Lecture 15 and 16 PTSD Flashcards
What is stress
The balance between internal and external forces on a body
Stressor
acute/chronic – one off event or repeated exposure
Distress
stress impedes function
Eustress
stress enhances function
coping strategies of stress
problem focused, emotion focused, appraisal focused, dis/engagment, cog/behvaioural/social and proactive
What makes stressor stressful
External: severity, duration, timing, cumulative
Internal: personal impact, predictability, controllability
Predisposing risk factors
Selyes general adaption syndrome
How body withstands stress: alarm, stage of resistance and exhaustion
HPA axis
the interaction between the hypothalamus, pituitary gland, and adrenal glands - all necessary for fight and flight
What is PTSD
Severe psychological and physical symptoms can result from sudden, unexpected environmental crises.
PTSD can include the following
A traumatic event is persistently
person avoids situation
experiences chronic tension or irritability
impacts concentration and memory
complex PTSD
Contains 3 clusters of PTSD symptom with affective dysregulation, negative self - concept and disturbances in relationships
risk factors for PTSD
Risk of experiencing trauma, risk of PTSD
protective factors of resilliance
Cog ability education, social support and increased levels of optimism, normality/safe zones, increased self esteem, increased justification
.Genetic risk PTSD?
- Higher risk in children of holocaust survivors + PTSD than – PTSD
- Cambodian refugee children more likely to have PTSD if parents had PTSD
Declarative memory
memories that can be consciously recalled (episodic and semantic memory)
procedural knowledge
knowledge for basic things we dont tend to think about
Memory in PTSD
Two memory systems: situation and verbally accessible memory - SAM is traumatic material that are not voluntarily triggered and are very disruptive
Fear distinction in PTSD
Milad et al 2009 - impaired fear extinctions in PTSD - due to dysfunctional activation of brain regions
PTSD therapies/treatments
Prevention: law, education, coping skills, stress inculcation training
Medications: SSRIs
Psychological therpay: Trauma focused CBT, prolonged exposure, EMDR and emerging therapies
Safety and stabilization in therpay:
- 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
treatment challenges
common maintaining factors: nature of trauma, role in trauma, meaning of trauma, isolation, guiilt
other factors: co - morbidity, alcohol and drugs, co - operation, compliance
trauma focused CBT
psycho - education, relaxation, stress inoculation, exposure, behavioral techniques, cognitive restructuring, problem solving
