Exam 1: Week 4 content Flashcards
1
Q
what are the criterion for PTSD according to DSM 5? (6)
A
- Criterion A: trauma definition ⇒ cant have PTSD without trauma
- Criterion B: re-experiencing symptoms
- Criterion C: avoidance symptoms
- Criterion D: arousal symptoms
- Criterion E: duration
- Criterion F: impairment
2
Q
what were DSM 4 classifications for PTSD? (3)
A
re-experiencing, avoidance/numbing, arousal, symptoms that last for more than 1 month and cause significant distress
3
Q
how did DSM 5 change PTSD compared to DSSM 4?
A
DSM 5 moved PTSD to a separate category of trauma related disorders
- avoidance is separate and numbness is broadened to include changes in mood and cognitions (self blame, guilt)
4
Q
what are re-experiencing events? (5)
A
- Recurrent, intrusive, distressing memories ⇒ memories that occur without warrant creating distress for someone
- Recurrent distressing dreams ⇒ nightmares that happen almost every night causing someone to not want to sleep
- acting/feeling as if event were recurring ⇒ having a flashback where you think it is happening again now
- Intense distress when exposed to event-related cues
- Physiological reactivity when exposed to event related cues
5
Q
T/F avoidance and numbing symptoms are combined in one category?
A
True
6
Q
CC avoidance symptoms (3)
A
- Efforts to avoid thoughts, feelings, conversation about event
- Efforts to avoid activities, places, people that arouse memories of the event
- Inability to recall an important aspect of the event
7
Q
CC numbing symptoms (4)
A
- Markedly diminished interest/participation in significant activities
- Feelings of detachment from others
- Restricted affect ⇒ can’t love
- Sense of foreshortened future ⇒ doesn’t expect normal lifespan
8
Q
CD arousal symptoms (5)
A
- Difficulty falling or staying asleep
- Irritability or outbursts of anger
- Difficulty concentrating
- Hypervigilance: constantly aware of surroundings
- Exaggerated startle response
9
Q
how long dues duration of experiencing need to be? (CE)
A
avoidance or numbing and arousal symptoms have to last for at least one month
10
Q
impairment (CF)
A
symptoms need to cause clinically significant distress and impairment in functioning
11
Q
what were disorder changes for PTSD in the DSM 5 criteria? (3)
A
- Acute stress disorder ⇒ first month after event
- Adjustment disorders ⇒ distress that doesn’t meet PTSD criteria
- certain things only in children => Reactive attachment disorder and Disinhibited social engagement disorder
12
Q
what happened to criteria C from DSM 4 to 5?
A
went from avoidance/numbing to avoidance and negative changes in cognition 2 separate categories (1 category originally)
13
Q
what does each category need in DSM 5? (how many symptoms for each)
A
- CA: 1
- CB: 1
- CC: 1
- CD: 2
- CE: 2
14
Q
criterion E alterations/arousal activity (5)
A
- irritable/aggressive behavior
- self destructive or reckless behavior
- hyper vigilance
- problems concentrating
- sleep disturbance
15
Q
criterion G
A
functional significance where symptoms are related to distress
16
Q
what are CD negative alterations? (4)
A
- Inability to recall key features of the traumatic event
- Markedly diminished interest in (pre-traumatic) significant activities
- Feeling alienated from others ⇒ detachment or estrangement
- Constricted affect: persistent inability to experience positive emotions
17
Q
what are new CD DSM 5 symptoms? (3)
A
- Persistent negative beliefs and expectations about oneself or the world
- Persistent distorted blame of self or others for causing the traumatic event or resulting consequences
- Persistent negative trauma related emotions ⇒ fear, horror, anger, guilt, or shame
18
Q
which of the following is not one of the four general symptom clusters for PTSD in DSM-V
- Re-experiencing
- Guilt and shame
- Avoidance symptoms
- Alterations in arousal
A
Guilt and shame
19
Q
what percent of people who experienced trauma developed PTSD for all countries?
A
4-8% lifetime PTSD prevalence in total and trauma exposed samples in all countries and US
- 1-2% currently have PTSD among trauma exposed group in past 30 days
20
Q
what percent of US people have PTSD?
A
8-10% approximately for both same event and composite events
- slightly higher for composite events
21
Q
what are prevalence rates for PTSD in college students?
A
about 6-12% but no good studies
- All used to self report symptom checklists ⇒ vs clinical interviews
- Most assess symptoms with regard to a self nominated worst event
22
Q
approximately what percentage of people exposed to criterion A traumatic events develop PTSD?
- 80-90%
- 5-10%
- 20-30%
- 40-50%
A
5-10%
23
Q
what are pre-event categories for PTSD?
A
- demographic characteristics
- prior trauma personality
24
Q
what are event factors for PTSD? (2)
A
- event severity
- event type
25
what are post-event factors for PTSD?
- early symptoms
- social support
26
umbrella review
review of multiple meta analyses
27
how many variables significantly predict PTSD across studies?
57 significantly predict
- Gender => Women (8% vs 4%)
- Race => Native Americans
are both mains
28
what are pre-trauma risk factors?
- prior trauma history
- personality
29
neuroticism
tendency to respond to threat/frustration/loss with negative emotion
30
how does neuroticism connect to PTSD
- neuroticism related to perceiving events as more distressing and other as less supportive
- More neuroticism pre-trauma ⇒ perceive event as more distressing or perceive others as less supportive ⇒ both related to more PTSD symptoms post trauma
31
what are event related risk factors for trauma? (2)
- perceived life threat
- fear distress during event
32
Dissociation during event
The experience of detachment or feeling as if one is outside of one's body ⇒ correlated with PTSD
33
which events are more likely to lead to PTSD?
