Anxiety Disorder: Post Traumatic Stress Disorder Flashcards
What is the definition of PTSD?
Mental and behavioural disorder that can develop because of exposure to a traumatic event.
What are some trauma related risk factors for PTSD?
Man-made rather than natural events
Prolonged exposure
Perceived threat to life
What are some patient-related risk factors for PTSD?
Family or personal history of mental disorder
Serious physical injury (patient’s perception)
Past experience of trauma, especially childhood/developmental trauma
What are some environmental risk factors for PTSD?
Lack of support network
Lack of economic resources
Disadvantage
Ongoing life stresses
What is the difference between type 1 and type 2 trauma?
Type 1 is single incident whereas type 2 is repetitive trauma
What is the pathophysiology behind PTSD?
When under threat, activity switches from pre-frontal cortex to brainstem (PAG) Periaqueductal gray and ventral tegmental area are origin of various trauma responses (eg fight, flight, freeze, hide, seek, avoid, attach, submit, despair)
What pathological changes occur to the brain in PTSD?
Hippocampal atrophy
Increased activation of amygdala and other limbic areas
Deactivation of Broca’s area (makes it difficult to explain trauma verbally)
Right-hemispheric lateralisation (‘timeless’ quality of traumatic history)
What are some clinical features of PTSD?
Intrusive phenomena
Avoidance symptoms
Negative alterations in cognitions and mood symptoms
Alterations in arousal and reactivity
How long must symptoms be present for to make a diagnosis of PTSD?
1 month
What is ICD-11 diagnostic criteria for PTSD?
≳ 1 intrusive symptoms
1 or both avoidance symptoms
≳ 1 negative alterations in cognitions and mood
≳ 2 increased arousal and activity
Functional impairment (social or occupational)
How is a diagnosis of complex PTSD made?
Core PTSD symptoms plus:
- Negative self-concept
- Emotional dysregulation
- Chronic interpersonal difficulties
What is the psychological treatment of PTSD that is mild and < 4 weeks from trauma?
Watchful waiting
What is the psychological treatment of PTSD that is within 3 months from trauma?
1) Trauma-focussed CBT
2) Hypnotic sleep medication for sleep disturbance
What is the psychological treatment of PTSD that is more than 3 months after trauma?
Trauma-focussed CBT or EMDR
What is the psychological treatment of complex PTSD?
Phase based approach:
- Stabilisation and safety (resourcing)
- Trauma treatment (reprocessing)
- Reintegration/rehabilitation
