31-10-23 - Post-traumatic stress disorder Flashcards
Learning outcomes
- Identify the symptoms associated with PTSD
- Discuss the risk factors of PTSD
- Discuss the psychological and biological factors associated with PTSD
- Identify the therapeutic options for PTSD
What is PTSD?
What is it associated with?
- PTSD is an anxiety disorder
- It is associated with experiencing or witnessing single, repeated or multiple events that could include:
1) Serious accidents
2) Assault (physical or sexual)
3) Abuse (including childhood or domestic)
4) Work-related exposure to trauma (including remote exposure)
5) Trauma related to serious health problems or childbirth experiences (e.g., intensive care admission or neonatal death)
6) War and conflict
7) Torture
What is believed to be the origin of PTSD?
What lead to the evolution of PTSD as an independent diagnostic category.?
- Studies based on veterans from WW 1 and 2 led to the conclusion that most cases were psychological in origin, not organic.
- Widely believed that the concussion of artillery shells cause CNS damage
- This did not explain the cases of shock or distress among those who were not exposed to the exploding shells
- Particularly, the extent and severity of distress among Vietnam veterans contributed to the evolution of PTSD as an independent diagnostic category.
How common is PTSD?
What are the most common traumas associated with PTSD?
Who can it affect?
What % of people who experienced a traumatic event develop PTSD.
- Estimated lifetime prevalence of PTSD is 6.8% (these numbers will change according to the diagnostic criteria used).
- Most common traumas are combat for men and sexual molestation for women (O’Carroll, 2019)
- It can affect people of any age.
- Not everyone who experiences trauma develops PTSD: NICE (2019): 25-30% of people who experienced a traumatic event develop PT
When do symptoms of PTS develop?
How can the assessment for PTSD cause problems?
What is a barrier to seaking treatment?
- Symptoms of PTSD can develop immediately but in some (<15%) the onset of symptoms may be delayed.
- Assessment of PTSD can, however, present significant challenges as many people avoid talking about their problems when presenting with associated complaints.
- PTSD sufferers may not seek help for months/years despite considerable distress.
- Many sufferers may also believe that it’s untreatable posing a barrier to seeking and getting treatment.
Why is it important to examine long-term experience of PTSD?
- Because PTSD symptoms subside in many people over time, and symptoms wax and wane, it is important to examine long-term experience.
Describe the criteria for recognition of PTSD (in picture)
When can complex post-traumatic stress disorder develop (CPTSD)?
How is CPTSD characterized?
- Complex post-traumatic stress disorder (CPTSD) develops in a subset of people with PTSD, usually after exposure to an event or series of events of an extremely threatening or horrific nature, most commonly prolonged or repetitive events from which escape is difficult or impossible
- The disorder is characterised by the core symptoms of PTSD, as well as:
1) Severe and pervasive problems in affect regulation— that is, the ability to regulate emotional state and behaviour.
2) Persistent beliefs about oneself as diminished, defeated or worthless, accompanied by deep and pervasive feelings of shame, guilt or failure related to the traumatic event.
3) Persistent difficulties in sustaining relationships and in feeling close to others.
Describe Intrusive memories/ Re-experiencing
- Intrusive memories/ Re-experiencing:
- Trauma is re-experienced through intrusive and distressing thoughts, images,flashbacks, or nightmares
- Flashbacks feel real
- Acting or feeling like the event is recurring
Describe avoidance in those with PTSD.
- Avoidance in those with PTSD.
- Avoidance of thoughts, feelings, people, places, and activities related to the event.
What are 5 examples of hyperarousal seen in those with PTSD?
- 5 examples of hyperarousal seen in those with PTSD:
1) Physiological reactivity (e.g., increased heart rate)
2) Sleep disturbance
3) Irritability
4) Anger
5) Hypervigilance Exaggerated startle response
Describe risk factors for PTSD (in picture)
How can characteristics of a traumatic event affect the risk of developing PTSD?
- How characteristics of a traumatic event affect the risk of developing PTSD:
- Natural disaster vs traumatic events involving intentional harm (Ayers and De Visser, 2018)
- Stressors involving intentional harm appear more likely to cause PTSD than are natural disasters
- How deliberate human-caused stressors are judged to be also seem to be important
What are 5 psychological factors that influence susceptibility to PTSD?
How are genetic factors found to influence susceptibility to PTSD?
- 5 Psychological factors that influence susceptibility to PTSD:
1) Resilience
2) Personal impact of the event
3) The extent of perceived control over future threats
4) How one is prepared to deal with a stressor
5) One’s beliefs and assumptions about trauma - All affect how severe the impact of a stressor may be and how likely an individual is to develop PTSD
- How genetic factors found to influence susceptibility to PTSD:
- International PGC (psychiatric genomics consortium)
- 200,000 people, largest ever genetic study on PTSD
- 5-20% genetic influence within different populations
- Genetic risk overlapped with that for depression, insomnia, coronary artery disease, amongst others
- First steps investigated to using genetic info to predict risk - Million Veterans Program
Describe 4 techniques for psychological prevention of PTSD (in picture)
Describe 4 techniques for psychological treatment of PTSD (in picture)
Describe the use of Eye movement desensitization and processing (EMDR) for treating PTSD (in picture).
What is EMDR not recommended for?
Summary (in picture)
