Module 3: Trauma Flashcards
What makes an event traumatic (Giller)?
- it overwhelms the individual’s ability to cope
- it is perceived as threatening
- it exceeds the ability to integrate the emotional experience into schemas
What are the typical reactions to trauma?
- physical,
- behavioral
- cognitive
- emotional
Types of traumatic events
- Acts of mass violence
- Natural disasters
- Acts of interpersonal violence
- Accidents
- Psychological abuse
- Deprivation of human rights
- Illness/Injury and its treatment
What is vicarious trauma?
- the individual does not directly experience the traumatic event, but feels traumatized in response to hearing about or seeing images (e.g., photos or videos) of the event.
- can also be from witnessing family/friends go through an event
What factors increase risk of developing vicarious trauma?
o organisational environment
o the therapist’s work experience
o interactions with clients
What is the strongest risk factor of vicarious trauma?
sense of isolsation both at work and home
How to protect psychologists from vicarious trauma?
CARE:
- Connection (managers, friends)
- Awareness (of symptoms)
- Resourcing (work-life balance)
- Effectiveness (training and supervision)
Assumptive World Model
- Janoff Bulman
- We live with 3 underpinning sets of assumptions:
1. benevolent world
2. meaningful world
3. worthiness of self. - these can become shattered and trauma leads to new world views
- Dual Representation Model
- Brewin
- information processing occurs at two levels from the outset of the traumatic event
- Verbally accessible memories (VAM): superficial level, can be accessed as desired, explicit memories.
- Situationally accessible memories (SAM): unconscious level, cannot be deliberately accessed by the victim, automatically triggered
Psychodynamic model - Freud
Traumatic neuroses
Failure of the pleasure principle
Wounding of the mind
Psychodynamic model - Horowitz
Drive towards completion
Active memory storage
Processing overload
Humanistic/existential models
- Considers how the client’s perceived world is changed by the trauma and sees that trauma divides a person’s life into: 3 Phenomenological ‘movements’: Before, during and after trauma
2 major concepts:
1. Emotional processing conflict model
(unfinished business to resolve)
Trauma-related emotion schemes model
(changes in the client’s view of the world, others and self)
Biological impact of trauma:
- attempting to keep homeostasis through allostasis
- neurotransmitters: catecholamines (norepinephrine, epinephrine and dopamine) and glucocorticoids (cortisol).
- emotional loop between the hypothalamus and the amygdala (allostatic load)
What percentage of Australians will experience PTSD in 12 months?
4.4% / 1 million
Life time prevalence of PTSD in Aus?
7.2%
What gender is more likely to experience PTSD?
Women 2 x more likely
What is the military rate of PTSD?
8.3% per 12 months
What are the neurological factors in PTSD?
- endocrine factors
- nuerochemistry
- brain circuitry
What are endocrine factors of PTSD?
- abnormal cortisol and thyroid regulation
- dysregulation of HPA axis
- hypocortisolism (low cortisol)
- HPT axis: elevated levels of tri-odo-thyronine (T3 - anxiety) and thyroxine (T4) in trauma victims
What are neurochemistry factors of PTSD?
Abnormal regulation of:
- catecholamine (dopamine, norepinephrine and epinephrine)
- serotonin
- amino acid (GABA and glutamate),
- peptide,
- opiod neurotransmitters.