CM: Effects of Trauma Flashcards
What is the effect of trauma on the brain?
medical prefrontal cortex interacts w limbic system which sends signals to HPA axis to release cortisol via ACTH
signals to locus ceruleus to release NE and DA –> sympathetic nervous response
What is the fight, flight or freeze response?
increased HR, sweating, persons being alert, redistribution of blood to heart, brain and skeletal muscles
What is criterion A?
exposure to actual or threatened death, serious injury, or sexual violation in one or more of the following ways: direct experience, witnessing it, learning it occurred to a loved one, repeated exposure to aversive details of event (not seeing on TV unless work related)
necessary for acute stress disorder and PTSD
What symptoms are required to diagnose acute stress disorder?
presence of nine or more symptoms from any of five categories: intrusion, negative mood, dissociation, avoidance, arousal, beginning or worsening after traumatic event occurred
What are intrusion symptoms of acute stress disorder?
intrusive memories
nightmares
flashbacks
panic symptoms in response to cues
What are dissociative symptoms of acute stress disorder?
altered sense of reality
inability to remember important aspect of traumatic event
What are avoidance symptoms of acute stress disorder?
efforts to avoid distressing memories, thoughts, feelings associated with trauma
efforts to avoid external reminders
What are arousal symptoms of acute stress disorder?
sleep disturbance, irritable behavior or angry outbursts, hypervigilance, problems w concentration, exaggerated startle response
What is the timeline of symptoms needed for diagnosis of acute stress disorder? other requirements?
3 days to 1 month after trauma exposure
causes distress or impairment in social, work, etc
not attributable to substance, another medical condition, other brief psychotic disorder
What is the only difference between acute stress disorder and PTSD?
symptoms are the same (except PTSD doesn’t have dissociative symptoms) but present longer than 1 month
What are specifiers for PTSD?
w dissociative symptoms - depersonalization, derealization
w delayed expression - diagnostic criteria not met until at least 6 mos after event
What is the treatment of stress disorders?
no longer psychological debriefing (talking about it)
psychological first aid - address current needs
w PTSD - SSRIs
trauma focused therapy - elements of exposure, cognitive restructuring - more common
What is the difference in response to trauma of a child?
trauma can be chronic w little or not time to recover b/w events
smaller intracranial, cerebral and cerebellar volumes, larger lateral ventricles, smaller CC
susceptible to distraction, increased impulsivity, poorer problem solving, poorer coping skills, increased risk for substance use disorders
What are the manifestations as an adult of someone who dealt with trauma as a child?
attempts at self-soothing - clingy relationships
self destructive
fear of abandonment or rejection
increased risk of developing mood, anxiety and substance disorders
What is resilience in the context of trauma?
successful adaptive coping
same neural plasticity that can harm children can also be helpful
process of gene expression modulated by environmental exposures
when people cope w moderate stressors they achieve sense of mastery and enhance sense of personal control
