Post-Traumatic Stress Disorder Flashcards
Define PTSD.
Anxiety disorder as a response to experiencing a traumatic event
What kind of events cause PTSD ?
Experiencing or witnessing single, repeated or multiple 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
Identify historical time periods or events which contribued to a better understanding of PTSD.
1) RAILWAY SPINE ( 19th Century, after Industrial Revolution)
- Variety of physical disorders in otherwise healthy and apparently uninjured railway accident victims. First thought to result from molecular changes in the spinal cord.
- But: The horror of experiencing a railway accident was part or all of the syndrome.
2) SHELL SHOCK (WW1)
- Cases of PTSD-like symptoms
- Widely believes that the concussion of artillery shells cause CNS damage
- But: This did not explain the cases of shock or distress among those who were not exposed to the exploding shells
- Studies based on veterans from WW1 (and WW2) concluded that most cases were psychological in origin, not organic
3) VIETNAM
- Extent and severity of distress among Vietnam veterans contributed to the evolution of PTSD as an independent diagnostic category
What is the lifetime prevalence of PTSD ?
6.8% (changes according to diagnostic criteria used)
What are the most common traumas leading to PTSD for men, and women ?
Men: Combat
Women: Sexual molestation
What proportion of people who experienced a traumatic event develop PTSD ?
25-30% of people who experienced a traumatic even develop PTSD.
What age groups does PTSD affect ?
Can affect people of any age.
Describe the timeline of symptoms of PTSD following the traumatic event.
- Symptoms can develop immediately but in some (<15%) the onset of symptoms may be delayed
- Symptoms subside in many people over time, and symptoms wax and wane (so important to examine long term experience)
Identify barriers to PTSD treatment.
- 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 when presenting with associated complaints.
- Many sufferers may also believe that it’s untreatable posing a barrier to seeking and getting treatment.
Identify the main symptoms of PTSD.
• Range of symptoms associated with functional impairment, including:
- Re-experiencing
- Avoidance
- Hyperarousal (including hypervigilance, and irritability)
- Negative alterations in mood and thinking
- Emotional numbing
- Dissociation
- Emotional dysregulation
- Interpersonal difficulties or problems in relationships
- Negative self perception (including feeling diminished, defeated, or worthless)
• Also much evidence that feelings of guilt, shame, sadness, betrayal, humiliation and anger frequently go with PTSD
Describe the symptom of re-experiencing in PTSD.
- Trauma is re-experienced through intrusive and distressing thoughts, images, flashbacks, or nightmares.
-Flashbacks feel ‘real’.
Acting or feeling like the event is recurring.
Describe the symptom of avoidance in PTSD.
Avoidance of thoughts, feelings, people, places, and activities related to the event.
Describe the symptom of hyperarousal in PTSD.
- Physiological reactivity (e.g. increased HR, exaggerated startle response)
- Sleep disturbance
- Irritability
- Anger
- Hypervigilance
What characteristic of a traumatic event make it more likely to cause PTSD ?
- Stressors involving intentional harm are more likely to cause PTSD than are natural disasters.
- How deliberate human-caused stressors are judged to be also seem to be important
- 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
➡ All affect how severe the impact of a stressor may be and how likely an individual is to develop PTSD
Identify risk factors for development of PTSD.
• Exposure to a traumatic event — the type of event affects the risk of PTSD, with higher rates reported following rape and physical assault than following an accident. People who may be at greater risk of experiencing trauma include:
-Members of the armed forces (including combat veterans and ex-service personnel).
-Members of the ambulance, police, prison, and fire services, other emergency personnel (including those no longer in service).
-Nursing and medical professionals (especially in front-line situations, such as casualty).
-Journalists.
-Refugees and asylum seekers (especially those from conflict zones).
• Severity of the incident — in general, the more severe the trauamatic event (and the greater the perceived threat to life) the higher the chance of PTSD.
• Female sex — overall, women experience higher rates of PTSD than men, however, this varies depending on the type of trauma and specific age group being assessed.
• Younger age — among people exposed to disaster or trauma, older adults have a lower risk of developing PTSD than younger adults.
• Previous experience of trauma.
• Presence of multiple major life stressors.
• Low social support, social disadvantage — meta-analyses have identified level of social support as one of the strongest predictors of PTSD.
• History of a mental health disorder.
