33. Head trauma/ mTBI Flashcards
Symptoms of PTSD include:
- distressing or intrusive memories of incident
- Intense emotional upset
- Avoidence of things that remind of event
- reliving event thru nightmares/flashbacks
- ongoing anxiety
symtom duration to qualify for dx of PTSD
DSM says symptoms must persist >1m
can be a 6 m delay from trauma to onset of PTSD
what did ICD do to improve the PTSD dx
divides PTSD into 2 separate dx: PTSD and complex PTSD
What is the core criteria for the dx of PTSD according to ICD (3)
Several weeks of:
- reexperiencing the trauma
- Avoiding reminders of the event
- Sense of weighted threat and arousal
What additional symptoms does complex PTSD come with along with 3 core symtoms (4)
- difficulty managing emotion
- belief that one is worthless
- Feelings of shame, guilt, or failure
- trouble maintaining relationships
What is the criteria for a clinical traumatic event in PTSD
The person was exposed to:
- death or threatened death
- actual or threatened serious injury
- Actual or threatened sexual violation
In one or more of the following ways:
- experiencing event themselves
- Witnessing the event as they occur to others
- learing about it happening to friens/relitive
- experiencing details of it over n over
cultivating mindfulness in trauma
It is not possible to control the occurrence of trauma, but as one cultivates broad mindfulness, one can begin to see that one can use the experiences as an opportunity to transform life
-as people learn to let go of a state f blame and remorse, they can transform painful affliction into compassionate self acceptance and forgiveness
Role of psychologists in trauma
can guide patient into path of self discovery where in the ego is deemphasized and an awareness of the interconnected nature of life arises
what are neural networks
are made up of complex connection bw neurone , formed by initial experiences and reinforced when those experiences are repeated
What areas of the brain are responsible for state dependent learning (4)
cortical brain regions
middle insular cortex
anterior cingulate cortex
hippocampus
What part of the brain does mindfulness affect
Thickens the right anterior insula (part of the brain associated with self awareness)
-ALSO shown to reduce the size of the amygdala
goals of tx in PTSD
- tx should be aimed at helping pts to live fully and securely in present
- involves neural restructuring to bring back the involvement of brain structures that are overwhelmed by trauma
bents of langerian mindfulness
- reducing hypertension
- lessening anxiety
- improving isomnia
- avoiding depressive relapses and self injury
- improved ability to cope w trauma
What is the short dynamic therapy stress syndrome theory to PTSDY
PSTD rxns occur when people have had a hard time successfully navigating the phases that everyone must face when dealing w trauma
The phases of trauma (5)
- Initial outcry
- . Danial and numbness (dissociation from world)
- Intrusive thoughts/feelings (about event)
- Working through (integrating thoughts/feeling w self
- Completion
What are the 12 sessions of short dynamo therapy of stress syndrome (w1-4, 5-8, 9-12)
1-4– Establish trust so pt can safely recount truama
5-8– Work thru pts unconscious conflicts, maladaptive interpersonal patterns and problematic beliefs
9-12– Integrate strides patients have made and process feeling about end of therapy
Behavioural approaches for tx of PTSD
- exposure therapy for PTSD
- exposure therapy for prolonged grief
- Behavioural activation for PTSD
What is exposure therapy for PTSD
-1st line intervention Uses techniques such as: =exposure + response activation (usually imagery or virtual reality) =Systemic desensitization =Modeling
What part of the brain may exposure therapy normalize
Normalize amygdala and prefrontal cortex
What is exposure therapy for prolonged grief
The patient gradually confronts loss by focusing on the most painful parts of a loved ones passing
–the goal is to stop avoiding feelings about loss and rather face the reality
What is behaviour activation for PTSD
- exists due to concerns that exposure therapies are often impractical in the real world
- pts are encouraged to engage in activities that they find rewarding
What is the cognitive approach to PTSD
cognitive approaches to PSTD aim to educate patients about typical responses to trauma and to challenge their automatic beliefs about the event
What are the different types of cognitive approaches (7)
- Emotional processing theory
- Dual representation theory
- Cognitive processing therapy
- Negative Appraisals theory
- Stress inoculation training
- Mindfulness and acceptance approaches
- Eye movement desensitization reprocessing
What is emotional processing theory
cognitive theory that attributes post traumatic stress as well as other fear anxiety responses to dysfunctional fear structures
