Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

PL3257 > 11. Working with People with PTSD & Complex Trauma > Flashcards

11. Working with People with PTSD & Complex Trauma Flashcards

1
Q

Which factors are more important in predicting PTSD severity?

A

Features of the trauma and situation around the trauma more important than historical factors

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What are some risk factors that predict the development of PTSD? (3)

A
  • trauma severity & perceived life threat
  • dissociation during/just after the traumatic event
  • subsequent life stressors (work, relationship etc.)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What does the diathesis-stress model of PTSD propose?

A

proposes that people have certain dormant vulnerabilities, and stress will trigger the vulnerabilities to create problems.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What is the most researched theory for PTSD?

A

Emotional Processing Theory (Edna)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What does the Emotional Processing Theory propose?

A

Proposes that the experience of trauma causes clients to develop faulty fear associations about trauma-related reminders (eg. people, place, situation, memories). Problems arise because of little opportunity to process these fears and related emotions.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Emotional processing theory argues that if traumatic events are re-experienced by clients regularly, what will happen?

A

The fear associated with the traumatic event should diminish over time through habituation. The more the client is in touch with the memory, the less it has an impact on them.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

In clients with PTSD, why is habituation disrupted?

A
  • Avoidance of memory due to cognitive biases that constitutes unrealistic predictions of harm, and catastrophizing of consequences. (“the fear will never go away”, “I will lose my mind”)
  • Avoidance leads to increased frequency of re-experiencing and arousal. Creates a vicious cycle of avoidance, re-experiencing, and avoidance again.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Emotional processing theory combines _____ and _____ theories.

A

behavioral; cognitive

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Who is prone to developing PTSD? (3)

A

1) clients with rigid pre-trauma core beliefs about the world or self. contribute to cognitive biases that maintain avoidance behaviors
2) clients who experience severe trauma
3) clients with poor post-trauma coping. unhelpful self-perceptions (eg. view themselves as unable to protect themselves from future trauma, view themselves as unable to lead a normal life)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

According to emotional processing theory, how do we alter these fear associations with traumatic event? (4)

A

1) Activate associations - Activate fear in session by re-experiencing fear of trauma.
2) Cognitive route - cognitive restructuring: introduce information that contradicts client’s beliefs to disconfirm predictions.
3) Behavioral route - get them to stop emotional numbing. hard because it is so habitual that sometimes the client can’t even access the emotion even if he/she tries. they don’t feel anything when exposed to the trauma
4) Behavioral -> Cognitive (habituation can lead to cognitive change about their coping ability)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What does social cognitive theory propose about the development of PTSD? (2)

A

1) Assimilation
- existing rigid beliefs in schema are reinforced by the trauma (eg. “bad things happen to bad people” -> “smth bad to me so I must be bad”)
2) Over-Accommodation
- Existing flexible beliefs are abandoned and replaced by rigid beliefs related to safety, trust, esteem, and intimacy (eg. “I was abused” -> “the world is not a safe place, I am helpless.”)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What are the key cognitive distortions to look out for? (4)

A

1) unhelpful appraisals about the traumatic event
2) unhelpful appraisals about symptoms after event
3) unhelpful appraisals about the self or the world
4) unhelpful appraisals about safety behaviors

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What are some unhelpful appraisals about the traumatic event that could be made?

A

1) shame-related - “I did not stand up for myself, I am useless.”
2) guilt-related - “it was my fault”

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What are some unhelpful appraisals about symptoms that could be made?

A

1) loss of control - “if i think of the event, I will have a total meltdown.”
2) fear of flashback - “if I go to that place again, I will have flashback that I cannot control.”

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What are some unhelpful appraisals about the self or the world that could be made after the trauma?

A

changes EITHER beliefs about the world, or the self.
1) self-focused inability
(I am weak/useless; I did something to deserve this)
2) “the world is dangerous”, “all men are dangerous”

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What are some unhelpful appraisals about safety behaviors that could be made?

A
  • believing in the efficacy of avoidance behaviors (eg. “I need to avoid crowded places as a precaution”)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

According to emotional processing theory by Edna, what therapy does she recommend for intervention?

A

Prolonged Exposure (PE) Therapy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What is Prolonged Exposure (PE) Therapy about?

