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Clinical Psychology > Lecture 7 > Flashcards

Lecture 7 Flashcards

PTSD

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1
Q

individual differences in physical and psychological illness

A

genetics, environment, life style, life events, psychological stressors, personality, coping skills, resilience, social rewords

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2
Q

when did PTSD emerge?

A

after group therapy following the World War

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3
Q

when may PTSD not occur?

A

if coping mechanisms and social support are in place

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4
Q

PTSD

A

trauma and stressor related disorder

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5
Q

individual differences

A

some people can experience traumatic events and are able to deal with them quite well
others may struggle

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6
Q

peripheral nervous system

A

autonomic nervous system
controls the involuntary physiological processes
e.g heart rate and blood pressure

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7
Q

if you saw a shark

A

ANS responds
move fast - increased blood supply to muscles
sharpened senses
heart works harder
release fuel

no time to think about sex
no time to digest last meal
no time to fight infection

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8
Q

hypothalamus

A

regulates the internal systems
in particular hormones such as cortisol

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9
Q

stress

A

a physiological response to a trigger or stressor
a disturbance which if chronic can lead to damage

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10
Q

chronic stress

A

long term high levels of stress can lead to high alert
high ticks - makes head jump thinking about it

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11
Q

Cobb and Rose 1973

A

interaction between stress and hypertension
2 groups of air traffic controllers
busy vs less busy airport
hypertension worse in workers at busy airport
interaction with age

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12
Q

anatomical and psychological factors

A

interactions between mind and body, emotions and personality, can have a big impact on functioning and health of the entire body

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13
Q

historical perspective

A

after World War 1 80,000 soldiers estimated to have shell shock associated with going over the top
flashbacks, nightmares, desertion
war neurosis

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14
Q

prevalence

A

most people with symptoms of PTSd shortly after a traumatic event will recover
approx. 25% of those exposed to a traumatic event will develop PTSD - Green 1994
effects 1 in 12 adults
1-3% of general population
9% exposed to trauma
depends on the severity
3% physical assault
20% wounded in combat
50% rape or sexual assault
7% New York dwellers post 9/11

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15
Q

what causes PTSD?

A

exposure to a traumatic event
- witnessed or experienced threatened or actual death
- threat to physical integrity of self or others
- response involving fear, helplessness or horror
juggling, rape, kidnapping, torture, natural disaster, terrorism, combat

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16
Q

risk factors

A

type of trauma
being female - 2x the risk
males experience different types of trauma - combat
previous exposure to trauma
pre-existing anxiety disorder or substance misuse
sexual trauma
poor social support

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17
Q

behavioural explanation

A

develops through classical conditioning
maintained through operant conditioning

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18
Q

cognitive explanation

A

appraisal - giving a reason to why something is happening
autobiographical memory - memory of past experiences

a matching trigger causes the memories of trauma and negative appraisals so repose is strong emotions

poor elaboration and strong memory leads to a less evolution of a situation

damages hippocampus - damages memory and emotions

19
Q

biological predisposition

A

oversensitive noradrenaline systems
threat detection system
increased levels of noradrenalin in PTSD
vulnerability to PTSD may be inherited

20
Q

brain damage in those with PTSD?

A

Bremner 1993
neuropsychological testing to probe the hippocampus functioning in 26 Vietnam veterans and 15 controls
decreased immediate and delayed recall in veterans

21
Q

does hippocampus size play a role?

A

combat related PTSD
controlled for depression, age, sex and total brain size
smaller hippocampus size and volume
other brain areas remain fine

22
Q

a predisposition?

A

Pitman et al 2012
soft neurological sings of pre-existing hippocampus problems in Vietnam vets with PTSD
- low IQ
- learning difficulties

23
Q

twin study

A

Gilbertson et al 2002
matched case study approach
combat twin with or without PTSD compared to twin at home
combat twin with PTSD = small hippocampus
BUT twin at home had small hippocampus too

24
Q

symptoms

A

intrusions
- flashbacks, nightmares, hallucinations
- distress at exposure to cues
- physiological réponse to cue exposure

avoidance
- avoid thoughts, places, people linked to event
- diminished interest in social engagement
- loss of interest and pleasure
- sense of foreshortened future

hyper arousal
- increased startle response
- hyper vigilance
- insomnia
- irritability
- outbursts of anger
- lack of concentration

25
Q

exposure to actual or threatened death, serous injury or sexual violence in on or more of the following ways:

A

directly experiencing the traumatic event
witnessing the event as it occurs to someone else, in person
learning that a traumatic event occurred tp a close family member or close friend
experiencing repeated or extreme exposure to adverse details of the traumatic event

