Module 2 revision Flashcards
How many people report a traumatic event occuring in their lifetime?
Over ⅔ of people
What is the most common trauma for men and women?
Military trauma is most common for men, rape is most common for women
What is the duration of symptoms needed for PTSD?
1 month - years
What are some struggles people with PTSD often have?
- relationship/martial dissatisfaction,
- divorce
- unemployment
- suicidal thoughts and self-injury,
- physical illnesses
Which gender is more likely to have PTSD and what factor seems to be contributing to this?
Women are 1.5-2x more likely to develop PTSD than men
arguably due to higher likelihood of being sexually assaulted, equal rates of PTSD after sexual abuse is controlled for
What cultural symptom is similar to PTSD?
Ataque de nervios (Puerto Rico)
Why is C-PTSD not in the DSM?
C-PTSD is not considered to be distinct enough from PTSD in the DSM
What are the two steps in Mowrer’s 2-stage model of PTSD?
- PTSD symptoms arise from classical conditioning, but people with PTSD often have elevated tendencies to develop and sustain conditioned fears, due to the severity of the original distressing event
- Operant conditioning maintains the negative association - eg. the intrusive/avoidant symptoms reinforce the distress initially experienced
What does Mowrer’s model help explain about the nature of PTSD?
Mowrer’s 2-stage model also explains how and why these symptoms of PTSD actively maintain the disorder and disrupt/interfere with the fear being reduced/eliminated
What are two features in the brain that are often found in people with PTSD?
- greater amygdala activation
- lower activity in medial prefrontal cortex
What 3 factors influence the chance of developing PTSD?
- duration / repeated exposure
- type of trauma
- severity of trauma
eg. PTSD is higher after seeing war casualties than just being in a warzone,
rates of PTSD are double in soldiers with two tours of Afghanistan compared to those who only had one tour
Why is human based trauma often worse for PTSD than natural disasters?
Distressing events caused by humans are more likely to cause PTSD than natural disasters probably because of the interpersonal effects it has on people’s rates of trustworthiness / targeted nature of the trauma to oneself
What nucleus and neurotransmitter is associated with PTSD?
Nucleus = L— C——–
What does it explain?
locus coeruleus and norepinephrine
it may explain hyperreactivity to threat-related stimuli
What’s up with hippocampi in people with PTSD and what does it help explain?
- diminished activity and often also lower grey matter in hippocampus in cognitive/ ER tasks
- explains diminished ability to distinguish autobiographical memories in space, time and context
What does a diminished smaller hippocampus help explain?
hippocampal changes might increase the risk that a person will experience fear even in safe contexts
What coping strategies may increase risk of PTSD?
- avoidant thinking about event
- dissociating during/immediately after event
What are 2 protective factors against PTSD?
- Strong social support
- Good cognitive (intellectual) ability to ‘make sense’ of distressing events, eg. rationalise and regulate emotions
What are 4 risk factors in PTSD?
- Lack of social support
- Lack of ability to make sense of event
- Tendency to dissociate during/after event / avoid thinking about event
- Comorbid disorders
- What SSRIs work well for PTSD?
- What doesn’t work well?
- paroxetine (Paxil) and sertraline (Zoloft)
- not benzodiazepines
What psych treatment is more effective than medication or other therapies?
- prolonged exposure therapy
What 3 things does prolonged exposure therapy apart from exposure include?
- psychoeducation
- breathing exercises
- challenging thinking patterns about the fear
What 3 things is prolonged exposure therapy trying to achieve?
- overgeneralized fear response
- beliefs of not being able to get through it/confront it
- negative self-beliefs from trauma, eg. reducing self-blame
What other therapies are often used?
1.VR training - exposure, less good
2. Cognitive Processing Therapy (CPT) to reduce self-blame, guilt and dissociation
3. EMDR therapy - to reprocess memories
What is used when patients are unable to go back to trauma in therapy?
imagined exposure
What are the outcomes for internet based CBT?
internet based CBT is shown to relief immediate acute symptoms of PTSD in short term, but not for long term outcomes
What’s the differences in perception and SNS between anxiety and fear?
- Anxiety is an apprehension over an anticipated problem
- moderate arousal from SNS
- leads to moderate physiological changes in body, eg. tension - Fear is a reaction to immediate danger
- high arousal from SNS
- leads to high physiological changes in body, eg. sweat, fight/flight system activated
What is the benefit to moderate anxiety in tests?
Small degrees of anxiety enhances lab performance tasks (Yerkes & Dodson, 1908)
Has an inverse U-shaped curve when plotted against performance
What are 3 examples of stress questionnaires?
- General Health Questionnaire, 38 languages to detect distress in clinical setting
- Kessler Psychological Distress Scale (10, 6 items) to identity significant levels of psych stress for adults
- Distress Questionnaire-5 (5 questions) based on DSM-5 - better validity than Kessler
What Fight or flight response activities occur in the sympathetic nervous system?
sweating, shaking, heart racing, pupils dilating and improved hearing
cortisol release
unnecessary functions are delayed to conserve and redirect energy to the threat
What are the 3 stages of the General Adaptation Syndrome?
- Alarm - encountering a stressor, body releases adrenaline and cortisol in reaction to threat
- Resistance - respiration and heart rate return to normal, glucose, other hormones high
- Exhaustration - after chronic/prolonged stress body’s defences break down
Causes increased risk to infection/disease
What are moderate health risks to stress?
Headaches, loss of appetite, increased blood pressure, sleep issues, sexual dysfunction, chest pain
What are some severe health risks to stress?
Cardiovascular disease, IBS, diabetes and mental health issues