A
  • About facing your emotions. Experience the “natural” emotions related to the traumatic event, rather than avoiding or suppressing them.
  • Proposes that primary “natural” emotions do not last, it will be habituated after a while.
  • Manual that guides clients to stay with the original fear for a long time within the therapy setting.
  • Leads to elaboration of trauma memories, help memories become more complete and include extra details.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What are some limitations of prolonged exposure therapy?

A
  • not systematic

- no processing done after therapy session (inefficient)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

How do we have recovery based on cognitive perspectives?

A

Correct faulty beliefs that are evoking “manufactured” emotions. Cognitive biases make you experience secondary emotions, and these emotions can continue indefinitely so long as the faulty appraisals are present. As such, we need to tackle cognitive biases and the primary emotion.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What is the difference between complex PTSD and PTSD?

A
  • repeated and prolonged trauma, often years of abuse

- more severe, secondary symptoms are more severe and complex

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Why might additional PTSD symptoms make intervention more challenging?

A

Adds complexity to treatment

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What challenges do people with complex PTSD face? (4)

A

1) Emotional regulation difficulties
- shame and guilt
2) Disturbances in their ability to relate to others
3) Dissociation - Alterations in attention and consciousness. Might temporarily lose touch with reality. Forgetting important aspects of their past.
4) Altered belief system
- see themselves as worthless, unlovable, and weak
- difficulty trusting others as they see others as dangerous

24
Q

In what ways does the dissociative experience scale sometimes not capture dissociation of the client?

A

Sometimes client might be experiencing a lot of dissociation to the point of having memory lapses. Cannot remember what was done during the week, during sessions, and between sessions. Client might be filling up the questionnaire in a state so detached from his own emotions that he can’t remember dissociation experiences. Only a part of him was reporting it. Symptom of dissociation itself prevents him from filling up the scale accurately, which is a big problem in assessment and therapy.

25
Q

Before you administer the PTSD questionnaire, what must you do?

A

Must forewarn the client that you might expose them to the traumatic event again, and they might have to recall these traumatic memories. If client is not ready, do something else first.

26
Q

When assessing for suicide risk, what factors must you look out for?

A 
Risk factors 
- suicide ideation
- means 
- plan of suicide
Protective factors 
- social support 
- responsibility for others
27
Q

What forms of risk must you assess?

A

1) risk to self
2) risk to others - person can be quite violent and aggressive
3) risk from others

28
Q

When exposing clients to their memories, what should we be careful with?

A

Make sure not to overwhelm the client too much. Give them an appropriate dose of exposure. If not it will re-traumatize the client, which will reinforce his core beliefs.

29
Q

What strategies should you teach the client as they re-experience the memories?

A
  • Emotional regulation strategies. But be careful as they can become safety behaviors and prevent the individual from actually experiencing the fear.
  • Mindfulness therapy to ground them in the present. (eg. aromatherapy like pungent smells, play dough, keep eyes open, stare at favourite part of the room)
30
Q

How often must you assess suicide risk?

A

must be monitored every week. (traffic light system - red, orange, green)

31
Q

How do you do a PTSD formulation?

A

1) Pre-trauma characteristics
2) Peri-trauma factors
3) Post-trauma factors
4) Current-threat
5) Strategies to control symptoms

32
Q

What pre-trauma characteristics must you look out for? (3)

A
  • key childhood experiences
  • beliefs about the self/world
  • functioning prior to trauma
33
Q

What peri-trauma factors must you look out for? (2)

A
  • salient primary emotions during the trauma

- points during trauma where emotions were most intense

34
Q

What are some post-trauma factors to look out for?

A
  • secondary emotion that maintain the sense of threat
35
Q

What current threats do we look out for?

A

Flashbacks (eg. intrusive images, arousal, strong emotions)

36
Q

What are some stratagies clients use to control their symptoms?

A

eg. avoidance (avoid doing certain activities, or talking about the trauma)

37
Q

What are the 3 phases involved in treatment of complex PTSD?

A

1) stabilisation phase
2) memory/trauma processing phase
3) re-integration

38
Q

What happens in phase 1 - stabilisation phase?

A
  • Improve behavioral, emotional, and social functioning (general functioning). Give them skills to cope.
  • establish safety and stability
  • motivational work. therapist should show confidence in treatment, show empathy, explain rationale clearly, and answer any concerns clients have.
39
Q

What happens in phase 2 - memory processing phase?

