PTSD

Question 1

What is PTSD?

Answer 1

An anxiety disorder associated with experiencing or witnessing single/repeated traumatic events that include:

Accidents 
Assault 
Abuse 
Work-related exposure to trauma 
Trauma related to health problems/childbirth experiences 
War and conflict 
Torture

Question 2

Describe the range of symptoms associated with PTSD

Answer 2

Functional impairment including:

• Re-experiencing the event (through intrusive/distressing thoughts, images, flashbacks, nightmares)
• Avoidance behavior (of thoughts, feelings, people, places, activities related to the event)
• Hyperarousal (hypervigilance, anger and irritability)
• Negative alterations in mood and thinking
• Emotional numbing
• Dissociation
• Emotional dysregulation
• Interpersonal difficulties or relationship problems
• Negative self-perception (feeling guilty, defeated or worthless)

Question 3

What are the risk factors associated with PTSD?

Answer 3

Exposure to a traumatic event – so increased risk of experiencing a traumatic event in individuals:

• In the armed forces
• Emergency services
• Journalists
• Refugees and asylum seekers (especially if from areas of conflict)
• Severity of an event (the greater the severity ie. The greater the perceived risk to life of an event, the higher the risk of developing PTSD). * There is also a greater risk if the event involves intentional rather than natural harm/danger.
• Females experience higher rates of PTSD.
• Younger age (those who are younger and experience trauma/disaster).
• Previous experience of trauma.
• Exposure to multiple major life stressors.
• Low social support, or at a social disadvantage.
• History of a mental health disorder.

Question 4

Describe the psychological factors associated with PTSD

Answer 4

Resilience (capacity to maintain healthy psychological and physical functioning in the face of adversity or threat):

• Process flexible adaptation to challenge
• Sense of continuity in beliefs about themselves and their life
• Retain ability to regenerate positive experiences
• Personal impact of the event (individual perception).
• Perceived control over future threats.
• How the individual is prepared to deal with a stressor.
• How the individual interprets trauma

Psychological factors decide the severity of the experience and the likelihood of the development of PTSD.

Question 5

Describe the biological factors associated with PTSD

Answer 5

Evidence of genetic influence of 5-20% in different populations. This is normally associated with the vulnerability towards developing it as the main risk of PTSD is having direct experiencing or witnessing a traumatic event.

Question 6

Describe the treatment options of PTSD

Answer 6

Psychological prevention and treatment with trauma focused CBT or EMDR:

• Cognitive processing therapy
• Cognitive therapy
• Narrative exposure therapy
• Prolonged exposure therapy

Pharmacological treatment:

• SSRIs – paroxetine and sertraline
• venlafaxine

DO NOT offer psychological debriefing as it can increase the risk of developing PTSD due to causing secondary traumatization by making someone talk through a traumatic experience, it medicalizes normal distress and it can prevent protective responses of denial and distancing.