PTSD

Question 1

What are the 4 broad diagnostic criteria for PTSD?

Answer 1

1. Intrusion symptoms (nightmares, flashbacks, intrusive memories)
2. Avoidance of trauma salient stimuli
3. Negative alterations in mood and cognitions related to trauma
4. Alterations in arousal and reactivity (e.g., hypervigilance, sleep problems)

Question 2

How does PTSD persist according to elhers and Clark cognitive model of PTSD? (Two maintenance processes that result in sense of serious current threat)

Answer 2

1. Appraisal of the trauma and trauma symptoms is negative and global (e.g., nowhere is safe, I’m going crazy, no one understands me). Leads to negative emotional states, e.g., fear, guilt, shame.
2. Nature of trauma memory - fragmented, highly sensory and affective, easily triggered, intrusive and involuntary. NOT integrated into autobiographical memory.

Question 3

How does elaboration and incorporation of the trauma memory into autobiographical memory reduce intrusion symptoms?

Answer 3

Enhances intentional semantic recall route
Inhibits involuntary retrieval triggered by trauma related stimuli (e.g., smells, music, environmental cues such as orange road cones)

Question 4

According to the cognitive model of ptsd (ehlers and Clark) what are the three key targets for treatment?

Answer 4

1. Trauma memory needs to be elaborated and integrated into autobiographical memory (placed in context and time)
2. Cognitive restructuring of negative appraisals of trauma and its sequelae
3. Behaviours such as avoidance, escape, and safety behaviour that prevent memory elaboration need to be dropped. Reintegrate previous activities they dropped from their life (e.g., hobbies, sport, social activities)