E2: PTSD And Trauma

Question 1

What are the physiological impacts of long term trauma?

Answer 1

• body sensitized to threat and the fight, flight, or freeze response is triggered when unnecessary
• heightened physical response to triggers and cues

Question 2

What are the emotional impacts of long term trauma?

Answer 2

• intense feelings that are difficult to contain

- tendency to all or nothing reactions

Question 3

What are the cognitive impacts of long term trauma?

Answer 3

• Disrupts what we previously believed to be true about ourselves, others, and the world
• memory and cognitive impairments
• tendency towards all or nothing thinking

Question 4

What are the 5 common areas that trauma disrupts?

Answer 4

• safety
• trust
• power and control
• esteem
• intimacy

Question 5

What are the common diagnoses associated with sexual trauma?

Answer 5

• PTSD
• depression
• SUD
• eating disorders
• physical health problems

Question 6

What are the protective factors for PTSD?

Answer 6

• Family closeness, positive family relationships
• school attachment, community support
• peer support
• emotional regulation skills
• spirituality
• self regard
• cognitive strategies

Question 7

What are the risk factors for PTSD?

Answer 7

• Sever trauma
• physical injury
• ongoing life stress
• lack of social support
• young age/female age
• psychiatric comorbidities
• low SES
• Bereavement
• Poor coping skills

Question 8

What is responsible for encoding fear within a traumatic event and pairs stress with sensory cues?

Answer 8

The amygdala

Question 9

What is the DREAMS Mnemonic for PTSD?

Answer 9

Detachment
Re-experiencing the event
Event had emotional effects
Avoidance
Month in duration
Sympathetic hyperactivity

Question 10

If a patient has PTSD symptoms for less than 1 month, what is the likely diagnosis?

Answer 10

Acute Stress Disorder

Question 11

What are the common clinical comorbidities with PTSD?

Answer 11

Heart disease, autoimmune disease, HLD, interstitial cystitis, dementia, Fibro, chronic pain

Question 12

How can the symptoms of PTSD present in the clinical setting?

Answer 12

• Avoidance (No-showing appointments, not completing therapy assignments)
• Trouble remembering a medication regimen or refusing to take them
• Resistance to therapy material and may challenge opportunities to change
• labile mood, difficulty self regulating, and tolerating distressing emotions

Question 13

What are the treatment goals for PTSD?

Answer 13

• Reduce severity of symptoms
• prevent or treat trauma-related comorbid conditions
• improve adaptive functioning
• restore sense of safety and trust
• prevent relapse
• limit generalization of danger experienced

Question 14

What are the psychotherapy options for PTSD?

Answer 14

• Trauma focused CBT
• EMDR
• Stress management
• Just CBT for those not ready for trauma focused work
• group therapy
• sleep hygiene
• anger management training

Question 15

What are the pharmacological options for the treatment of PTSD?

Answer 15

• Sertaline and Paroxetine
• Other SSRIs/SNRIs
• Trazodone
• Mood stabilizers
• Antipsychotics and benzos are not recommended