26
Q

presses of one or more of the following intrusion symptoms associated with the traumatic event, beginning after the traumatic event has occurred

A

recurrent, involuntary and intrusive distressing memories of the traumatic event
recurrent distressing dreams in which the content and/or affect of the dream are related to the traumatic event
dissociative reactions in which the individual feels or acts as if the traumatic events were recurring

27
Q

persistent avoidance of the stimuli associated with the traumatic event, beginning after the traumatic event occurred, as evidence by one or both of the following

A

avoidance of or efforts to avoid distressing memories, thoughts or feelings about or closely associated with the traumatic event
avoidance of or efforts to avoid external reminders that arouse distressing memories, thoughts, or feelings about or closely related with the traumatic event

28
Q

negative altercations in cognition and mood associated with the traumatic event, beginning or worsening after the traumatic event occurred, as evidence by two or more of the following

A

inability to remember an important aspect of the traumatic event
persistent and exaggerated negative beliefs or expectations about ones sled, other or the world
persistent, distorted cognition about the cause or consequences of the traumatic event that lead the individual to blame themself or others
persistent negative emotional state
markedly diminished interest or participation in significant activities
feelings of detachment or estrangement from others
persistent inability to experience positive emotion

29
Q

marked alterations in arousal and reactivity associated with the traumatic event, beginning or worsening after the traumatic event has occurred, as evidence by two or more of the following

A

irritable behaviour and angry outbursts typically expressed as verbal or physical aggression towards people or objects
reckless or self-destructive behaviour
hyper-vigilance
exaggerated startle response
problems with concentration
sleep disturbance

30
Q

following DSM 5 criteria

A

duration of the disturbance is more than a month
the disturbance causes clinically significant distress or impairment in social, occupational or other important areas of functioning
the disturbance os not attributable to the physiological effects of substance or another medical condition

31
Q

medication

A

should come second to trauma based therapy

32
Q

SSRIs

A

SSRIs increase serotonin levels by blocking the reuptake of serotonin into nerve cells

33
Q

SNRIs

A

SNRIs increase both serotonin and norepinephrine levels by blocking the reuptake of both neurotransmitters

34
Q

pros of drug therapy

A

the use of antidepressants can be helpful to reduce the depression that occurs alongside PTSD
the use of anti-anxiety meds can reduce the symptoms of hyper arousal
in some cases, individuals with PTSD may have underlying mental health issues which may need to be addressed

35
Q

cons of drug therapy

A

potential side effects such as nausea, insomnia, sweating, change in appetite
may only work while patient takes medication therefore may not be effective in the long term

36
Q

emotional processing theory

A

Rauch and Foa 2006
traumatic events lead to associations developing among objectively safe reminders of the event, meaning and reposes
changing these associations that lead to unhealthy functioning is the core of emotional processing

37
Q

social cognitive theory

A

Benight and Bandura 2004
incorporating the experience of trauma into existing beliefs leads to unhelpful understandings of their experiences and perceptions of control of the self or the environment

38
Q

cognitive behavioural therapy

A

CBT focuses on the connection between thoughts, feelings, and behaviors, and how changing one can improve the others. For PTSD, CBT uses psychological techniques to help people come to terms with a traumatic event

39
Q

behavioural therapy

A

based on systematic desensitisation
build a hierarchy of imagined images of events
visual flooding
teaching counter measures such as relaxation
exposure therapy
extinguish fear by changing the meaning of the event

40
Q

research supports of psychotherapy

A

meta analysis of studies published between 1980 and 2003 looking at psychotherapy as a treatment for PTSD
results suggested that psychotherapy leads to a large initial improvement from the baseline

41
Q

effectiveness of CBT

A

exposure therapy is as effective ad CBT
CBT is effective but the internet based versions need more evidence
CBT is effective as an early intervention
effective as a treatment following certain types of trauma such as a motor vehicle accident

42
Q

adaptive information processing model

A

Shapiro 1995
all humans possess an information processing system that processes experiences and stores these as memories in a way that are easily accessible and linked to a network of accompanying images, sensations, emotions and beliefs

43
Q

eye movement desensitisation reprocessing

A

the idea behind EMDR is that PTSD symptoms are really a matter of incomplete processed experiences, and your brain is designed to take your everyday experiences and sort them out, store them as useful parts and get rid of those that you don’t need.

thinking about trauma while following therapists finger with eyes
talk about negative thoughts
replace them with positive thoughts with eye exercises
resolve incomplete processing of events

44
Q

critical incident debriefing

A

immediate support within 72 hours
visit the site of the event
prevent PTSD occurring

Clinical Psychology (7 decks)

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