Lecture 15 and 16 PTSD

Question 1

What is stress

Answer 1

The balance between internal and external forces on a body

Question 2

Stressor

Answer 2

acute/chronic – one off event or repeated exposure

Question 3

Distress

Answer 3

stress impedes function

Question 4

Eustress

Answer 4

stress enhances function

Question 5

coping strategies of stress

Answer 5

problem focused, emotion focused, appraisal focused, dis/engagment, cog/behvaioural/social and proactive

Question 6

What makes stressor stressful

Answer 6

External: severity, duration, timing, cumulative
Internal: personal impact, predictability, controllability
Predisposing risk factors

Question 7

Selyes general adaption syndrome

Answer 7

How body withstands stress: alarm, stage of resistance and exhaustion

Question 8

HPA axis

Answer 8

the interaction between the hypothalamus, pituitary gland, and adrenal glands - all necessary for fight and flight

Question 9

What is PTSD

Answer 9

Severe psychological and physical symptoms can result from sudden, unexpected environmental crises.

Question 10

PTSD can include the following

Answer 10

A traumatic event is persistently
person avoids situation
experiences chronic tension or irritability
impacts concentration and memory

Question 11

complex PTSD

Answer 11

Contains 3 clusters of PTSD symptom with affective dysregulation, negative self - concept and disturbances in relationships

Question 12

risk factors for PTSD

Answer 12

Risk of experiencing trauma, risk of PTSD

Question 13

protective factors of resilliance

Answer 13

Cog ability education, social support and increased levels of optimism, normality/safe zones, increased self esteem, increased justification

Question 14

.Genetic risk PTSD?

Answer 14

• Higher risk in children of holocaust survivors + PTSD than – PTSD
• Cambodian refugee children more likely to have PTSD if parents had PTSD

Question 15

Declarative memory

Answer 15

memories that can be consciously recalled (episodic and semantic memory)

Question 16

procedural knowledge

Answer 16

knowledge for basic things we dont tend to think about

Question 17

Memory in PTSD

Answer 17

Two memory systems: situation and verbally accessible memory - SAM is traumatic material that are not voluntarily triggered and are very disruptive

Question 18

Fear distinction in PTSD

Answer 18

Milad et al 2009 - impaired fear extinctions in PTSD - due to dysfunctional activation of brain regions

Question 19

PTSD therapies/treatments

Answer 19

Prevention: law, education, coping skills, stress inculcation training
Medications: SSRIs
Psychological therpay: Trauma focused CBT, prolonged exposure, EMDR and emerging therapies

Question 20

Safety and stabilization in therpay:

Answer 20

• Safe environment
• Enhance coping mechanisms and social support
• Relaxation and emotion regulation skills training e.g., DBT
• Psychoeducation
• If in – patient, consider ward structure and group programme (rare)
• Medications are often used to help stabilise the symptoms prior to psychotherapy AND because in reality the waiting lists for psychological therapy are so long

Question 21

treatment challenges

Answer 21

common maintaining factors: nature of trauma, role in trauma, meaning of trauma, isolation, guiilt
other factors: co - morbidity, alcohol and drugs, co - operation, compliance

Question 22

trauma focused CBT

Answer 22

psycho - education, relaxation, stress inoculation, exposure, behavioral techniques, cognitive restructuring, problem solving