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NEUR1202 > Class 11: Trauma and Related Disorders > Flashcards

Class 11: Trauma and Related Disorders Flashcards

1
Q

Name 3 disorders in the subclass of trauma and stressor-related disorders.

A
  1. Childhood attachment disorder
  2. Acute stress disorder
  3. PTSD
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2
Q

Name 3 examples of Childhood attachment disorders

A
  1. Adjustment disorder
  2. Disinhibited social engagement disorder
  3. Reactive attachment disorder
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3
Q

What criteria must be met to be diagnosed with a trauma and stressor-related disorder according to the DSM-5?

A

Exposure to a traumatic or stressful event MUST occur

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4
Q

Define Trauma

A

Actual or threatened death, serious injury, or sexual violence

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5
Q

Why would job loss not be trauma?

A

Trauma needs to involve an immediate threat to life or physical injury

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6
Q

What are the 4 types of symptoms of Psychological Trauma?

A
  1. Intrusion symptoms
  2. Avoidance
  3. Negative Alterations in Cognitions and Mood
  4. Hyperarousal
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7
Q

What are 3 intrusion symptoms?

A

Flashbacks, Nightmares, and Intrusive thoughts

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8
Q

What is the Avoidance Symptom of Trauma?

A

Avoidance of stimuli associated with trauma

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9
Q

What are two examples of negative alterations in cognition and mood in trauma?

A
  1. Difficulty recalling important aspects of trauma

2. Emotional detachment

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10
Q

What are 6 examples of hyperarousal symptoms of trauma?

A
  1. Hypervigilance
  2. Insomnia
  3. Agitation
  4. Irritability
  5. Impulsivity
  6. Anger
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11
Q

What percentage of Canadian meet the criteria for PTSD?

A

8%

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12
Q

Define PTSD

A

Post-traumatic stress disorder is when trauma symptoms persist

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13
Q

Are men or women more likely to have PTSD?

A

Women due to sexual assault

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14
Q

What are the 5 PTSD’s Criterion Categories and for how long are they required to be?

A
  1. Stressor
  2. Intrusion Symptom
  3. Avoidance
  4. Negative Alterations in Cognition and Mood
  5. Alteration in Arousal and Reactivity

for more than 1 month

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15
Q

What two criteria must be met otherwise it is NOT PTSD?

A
  1. Must have Functional Significance
  2. Cannot be due to medication, substance use or other illness
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16
Q

What are the 5 events that typically cause PTSD?

A
  1. Experiencing or witnessing a traumatic event
  2. Physical assault
  3. Threat of death, sexual violence or serious injury
  4. Learning about a violent death of a loved one
  5. Job exposure in jobs relating to trauma
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17
Q

Name 5 intrusive symptoms of PTSD.

A
  1. Unwanted upsetting memories
  2. Nightmares
  3. Flashbacks
  4. Emotional distress after triggers
  5. Physical reactivity after triggers
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18
Q

What are 2 ways that Criterion C: Avoidance symptoms of PTSD can be met?

A
  1. Avoidance of trauma-related thoughts or feelings

2. Avoidance of trauma-related external reminders

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19
Q

What are 7 ways that Criterion D: Negative Alterations in Cognition and Mood symptoms of PTSD can be met?

A
  1. Inability to recall key features of the trauma
  2. Overly negative thoughts and assumptions
  3. Exaggerated blame of self or others for causing the trauma
  4. Negative affect
  5. Decreased interest in activities
  6. Feeling Isolated
  7. Difficulty experiencing positive affect
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20
Q

What are 6 ways that Criterion E: Alterations in Arousal and Reactivity symptoms of PTSD can be met?

A
  1. Irritability or aggression
  2. Risky or destructive behaviour
  3. Hypervigilance
  4. Heightened startle reaction
  5. Difficulty concentrating
  6. Difficulty sleeping
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21
Q

What are 6 risk factors of PTSD?

A
  1. History of substance abuse
  2. Inadequate coping skills
  3. Lack of social support
  4. Childhood trauma
  5. Sex
  6. Genetics
22
Q

What three brain systems experience alterations in PTSD?

A

1 Neuroendocrine (Hormones)
2. Neurochemical (NTs)
3. Neuroanatomical (Structures)

23
Q

What is the endocrine reaction in PTSD?

A

Dysregulation in glucocorticoid signaling

24
Q

In PTSD what is the effect ‘from normal’ of the CRH and cortisol level?

