symptoms must be present for more than one month to qualify for
a diagnosis of PTSD.
Everyone Is Always Nagging About DSM: (45276)
A. Exposure:
A person with PTSD has been exposed to a traumatic event, such as serious
physical injury, actual or threatened death, or sexual violence. This includes direct
exposure (where the exposed event happened to them), indirect exposure
(witnessing the event occurring to others), learning that a traumatic event happened
to someone close to this person (close friend or family member), or extreme
repeated exposure to the event (first responders dealing with human remains on a
regular basis).
B. Intrusion Symptoms:
These symptoms consist of distressing dreams related to the traumatic event,
experiencing flashbacks (feeling like the trauma is happen again), recurring,
distressing memories about the traumatic event, intense psychological distress to
cues resembling the traumatic event and physiological reactions to cues resembling
the traumatic event.
, C. Avoidance:
A person with PTSD will avoid or make continuous efforts to avoid the following:
thoughts, memories, or feeling associated with the traumatic event, or external
reminders (people, situations, places) that evoke distressing memories, feelings, or
thoughts about the traumatic event.
D. Negative alterations in cognitions and mood:
This category is characterised by the following: dissociative amnesia (having trouble
remembering important aspects of the traumatic event), a negative outlook on the
world and negative alterations of oneself or others (viewing the world as a bad,
dangerous place, feeling like nobody can be trusted), anhedonia (inability to
experience positive emotions like happiness or love, negative emotional state shown
through feelings of anger, fear, guilt or shame, distorted cognition about what caused
the event leading to blaming oneself for the event occurring by thinking that there is
something one could have done better or differently to prevent it from happening, as
well as lack of interest in activities and feeling detached from oneself or others.
E. Alterations in arousal and reactivity:
Being hypervigilant (easily aroused, one’s body is permanently on high alert,
awaiting something potentially dangerous), difficulty sleeping (falling asleep or
staying asleep), easily startled (by loud noises, someone’s sudden appearance or
fast movements), and being irritable and angry which is often expressed either
verbally or physically. Also characteristic of this category is problems concentrating
(being easily distracted or having trouble recollecting memories), and dangerous,
self-destructive, and reckless behaviour (driving under the influence of alcohol, non-
suicidal self-injury).
F-H. Duration, distress, and medical conditions:
The duration of the above symptoms, excluding exposure must be longer than one
month to qualify for a PTSD diagnosis. These symptoms should also cause clinically
significant distress and/or impairment in social, occupational, or other important
areas of functioning. Important for the diagnosis, is establishing that these symptoms
, are not due to another medical condition or the physiological effects of a substance,
such as alcohol or medications.
In diagnosing PTSD, it is important to specify the following: If it is PTSD with
depersonalisation (feeling outside of oneself – like an outsider witnessing one’s life),
or derealisation (feeling like one is in a dreamlike state and that reality is not real), as
well as if PTSD is with delayed onset, where the full criteria of symptoms are not met
until at least six months after the event has occurred.
PTSD among adults in South Africa – psychosocial factors:
South Africa is referred to as a country of violence, where it is acceptable and even
preferred to solve problems and reach goals by violent means. South Africa has a
high rate of murder, attempted murder, civil unrest, assault, as well as rape and
sexual assault. Psychosocial stressors associated with the development of PTSD
among adults in this country can include the following:
Living in poverty can cause a person stress since there are not a lot of financial
resources available. The stress can be dealt with by means of turning to substances
as a way of self-medicating. The social environment in which a person finds
themselves, may not always be safe. Violence is common among rural communities,
as is PTSD as a result of this violence and unsafe conditions. Being directly exposed
to violence, whether in the community among community members, or in the home
as domestic violence, can result in an individual developing PTSD.
Those who are socially isolated, or who have little to no social support, can have
nobody to talk to if a traumatic event has occurred. Experiencing childhood trauma is
a risk factor for developing PTSD, either as a child, or years later as an adult.
Women are more prone to develop PTSD than males are, women are also more
vulnerable for traumatic experiences like domestic violence and rape. Rape is
associated with more severe PTSD. Women are unprotected, violence is common
and acceptable, and this can result in sexual violation.
Growing up in a violent community can add stress to one’s everyday life from
childhood right through to adulthood. This can make one resilient to stressors, or it
can cause significant psychological difficulties. Having ineffective coping strategies
to life stressors can result in someone developing PTSD, while others do not.
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