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Extremely Loud & Incredibly Close
Transcript of Extremely Loud & Incredibly Close
-Age: 9 yrs old
-Location: Lives in NYC
-Family: Mother, Grandmother, Grandfather
Krystal Sheridan, Hayley Kohler, Laura Bearth
9/11 Trauma and Loss - Father's Death
Persistent Complex Bereavement Disorder w/trauma
prenatal environment (toxins, infections e.g. rubella)
big city - stimuli overload
prior dependence on father
Positive: movie portrayed symptoms very well
Negative: fact that he resolves everything on his own is not realistic
• Highly restricted, fixated interest
• Deficits in social communication
• Deficits in developing, maintaining and understanding relationships
• Decreased interest in social interactions
• Hyper reactivity to sensory input or unusual interest in sensory aspects of the environment
DSM V Criteria: Autism spectrum disorder
dsm v criteria: persistent complex bereavement disorder w/ trauma
. Individual experienced the death of someone with whom he or she had a close relationship
. Since the death, at least one of the following symptoms is experienced on more days than not and to a clinically significant degree and has persistent for at least 6 months after the death for bereaved children:
− Persistent yearning/longing for the deceased.
− Preoccupation with the deceased
− Intense sorrow and emotional pain in response to the death
Reactive distress to the death and Social/identity disruption
Clinically significant impairment in social, occupational, etc.
The bereavement reaction is out of proportion to or inconsistent with cultural, religious, or age-appropriate norms.
1.) Autism Spectrum Disorder w/o intellectual or language impairment, Level 1 Severity
2.) Persistent Complex Bereavement Disorder with trauma
Strengthen relationship with mother
Complex Grief Treatment
16-session psychotherapy (CBT)
come to terms with loss
find new purpose/meaning without father (plan future events to look forward to)
Join school ASD program
Parent training for mom (CBT @ home)
Modeling and Operant Conditioning
Change distorted cognitions
self-blame and guilt
distressing thoughts about death
Teach constructive coping strategies
Goal-oriented exposure therapy to reduce anxiety in high-stimuli environments
ASD: genetic- heritability rates ~37-90%;
-increased volume & white matter, limbic system; neurophysiology-dvpmt of cerebellum, activity in amygdala & PFC; birth complications
PCBD: Grandfather=selective mutism from past trauma - possible genetic predispositions
- Highly functioning and intelligent
- Close relationship with his father through activities and the search for the fifth borough
- Few friends his own age
Persistent deficits in social communication and social interaction across multiple contexts
. Restricted, repetitive patterns of behavior, interests, or activities
. Symptoms must be present in the early developmental period
. Symptoms cause clinically significant impairment in social, occupational, or other important areas of current functioning.
. These disturbances are not better explained by intellectual disability (intellectual developmental disorder) or global developmental delay.
- Intense preoccupation with his father and the circumstances relating to his death
- Maladaptive appraisals associated with his death for example guilt and self blame
- Disbelief, bitterness and anger