A
  • Exposure to traumatic memories
  • Dealing with its emotional/behavioral consequences.
  • Integrate trauma memories into schema of the self, relationships, and the world in an adaptive way.
40
Q

What happens in phase 3 - reintegration?

A
  • cognitive restructuring
  • review and reconsolidate learning
  • planning into the future. Transition to engagement with outside world.
41
Q

Why do we need to treat patients in phases?

A

because clients need help to tolerate the distress of the trauma work.

42
Q

In prolonged exposure therapy (PE) which is a form of behavioral intervention, which 2 ways do we expose clients to their traumatic memories?

A

1) imaginative exposure
2) in-vivo exposure
Both methods reduce automatic fear responses (habituation), and provides new learning that he/she is able to cope. Emotions should come high.

43
Q

Describe imaginative exposure.

A
  • Repeatedly retelling the trauma in the first person to the therapist.
  • Start with 3rd person then 1st person
  • record the retelling of story. ask them to go home and listen to the recordings everyday
44
Q

Describe in-vivo exposure.

A

Exposure to trauma-related reminders (eg. person, place, situation), but make sure client is objectively safe.

45
Q

Besides prolonged exposure therapy, what is the other therapy that is used for clients with PTSD?

A

Cognitive Processing Therapy (CPT) informed by cognitive theories.

46
Q

What is the aim of cognitive processing therapy (CPT)?

A

Cognitive restructuring - Help clients develop a personal sense of meaning of traumatic event. changing how they views themselves, the trauma, and its consequences.

47
Q

What are the 3 phases of Cognitive Processing Therapy (CPT)?

A

1) psychoeducation
- how trauma symptoms develop
- connection between thoughts and feelings
2) identify and modify problematic beliefs

48
Q

What are the key features of PTSD? (4)

A

1) Intrusive memories. Accompanied by images, smells, bodily sensations that were experienced at time of trauma.
2) Flashback - person feels like they are reliving the trauma
3) Startle easily at something unexpected
4) Difficulties in mood regulation (emotional numbing, detachment from others and the world.)

49
Q

Describe the evolutionary biological mechanism that prevents the individual from processing traumatic memories.

A
  • person perceives a threat and registers it in amygdala. system goes into fight or flight mode.
  • if not possible, the body freezes. Activity of the brain and hippocampus shuts down.
  • Experience cannot be processed, time-tagged, or stored
  • Hence, memory may be re-experienced sometime in the future in the form of intrusions.
  • occurs outside the person’s conscious control
50
Q

According to NICE guidelines, what are the 2 types of therapy recommended for clients with PTSD?

A

1) Trauma-focused cognitive behavioral therapy (TF-CBT)
- prolonged exposure therapy
- cognitive processing therapy
2) Eye movement desensitisation and reprocessing (EMDR)

51
Q

The eye movement desensitisation and reproducessing (EMDR) therapy is based on what model?

A

Based on Adaptive Information Processing Model. Proposes that the natural physiological system has the capacity to transform a traumatic memory into an adaptive resolution and file it away. However, due to blockage in information processing, it will react to the present as if in the past, experiencing the traumatic memory again. The brain does not discard the maladaptive material and thus cannot access more adaptive material from the present.

52
Q

Describe the mechanisms of EMDR.

A

Access the target trauma memory and all its emotions, thoughts, and physical sensations. Client has dual attention on both past memory and current safety. Allows them to process the unprocessed memory and access more adaptive memory networks

53
Q

Which stimulation is used in EDMR?

A

Bilateral stimulation
- follow therapist’s hand moving from side to side, listening to bilateral sounds, activating both hemispheres of the brain

54
Q

When does dissociation occur?

A

When an experience is too threatening or overwhelming for a person to integrate it. Changes our sense of self and personality. Treatment will first focus on recognising dissociation and learning to stabilize oneself before trauma is processed.

55
Q

Severe trauma can split the personality into characteristic parts. What are they?

A

1) Apparently normal part (ANP)
- continues to adapt to demands of daily living
2) Emotional part (EP)
- Holds experience of trauma in the form of reliving (intrusions)

56
Q

What is vicarious traumatisation?

A

As a therapist, hearing so many distressing and traumatic stories can challenge our own cognitive schemas, or beliefs, expectations and assumptions about ourselves and others. Hence, the therapist needs supervision and enriching experiences outside work to cope,

PL3257 (11 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions