4: Trauma

Question 1

define: trauma

Answer 1

Exposure to events and circumstances that are experienced as harmful (physically or emotionally) and that have lasting impacts on mental, physical, emotional and/or social well-being

Question 2

how prevalent are adverse childhood experiences in the UK?

Answer 2

47% of participants reported at least 1 ACE
9% reported 4 or more ACEs

Question 3

what is the trauma -> PTSD percentage?

Answer 3

25–30%

Question 4

what are the 4 key clusters of symptoms for trauma?

Answer 4

intrusions, avoidance, hyperarousal and attention in mood/beleif

Question 5

what characterises intrusions? (trauma)

Answer 5

Recurrent, involuntary, intrusive memories
Re-living the traumatic experience(s) in the here and now (flashbacks)
Distressing dreams (nightmares)
Experiencing distress when confronted with reminders of the trauma

Question 6

what characterises hyperarousal? (trauma)

Answer 6

Difficulty falling or staying asleep
Irritability or outbursts of anger
Difficulty concentrating
Hyper-vigilance
Exaggerated startle response

Question 7

what characterises avoidance? (trauma)

Answer 7

avoiding circumstances resembling or associated with the stressor
avoiding trauma-related thoughts and feelings

Question 8

what characterises attention in mood/belief? (trauma)

Answer 8

Inability to recall key features of the traumatic event
Change to beliefs and expectations about oneself, the world and others.
Persistent trauma-related emotions (e.g. fear, horror, guilt, shame)

Question 9

what distinguishes trauma & complex trauma?

Answer 9

All of the difficulties commonly associated with trauma as well as difficulties with…
Relationships: Difficulties in forming and maintaining close relationships with others.
Emotion Regulation: Experiencing strong emotions such as anger, fear or feeling emotionally numb.
Self-concept: Beliefs about oneself as worthless or feelings of shame and guilt.

Question 10

What are the 5 stabilisation tools to stop people getting triggered in therapy?

Answer 10

psychoeducation, grounding, breathing, mindfulness, trigger discrimination

Question 11

what is the fright component of the fear cascade?

Answer 11

the physiological response to the threat

Question 12

describe the neural pathway for the fear response

Answer 12

amygdala receive information about sensory
prefrontal cortex makes sense of that information
hippocampus stores information with time & date

Question 13

which brain areas are involved in memory formation and reoccurrence for trauma

Answer 13

prefrontal cortex & hippocampus

Question 14

Explain the procedure for narrative exposure therapy

Answer 14

Normalisation and psychoeducation.
Laying the lifeline (creating a visual representation of positive and negative influential experiences)
Narrating the lifeline paying attention to traumatic events and going through these in slow motion.
Reading the narrative

Question 15

how can services re-traumatise patients?

Answer 15

removing choice, being overly controlling, lack of collaboration, focus on the individual as the problem

Question 16

what are the NICE recommendations for trauma treatment?

Answer 16

cognitive processing therapy
cognitive therapy for PTSD
narrative exposure therapy
prolonged exposure therapy
EMDR for non-combat related trauma)

Question 17

what is the main goal of trauma informed care?

Answer 17

creating services that aim to reduce harm and promote healing