Lecture 6: PTSD Flashcards
Name some diagnostic criteria of PTSD according to DSM-5. Which criterium is required for the diagnosis?
A: Exposure to stressor (Required for diagnosis!)
B: Intrusions (memories, nightmares, flashbacks) C: Avoidance
D: Negative alterations in cognition and mood E: Alterations in arousal and reactivity
F: > 1 month
G: significant distress/dysfunction
Specify: dissociative subtype
Which types of trauma are defined in the DSM-5?
Direct exposure, witnessing the trauma, learning that a relative or close friend was exposed to trauma, indirect exposure to aversive details of the trauma (usually in the course of professional duties, e.g. first responders).
Describe the four steps of memory consolidation. What happens on the cellular and system level during consolidation?
Enconding, consolidation, retrieval and reconsolidation. On a cellular level an increase in synaptic efficiency can be seen, while on the system level a reorganization of neuronal networks takes place.
How are trauma, flashbacks and nightmares related to memory consolidation processes?
Trauma affects encoding of memory, flashbacks and nightmares are dysfunctional forms of retrieval.
Shortly describe the system level consolidation theory. On which factors does the consolidation rely on?
According to this theory, memory consolidation is a gradual process in which memories, initially reliant on the hippocampus, become more and more independent from the hippocampus by being “outsourced” to neocortical networks. The consolidation relies on time and sleep.
Which brain area plays an important role in emotional memories? How does this area influence memory consolidation?
The amygdala is important for emotional memory. It exerts its influence by acting on the hippocampus to prioritize certain memories. This influence can be seen back in theta oscillations.
What happens during repeated periods of sleep to emotional memories in healthy individuals? Which pattern can be seen in individuals with insomnia disorder?
With every period of sleep the affective tone of a memory is decreasing, eventually decoupling completely from the memory. In insomnia disorder the reverse pattern can be seen, with sleep increasing distress levels, while staying awake decreasing distress levels.
Shortly describe the technique of targeted memory reactivation (TMR).
In TMR participants are exposed to a specific perceptual stimulus (e.g. odor) during memory encoding. Then, during slow-wave sleep, the same stimulus is presented again to the participants, thereby reactivating the memory and prioritizing consolidation for this memory.
What was the result of TMR in a fear conditioning setting (Hauner, 2015; compare slide 35 )?
TMR in fear conditioning lead to a decreased fear reaction during awake testing when the fear-conditioned (and targeted-reactivated) stimulus was presented, compared to a control stimulus.
In how far does consolidation for neutral memories differ from consolidation in traumatic memories?
In neutral memories consolidation leads to independence from the hippocampus over time. Moreover, neutral memories become verbally accessible, become integrated into an autobiographical context and can be voluntarily retrieved.
In traumatic memories consolidation does not lead to independence from the hippocampus. Instead the amygdala prioritizes the traumatic experience, linking it to sensory, emotional and autonomic markers. The traumatic memory becomes verbally inaccessible, does not become integrated in an autobiographical context and the retrieval occurs (mostly) involuntary leading to flashbacks and dissociation.
Name some possible strategies to adapt traumatic / fear related memories.
Eliminate old memory trace, disrupt old memory trace, update old memory trace, strengthen old memory trace.
(1) Protein Synthesis Blocker, (2) Exposure therapy (extinction) and (3) targeted memory reactivation.
What is one supposed working mechanism behind psychotherapy for PTSD?
Psychotherapy is supposed to help with (re)consolidating the traumatic memory, by reactivating it through replaying the traumatic situation. The original amygdala response is supposed to vanish and the memory becomes independent from the hippocampus (outsourced to neocortex). In this way the memory is integrated in an autobiographical context and becomes verbally accessible (my interpretation of the slide 55).
Name some possible immediate interventions after a traumatic experience.
Pharmacological treatments, including propanolol, cortisol and oxytocin, as well as sleep deprivation.
