PTSD Flashcards
Define PTSD.
Intense, delayed, prolonged reaction to stressful stimulus.
Event is likely to cause pervasive distress in anyone + usually involves threat to self.
Explain the aetiology/risk factors of PTSD.
Traumatic event (i.e. rape, death, war, torture). May be due to:
- Event challenges held beliefs, resulting in inability to cognitively rationalise
- Normal processing of emotionally charged info leading to overwhelming feeling + memories.
- Negative appraisal of intrusive thoughts, leading to lack of processing + therefore maintaining Sx over time.
Subjective meaning of event is one of the most important factors for development.
Summarise the epidemiology of PTSD.
Lifetime incidence 1-3%.
War veterans 30%.
Give 6 risk factors for PTSD
Younger age
Female
Low SES
Multiple major life stressors
Previous trauma
Past psych hx.
What are the 3 main elements which arise from PTSD?
Re-experiencing/ Intrusion
Avoidance
Hyperarousal
What are 6 signs of hyperarousal?
Hypervigilance
Poor concentration
Feeling tense/ on edge
Sleep disturbance- falling/ staying/ restless
Irritability + angry outbursts
Exaggerated startle response
What are 4 signs of intrusion?
FLASHBACKs: feel as if event recurring, may lose awareness of surroundings
Recurrent NIGHTMAREs with content related to event
Recurrent involuntary + INTRUSIVE distressing MEMORIES of event
Intense psychological distress +/- physiological reaction to internal/ external cues resembling event
What are 3 signs of avoidance?
Avoid memories, thoughts, feelings a/w event
Avoids external reminders
May change routine/ environment
What 6 mood and cognition symptoms may occur in PTSD?
Unable to recall details- dissociative amnesia
Persistent + exaggerated negative beliefs/ expectations about self + others
Persistent distorted cognitions about the cause/ consequences of the event
Diminished interest/ participation in activities
Emotional detachment
Persistent inability to experience positive emotions
For how long do symptoms have to be experienced for PTSD to be diagnosed?
> 1 month
Usually manifest within 6 months of event
How might a PTSD patient appear on examination?
Neglect
Depression
Anxiety
Hypervigilant
Poor eye contact
Tearful
Slow speech
Low mood
Poor concentration
How may PTSD present in children/ adolescents? (6)
Wetting the bed
Forgetting how to/ being unable to talk
Acting out the scary event during playtime
Being unusually clingy with a parent or other adult
Disruptive, disrespectful, destructive behaviour
Feelings of guilt
What screening assessment can be used for PTSD?
Trauma Screening-Questionnaire (TSQ)
What are 3 differentials for PTSD?
Depression: low mood, anhedonia, anergia
GAD: excessive anxiety, restlessness, difficulty concentrating
Adjustment disorder: low mood, anxiety, feeling of inability to cope
What is the short term management for PTSD?
Screen for comorbidities + other MH disorders
Risk assessment for suicide (admit/ CRHT)