A

CRH increases, but cortisol is reduced.

25
Q

Given the HPA axis, how can an increase of CRH AND decrease of cortisol happen?

A

The Anterior Pituitary will decrease the CRH receptors when CRH is too high which in turn results in less ACTH then less cortisol

26
Q

Define Hypocortisolaemia and what could it predict

A

Low cortisol levels perhaps due to a dysfunction in the adrenal glands or simply not being stressed.

If this is found at time of trauma exposure it may predict PTSD.

27
Q

What is one preventative measure to PTSD?

A

a high dose of hydrocortisone IV within 24 hours of trauma

28
Q

What two parts of the PFC are involved in PTSD?

A

Medial PFC (mPFC) and the Anterior Cingulate Cortex (ACC)

29
Q

What happens to the mPFC and ACC in PTSD?

A

They both reduce in volume which correlates with the increase in amygdala activity

30
Q

What do the mPFC and ACC help mediate?

A

They both mediate fear extinction

31
Q

What 4 things happen when PFC activity is reduced (and hypersensitive amygdala)?

A
  1. Hypervigilance
  2. Intrusion symptoms
  3. Avoidance of stimuli associated with trauma
  4. Cognitive Symptoms
32
Q

What is fear conditioning?

A

fear conditioning is when the circuit occurs so dramatically it cements this circuit into place

33
Q

How do you ‘forget’ a fear?

A

You do not forget fear you can just learn that the fearful thing is not fearful. This occurs in the 3 synaptic system of the amygdala take over the fear from the 2 synaptic system

34
Q

How does the 3 synaptic circuitry in the amygdala stop the 2 synaptic circuitry?

A

The 3 synaptic circuitry release GABA which inhibits the 2 synaptic circuitry neurons from firing

35
Q

NE Neurons originate where?

A

Locus coeruleus of the brainstem

36
Q

What happens in to the amygdala if NE is blocked from the 2-synapse circuit immediately after trauma?

A

The fear response/conditioning does not become permanent since the NE does not activate and solidify the 2-synapse circuit.

37
Q

Define unconditioned stimulus and unconditioned response

A

A stimulus that invokes a fear response for the stimulus itself. (Electric shock causes fear)

38
Q

Defined conditioned stimulus and conditioned response.

A

A stimulus that has become associated with the original unconditioned stimulus that originally caused the fear now causing it without the unconditioned stimulus. (A noise is played at the same time as a shock, the noise now causes fear (as a conditioned response)

39
Q

How does fear extinction occur?

A

Recondition the amygdala to realize that the conditioned stimulus is not harmful

40
Q

What part of the brain “remembers” the context of a event?

A

The hippocampus (which can in turn relay the info to the amygdala to initiate fear response)

41
Q

How is the volume of the left hippocampus related to the level of PTSD?

A

The smaller the left hippocampus volume the higher the level of PTSD

42
Q

What are the 6 physiological steps of PTSD?

A
  1. There is an enhanced NE activity
  2. Leading to synaptic changes in amygdala leading to the fear response
  3. The surrounding neutral stimuli becomes associated with the trauma (as triggers)
  4. The fear response is difficult to turn off due to less hippocampal neuronal input signaling safety
  5. Circuits become increasingly activated
  6. A lot of stimuli triggers can result in PTSD
43
Q

What PTSD symptom is represented within these brain areas?

A

Altered arousal and reactivity

44
Q

What PTSD symptom is represented within these brain areas?

A

Altered Cognition and Mood

45
Q

What PTSD symptom is represented within these brain areas?

A

Intrusions

46
Q

What PTSD symptom is represented within these brain areas?

A

Avoidance

47
Q

What is the first line of treatment for PTSD?

A

SSRI’s

48
Q

What PTSD Treatment helps with night-time symptoms?

A

Anti-adrenergic drugs

49
Q

Name 3 examples of non-pharmacological approaches to PTSD Treatment

A
  1. Prolonged Exposure Therapy
  2. Cognitive Processing Therapy
  3. Virtual Reality
50
Q

Why are people with PTSD at increased odds of using cannabis?

A

PTSD patients have higher number of cannabinoid receptors (CB1 and CB2) and a lower level of endocannabinoid (AEA, 2-AG, etc).

51
Q

What are the effects on the PTSD symptoms when THC or CBD is used?

A

THC makes the symptoms worse

CBD reduces the symptoms

NEUR1202 (15 decks)

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