CP: Lecture 7 Trauma Related Disorders

Question 1

6 trauma related disorders

Answer 1

post traumatic stress disorder
acute stress disorder
adjustment disorder
reactive attachment disorder
disinhibited social engagement disorder
other/unspecified TSR disorder

Question 2

welke 2 worden in NL vergoed

Answer 2

ptsd en asd

Question 3

verschil timeframe asd en ptsd

Answer 3

asd = symptoms between 3 days and 1 month after trauma
ptsd = symptoms after one month after trauma

Question 4

asd criticism

Answer 4

medicalizing normal reactions to trauma.

Question 5

hoeveel mensen met asd developen ptsd

Answer 5

50%

Question 6

DSM 3 trauma definition A

Answer 6

event outside usual human experience

Question 7

DSM 4 trauma definition

Answer 7

actual or threatened death, serious injury, physical integrity. fear, helplessness and horror

Question 8

DSM 5 definition trauma

Answer 8

exposure to actual or threatened death, serious injury or sexual violence
1. directly experiencing
2. witnessing inperson
3. learning: close family member or friend
4. repeated/extreme exposure to aversive details (not through movies or pictures unless work related)

Question 9

3 possible outcomes of psychotrauma

Answer 9

post traumatic growth
no problems/quick recovery
mental health problems (bv ASD/PTSD)

Question 10

criticism DSM 3 definition of trauma

Answer 10

unsual human experience: may be true on individual level, but natuurrampen, covid, WWII -> not true on a group level, rather common than rare.

Question 11

DSM 4 criticism

Answer 11

moet gelijk fear, helplessness or horror zijn -> dit is niet eerlijk tov. mensen die pas jaren na ptsd ontwikkelen. spreekt ook psychological dissociation tegen.

Question 12

prevalence trauma =

Answer 12

80%

Question 13

prevalence ptsd =

Answer 13

7%

Question 14

PTSD in ICD

Answer 14

kijkt minder naar de etiology, en meer naar alleen symptomen

Question 15

positive association between, post traumatic stress and…

Answer 15

post traumatic growth.

want meer problemen=meer opportunities?

Question 16

predictors of PTSD

Answer 16

meeste:
trauma
lack of social support
life stress

low iq
childhood abuse

Question 17

dus wat voor soort predictors hebben de meeste impact

Answer 17

things that happen during or after the trauma, dit is fijn! want daar kunnen we dan interventies op aanpassen.

Question 18

welk gender meer ptsd

Answer 18

females

Question 19

other predictors of trauma

Answer 19

peritraumatic emotions
peritraumatic dissociation
percieved support
prior trauma
prior adjustment
family history of psychopathology

Question 20

peritraumatic emotions =

Answer 20

negative emotions felt at the time of or in the hours and days following a traumatic event

Question 21

ptsd a criteria=

Answer 21

Exposure to actual or threatened death, serious injury, or sexual violence in one (or more) of the following ways:

1. Directly experiencing the traumatic event(s).
2. Witnessing, in person, the event(s) as it occurred to others.
3. Learning that the traumatic event(s) occurred to a close family member or
   close friend. In cases of actual or threatened death of a family member or
   friend, the event(s) must have been violent or accidental.
4. Experiencing repeated or extreme exposure to aversive details of the
   traumatic event(s) (e.g., first responders collecting human remains; police
   officers repeatedly exposed to details of child abuse).

Question 22

ptsd b criteria=

Answer 22

reexperiencing at least 1:

intrusions
dreams
(dissociative) flashbacks
emotional distress upon cues
physiological reactions upon cues

Question 23

ptsd c criteria

Answer 23

avoidance

avoidance of internal cues (memories/flashbacks/feelings)
avoidance of external cues (places/situations/people)

Question 24

ptsd d criteria

Answer 24

negative changes in mood and cognition, at least 2:

dissociative amnesia
negative convictions and expectations
excessive conditions about cause or guilt
persistent negative mood
loss of interest
estrangement
inability to experience positive feelings

Question 25

ptsd criteria e

Answer 25

arousal and reactivity, at least 2: irritation/anger outburst self-destructive/reckless behaviour hypervigilance exaggerated startle concentration problems sleeping problems

Question 26

hoelang moet ptsd duren

Answer 26

1 maand!

Question 27

wat is een flashback

Answer 27

not just a memory, but more a reexperience of the whole situation.

Question 28

cognitive model ptsd (check samenvatting)

Answer 28

trauma type/coping <-> cognitive processing during trauma leidt tot trauma memory <-> negative appraisal leidt tot current threat (intrustions, arousal, emotions) leidt tot strategies intended to control threat en gaat weer terug naar negative appraisal.

Question 29

voorbeeld idiosyncratic appraisal over trauma

Answer 29

nowhere is safe for me, i deseve bad things, i cannot cope with stress, i attract disaster etc

Question 30

ptsd paradox

Answer 30

the feeling of current threat: how are people afraid of something that happened in the past?

Question 31

2 types of processing

Answer 31

data-driven processing: sensory details of an event, quickly conceptual processing: think carefully about it, integrate it in memory

Question 32

which type of processing bij ptsd

Answer 32

vaak data driven meer kans: want dan isolated trauma memories that come back, no clear timeline.

Question 33

wat gebeurt er bij de andere vorm van processing

Answer 33

conceptual processing: echt er over nadenken, het een plekje geven in autobiografisch memory, this happened to me back then, not here and now. minder kans op ptsd want je weet dat er geen current threat is.

Question 34

single session debriefing

Answer 34

early intervention, makkelijk bij ptsd want duidelijk startpunt. maar... dit werkt niet goed, juist averechts.

Question 35

treatment of ptsd

Answer 35

1. first choice treatment: imaginal/prelonged exposure cognitive therapy emdr trauma focused congitive behaviour therapy brief electric psychotherapy for ptsd narrative exposure therapy writing therapy imaginal rescripting 2. try other first choice 3. intensified care (pharmacotherapy, clinical treatment) 4. alternative/complementary treatment

Question 36

prolonged exposure

Answer 36

expose ppl to traumatic stimuli, anxiety decreases

Question 37

learning theory of prolonged exposure

Answer 37

CS-US association stays intact, but new CS-no US association is learned that competes with original CS-US association want... er is wel relapse, dus CS-US verdwijnt niet helemaal

Question 38

other theories of prolonged exposure

Answer 38

memory: trauma becomes contextualized (conceptual processing) into autobiographical memory cognitive: new insights

Question 39

cognitive therapy

Answer 39

- Directly identify and challenge dysfunctional/irrational cognitions - Often combined with exposure into (TF-)CB

Question 40

working memory theory model of emdr

Answer 40

long term memory (stable) -> working memory (liable, limited capacity) -> competing tasks (reduces vividness of emotionally traumatic memory) -> modified memory reconsolidation into long term memory

Question 41

dus... verschillen in werking tussen exposure en emdr

Answer 41

exposure: learning new CS- no US association emdr: trauma imagery is directly modified!

Question 42

imagery rescriping

Answer 42

veranderen van ending in hoofd

Question 43

disturbing reconsolidation

Answer 43

reactivation of hotspot memories, emotional reexperiencing via retrieval -> administer betablocker -> minder noradrenergic receptors -> amygdala does not strenghten memory trace -> reconsolidation (a weaker memory is installed)

Question 44

wat zou fijn zijn aan deze nieuwe interventie distrubing reconsolidation

Answer 44

intensive, maar wel hopeful: want past de CS-US associatie aan! dit zou dus minder relapse betekenen, large effect, minder sessions. but... suitable for which problems? how to reactivate? is new learning neccessary?