Interpersonal and sexual violence
- Death of loved ones has a lot of people experiencing PTSD even though the rate is low because it is such a common event
34
which 2 events are important for intervention?
Interpersonal violence is high as well as combat
- Negative affect is very high for interpersonal violence
35
what types of events are associated with higher PTSD risk? (2)
1. Directly experienced events associated with more PTSD risk than events that happened to others
2. Intentional harm is worse than unintentional harm
36
what happens when people have PTSD symptoms early on?
they are much more likely to develop PTSD 4-15 months later
37
how does social support related to PTSD?
lower social support associated with greater risk of PTSD
- Lower social support predicted more PTSD symptoms later (r = 0.1)
- PTSD symptoms predicted lower support later on (r = 0.09)
38
T/F women are more likely to experience traumatic events?
False
- women are 23% less likely to experience potentially traumatic events across studies
39
why do women have PTSD more than men do?
Women are 6 times more likely to report adult sexual assault and almost 3 times more likely to report child sexual abuse
- These events carry high risk to PTSD
- rape has the highest rate of PTSD event
40
T/F when men and women experience the event women still have higher PTSD ratings?
True
- Appraise events as more threatening ⇒ risk factor
- Report a loss of control during the event
- Report fear, helplessness, or horror
- Have dissociative reactions
41
why is trauma a trans diagnostic risk factor?
people with any type of trauma were 3 times more likely than people with no trauma to have any mental disorder
42
which trauma type has the strongest evidence for mental disorders?
childhood traumas
43
what other types of trauma highly related to mental disorders? (3)
- physical abuse
- sexual abuse
- emotional abuse
44
which disorders have the highest odds ratio after trauma?
- Bpd is highest but less studies have been done
- anxiety is also high
- so is OCD, PTSD, and bipolar
45
what is the best evidence for trauma and anxiety? (2)
- physical and emotional abuse are strongest
- 3 and 2 times more likely
46
what mental illnesses do ACEs correlate with?
anxiety and depression
- more ACEs correlate with higher likelihood
- child maltreatment that first occurred in early childhood (0-5) had the strongest relations with adult depression and PTSD symptoms
- Maltreatment that started later was also associated with more symptoms but not as strongly
47
why is early childhood trauma so impactful?
- Negatively affects brain development and neurobiological systems involved in stress responses ⇒ brains are more malleable to experience
- Young kids don't understand cause and effect => think its their fault
- Cant express in words how they feel => especially when the caregiver is the abuser
48
which children are more likely to have PTSD?
when the caregiver also sexually abuses them but also caregiver in general
- especially for attachment problems
- non-caregivers cause more PTSD than caregivers that don't sexually abuse children
49
what is complex ptsd? (3)
1. Affective problems ⇒ emotional dysregulation
2. Negative self concept ⇒ worthlessness, shame/guilt
3. Interpersonal problems ⇒ difficulty sustaining relationships
50
what traits are higher for complex PTSD? (4)
- Anger
- Temper outbursts
- Feeling isolated
- Self worthlessness
51
T/F child abuse is a risk factor for complex PTSD?
True
- Different brain regions may have unique sensitive periods (or windows of vulnerability) to the effects of early stress/trauma
52
what do studies say about sensitive periods?
- Studies suggest that there may be specific sensitive periods in development when exposure to distinct types of maltreatment may differentially increase risk for affective disorders in adulthood
- More work investigating timing of maltreatment and associated clinical outcomes and whether there are sensitive periods in development when maltreatment has more robust consequences on neurobiology
53
comorbidity
presence of more than one diagnosable disorder occurring in an individual at the same time
- Individuals with PTSD often have other comorbid disorders => depression, alcohol abuse, etc.
54
what percent of people with PTSD also have major depression?
about 52%
55
what symptoms of PTSD overlap with depression (5)
- Feelings of worthlessness or guilt
- Loss of interest in activities
- Depressed mood/negative emotional state
- Change in sleep/disturbances
- Problems concentrating
56
moral injury
events that violate your moral code ⇒ can lead to moral injury outcomes
57
what are PMIEs? (3)
- perpetrated by self => doing harm or failing to prevent
- perpetrated by others => witnessing
- betrayed by others => leaders
58
how common are PMIEs in veterans? (3) (marines, combat vets, killing others)
- 38% marines agreed with an item on moral injury
- 38% of combat veterans named a PIE as one of their worst 3 traumas => Most often killing an enemy combatant
- 40-65% have killed a combatant in other studies
Not necessarily morally injurious
59
how were healthcare workers affected during the pandemic?
they felt they violated their own moral code (19%), felt things were morally wrong (55%), or felt betrayed by leaders (45%)
60
how do PTSD and moral injury overlap? (2) (2 distinct)
- guilt and shame are core features of MI but are also symptoms of PTSD ⇒ Criterion D
- betrayal and loss of trust could be part of either depending on the event
- PTSD symptoms like hyperarousal are not central to moral injury
- can experience moral injury without PTSD
61
what do PMIEs lead to? ( x => y => z)
guilt and then PTSD and suicidality
62
what do combat exposures lead to?
fear and PTSD
63
which of the following experiences would be most likely to lead to moral injury?
- Being sexually assaulted by a stranger
- Witnessing civilians being killed in war
- Unexpected death of a loved one
- Being wounded in combat
Witnessing civilians being killed in war?
64
extra card
hehe
