Post-traumatic stress disorder Flashcards
What is PTSD ?
PTSD - An anxiety disorder
Associated with experiencing or witnessing single, repeated or multiples events that could include:
- Serious accidents
- Assault (physical or sexual)
- Abuse (including childhood or domestic)
- Work-related exposure to trauma (including remote exposure)
- Trauma related to serious health problems or childbirth experiences (e.g intensive care admission or neonatal death)
- War and conflict
- Torture
COVID ICU increased this
You don’t need to be the one experienced the trauma you can get it resulting from someone else getting it
What did studies on WW 1 and 2 veterans show with their PTSD like symptoms?
It was initially believed that the concussion or artillery shells would cause CNS damage
This did not explain the cases of shock or distress among those who were not exposed to the exploding shells
Studies were conducted which showed that most cases of PTSD were psychological in origin and not organic.
Particularly the extend and severity of distress among Vietnam veterans contributed to the evolution of PTSD as an independent diagnosis category
However tragedy is not limited to war and the development of PTSD is not limited to soldiers
How common is PTSD?
Estimated lifetime prevalence: 6.8% (these numbers will change according to the diagnostic criteria used)
Most common traumas are combat for men and sexual molestation for woman (O’Carroll 2019)
It can affect people of any age
Not everyone who experiences trauma develops PTSD: NICE 2019: 25% - 30% of people who experienced a traumatic event develop PTSD
When are symptoms likely to develop, when will patients seek help and how can we help them?
- Symptoms can develop immediately but in some (<15%) the onset of symptoms may be delayed
- PTSD sufferers may not seek help for months / years despite considerable distress
- Assessment of PTSD can, however, present significant challenges as many people avoid talking about their problems presenting with associated complaints
- Many sufferers may also believe its untreatable posing a barrier to seeking and getting treatment
Why should you check in on PTSD patients long term ?
Because PTSD symptoms subside in many people over time, symptoms wax and wane, it is important to examine long term experience
Vast bulk of symptoms subside within 1 month (mental health won’t see) , after this is PTSD
What are the core features of PTSD?
PTSD and complex PTSD may present with the following;
- Re-experiencing
- Avoidance
- Hyperarousal (including hyper vigilance, anger and irritability)
- Negative alterations in mood and thinking
What are intrusive memories / Re-experiencing symptoms ?
Trauma is re-experienced through intrusive and distressing thoughts, images, flashbacks or nightmares
Flashbacks feel ‘real’ acting or feeling like the event is recurring
What is avoidance ?
Avoidance of thoughts, feelings, people, places and activities related to the event
What is Hyperarousal ?
Constantly on alert!
Will experience;
- Physiological activity (e.g increased heart rate)
- Sleep disturbance
- Irritability
- Anger
- Hypervigilance
What are some risk factors for developing PTSD?
- Exposure to a traumatic event
- Severity of incident
- Female sex
- Younger age
- Previous experience of trauma
- Presence of multiple major life stressors
- Low social support, social disadvantage
- History of mental health disorder
- In children exposed to trauma, the risk of PTSD is reduced by good family support and when there its less parental distress
What is more likely to cause PTSD natural disasters of intentional harm ?
Stressors involving International harm appear more likely to cause PTSD than are natural disasters
How deliberate human-caused stressors are judged to be also seem to be important
What are the susceptibility factors in PTSD?
- Psychological
- Biological
What are some Psychological factors preventing PTSD?
Resilience !
- Majority of adults are exposed to at least one potentially traumatic event in their lifetimes
- Although most experience confusion and distress, only a small subset of exposed adults develop PTSD
- Adult capacity to maintain healthy psychological and physical functioning: Resilience
In 9/11 65% of the respondents had only 1 or no PTSD symptoms for the first 6 months
- Even more than half of people who were in World Trade Centre at time exhibited resilience
What are the Characteristics of Resilient people ?
Exceptional coping abilities ?
Denial?
- Evidence suggest its neither !
Characteristics of resilient people;
- Process a flexible adaptation to challenges
- Sense of continuity in their beliefs about themselves / lives
- Retain ability to regenerate positive experiences
What are some other Psychological factors that may precipitate PTSD?
- Personal impact of the event
- The extent of perceived control over future threats
- How one is prepared to deal with a stressor
- One’s beliefs and assumptions about trauma
These all affect how severe the impact of a stressor may be and how likely an individual is to develop PTSD
