Lewis- PTSD Flashcards
PTSD must occur for at least ___while ASD lasts up to ____.
1 month
1 month
PTSD is more prevalent among males or females?
Females
Adults diagnosed with PTSD are more likely to also be diagnosed with:
Depression, anxiety and SUD
NOT ODD
What is reactive attachment disorder?
- Patter of withdrawn behavior from adult caregivers
- Persistent social and emotional disturbance
- a pattern of extremes of insufficient care
What is disinhibited social engagement disorder?
Similar to RAD, it instead of disengagement it involves culturally inappropriate overly familiar behavior with relative strangers.
What are adjustment disorders?
Stress-response syndromes occurring after exposure to a distressing event
- begins w/in 3 months of onset of stressor and lasts no longer than 6 months after stressors
- Adjustment disorders last 1 month then progress to PTSD
What is PTSD?
A reaction to a serious traumatic event that involves actual threatened death, serious injury or sexual violation.
How is it possible to experience trauma associated w/ PTSD?
Direcly experiencing
Witnessing in person
Learning that event has happened to a close friend/family member
Repeated exposure to aversive details of event (first responders)
What are the four general groups that symptoms are associated with?
Intrusive sx (flashbacks)
Avoidance (people/places/activities)
Negative alterations in cognition and mood
Alterations of arousal and reactivity (hypervigilance)
How long do PTSD sx last?
At least 1 month
What are examples of traumatic events experienced directly (A1)?
- Military related
- Personal assault
- Accidents/disasters
What are examples of witnessed traumatic events (A2)?
- Accident of war, disaster, other
- Injury to other
- Death of other
- Domestic violence
- Life-threatening illness/experience of child
What are examples of indirect exposure to traumatic events A3?
Learning of violent assault, serious accident, unexpected death, life-threatening disesase
What are examples of traumatic events experienced repeatedly (A4)?
Repeated exposure to aversive details of an event
First responders to accidents
Social workers, therapists, POs, psychologists
What occurs during a traumatic event?
NE is released causing sympathetic activation that activates the fear response.
What is the cause of too much NE?
Hypervigalence, autonomic arousal, flashbacks and intrusive memories
What is the cause of too little seratonin?
Aggression, violence, impulsivity, depression and anxiety
What happens neurochemically to pts with PTSD?
The switch is stuck on leading to too much NE and not enough 5HT
What is the prevalence of PTSD?
10% women
5% men
Which event has the greatest risk of causing PTSD?
Rape
severe beating/assault
serious accident
What is the prevalence of PTSD causing events by gender?
Men- rape, combat exposure, childhood neglect
Women- rape, sexual molestation, physical attack
What are the comorbidities associated w/ PTSD by gender?
W- anxiety and depression
M- irritability, impulsiveness and Substance abuse
What percentage of PTSD sufferers have a comorbid disorder that may precede, follow or emerge concurrently w/ PTSD?
80%
Anxiety Disorder, affective disorders, SUD, somatization, psychosis
Children-ODD, SAD
Women and men who have PTSD are more likely to develop major depression and mania.
TRUE
What is the rate of attempted suicide in pts with PTSD?
20%
How can you assess PTSD through DREAMS?
Detachment
Re-experiencing the event
Event had emotional effects
Avoidance
Month in duration
Sympathetic hyperactivity or hyper-vigilance
*Components are a clue that a full diagnostic exam may be necessary
What is secondary stress?
Partners develop symptoms that mirror PTSD without any primary trauma experience.
What is exposure therapy
Education about common reactions to trauma, breathing retraining and repeated exposure to the past trauma in graduated doses. Goal is for traumatic event to be remembered w/out anxiety/panic.
What is cognitive therapy?
Separating intrusive thoughts from the associated anxiety that they produce.
What is stress inoculation traning.
Variation of exposure training teaches clients to relax. Helps client to relax when thinking about traumatic event by providing them a script.
What is CBT?
Cognitive re-structuring
Creating different relationships with triggers
What SSRIs are used to treat PTSD?
Sertraline, Paroxetine, Citalopram, Fluvovoxamine, Fluxetine
-Affects conc of 5ht and may reduce depression, anger, outbursts, avoidant, hyperarousal sx and numbing
How do TCAs affect PTSD?
They affect concentration and activity of neurotransmitters 5TH and NE
-reduce insomnia, dream disturbance, anxiety, guilt, flashbacks and depression
What medication is used for children w/ PTSD?
Prozac and Zoloft (for OCD) in children in conjunction w/ therapy
