L16 - PTSD Flashcards
1
Q
What is Stress?
A
- Certain level of stress is important for us to function evolutionary and even now
- Prior term was used by engineer: balance between internal/external forces on a body
- When stressor is greater than coping = stress
- Have a stressor: acute/chronic
- Have Distress: stress impedes function
- Have eustress: stress enhances function
2
Q
What are coping strategies?
A
- Problem focused: reduce stressor, adaptive behaviour e.g planning out exam revision
- Emotion focused: changed emotional reaction e.g exercise or meditation
- Appraisal focused: challenge assumptions, adaptive cognitive e.g change relationship to the problem oh well its only one exam
- Engagement/disengagement
- Cognitive/behavioural/social
- Proactive
- Everyone has different levels of vulnerability/resilience in respect to env and bio
3
Q
What makes a stressor stressful?
A
- Physical or emotional external and environmental demands
- External: Severity, duration, timing, and whether traumas are cumulative
- Internal: Personal impact, predictability, controllability
4
Q
What was Selye’s General Adaptation Syndrome?
A
- Exposure phase, and alarm reaction in phase one: fight/flight, shock/counter shock
- Hits a peak and goes to a stage of resistant: coping and appraisal skills used: allostatic load
- Phase 3: exhaustion: normal level of resistance to stress and recovery
5
Q
What mediates the stress response?
A
- HPA: axis: Hypothalamic- Pituitary-Adrenal
- Feedback access with three endocrinal systems
- Stressors = stimulate hypothalamus, releasing a hormone trigger pituitary gland which triggers adrenal glands to secrete cortisol = increases flight/flight response through physiological responses
- Negative feedback loop = when too much cortisol is present, hypothalamus stops production
6
Q
What is PTSD?
A
- Severe Psychological disorder made up of psych and physical symptoms from sudden crisis
- Symptoms must be persistent, elements of trauma are re-experienced, some sense of avoidance of things associated with trauma, and hyperarousal: often anxious and baseline anxiety and stress is increased
- Can be impaired concentration/memory
- Chronic tension/irritability and insomnia
- Feelings of depression
- Some will naturally recover
7
Q
What does the DSM V say about PTSD? (What are the criteria)
A
Criteria A: stressor exposure
Criteria B: intrusion symptoms
Criteria C: avoidance is persistent
Criteria D: negative alterations in mood/cognition
Criteria E: alterations in arousal and reactivity
Criteria G&H: functional significance and attribution
8
Q
What is Complex PTSD?
A
- Contains three clusters of symptoms of PTSD: re-experience trauma in present, persistent sense of threat, avoidance
- CPTSD contains 3 additional symptom clusters:
- Affective dysregulation
- Negative self-concept
- Disturbance in relationships
9
Q
Who will get PTSD?
A
- People who went to war and psychologists listen to trauma and must learn how to manage this
- Members in emergency services/natural disasters
- People who are abused
- More random things like childhood trauma: more likely to be trauma in adulthood
- Increased risk of trauma involved human intent: victims of terrorist attack vs car accident comparison, no diff in symptoms in a week, at 4 weeks months increased PTSD among victims of terrorism
- Increased risk if the trauma is personal in nature: destroys sense of safety and challenge beliefs
10
Q
What are the risks of getting PTSD?
A
- Quite common, US Prevalence 6-8%
- Greater risk if female
- females may experience greater traumas but more males are exposed
- Womens PTSD are more personal
- 1/3 of those who have experienced a traumatic event may go on to develop PTSD
- May affect about 8% of people at some point in life
- Can develop in people of any age, including children
11
Q
What are the risk factors for experiencing trauma
A
- Occupation
- Gender
- Lower education level
- Fam history of trauma, psych disorders
- Conduct problems
- Personality characteristics
- High scores on measures of extraversion and neuroticism
12
Q
What are protective factors/resilience to PTSD?
A
- Cog ability/education: those with higher IQ after event were less likely to develop PTSD as they have better understanding and probably could reflect/integrate experience
- Social support and levels of optimism
- Normality/safe zones
- Increased self-esteem
13
Q
Is the Stress response different in PTSD?
A
- Lower cortisol to normal but heightened response to stress induction
- Higher cortisol at baseline in females
- Lower cortisol among sexual/physical abuse = exhaustion
- Cortisol is easy to measure
14
Q
What is the aetiology of PTSD? (Models)
A
- Diathesis Stress Model: Individual risk factors through genes/pre-natal env
- Early life stress: Neurochemistry, endocrinology, associative learning, cognition
- Things that happen to mum and what we learn e.g sociocultural factors, justification, identification and social support
15
Q
Is there a genetic risk?
A
- Runs in fams: higher risk in children of holocaust survivors & Cambodian refugee children if parents had PTSD
- Evidence from twin studies = 30% concordance
- Genetics - related to risk factors and other anxiety disorders
- Personality traits - childhood conduct problems
