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336: Clinical Psychology > PTSD > Flashcards

PTSD Flashcards

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1
Q

What is Trauma

A

experiencing or witnessing a life-threatening event

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2
Q

What is the diagnostic criteria for PTSD

A
  1. exposure to a traumatic event
  2. one intrusion symptom
  3. one avoidance symptom
  4. two+ negative cognitions and mood
  5. two arousals and reactivity
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3
Q

what is the duration required to be diagnosed with PTSD

A

at least one month

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4
Q

Provide examples of intrusion symptoms

A
  1. persistent and distressing memories
  2. recurrent nightmares
  3. dissociative reactions
  4. intense psychological and physiological reaction in response to trauma cues
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5
Q

Provide an example of a negative cognition and mood symptom

A
  1. guilt, anger, fear
  2. numbing and amnesia of positive feelings
  3. self-blame
  4. blame of others
  5. negative beliefs of self, others, and world
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6
Q

Provide an example of arousal and reactivity symptoms

A
  1. sleep difficulties
  2. concentration impairment
  3. hypervigilance
  4. aggressive or irritable behaviour
  5. recklessness
  6. self-destructive behaviour
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7
Q

What is PTSD with delayed expression

A

when the diagnostic threshold is not met until at least 6 months after the traumatic event

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8
Q

What is acute PTSD

A

PTSD with a duration of 3 days to one month

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9
Q

What is PTSD subtype for children

A
  1. do not display as many avoidance and mood symptoms
  2. more behaviorally anchored
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10
Q

What is PTSD with prominent dissociative symptoms

A
  1. meet criteria of PTSD
  2. experience depersonalization or derealization
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11
Q

What is the internalizing subtype of PTSD

A

those with a tendency to direct distress inwardly through shame and self-deprecation

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12
Q

What is the externalizing subtype of PTSD

A

those with a tendency to express distress outwardly by blaming others and acting out

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13
Q

What is the lifetime prevalence of PTSD

A

~7%

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14
Q

What is the gender ratio for PTSD

A

3:1
women 3x more likely to have a diagnosis

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15
Q

what is the gender ratio is veteran populations for PTSD

A

1:1

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16
Q

What disorders is PTSD frequently comorbid with

A
  1. MDD
  2. GAD
  3. Alcohol and Substance abuse
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17
Q

What does it mean when it is said: “ exposure to trauma is a necessary but not a sufficient cause of PTSD.”

A

Explains that some people are more at risk for developing PTSD in the face of trauma than others

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18
Q

What are the demographic risk factors for the development of PTSD

A
  1. female gender
  2. lower levels of income
  3. lower levels of education
  4. divorced/widowed
  5. minority status
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19
Q

What are the psychological risk factors for the development of PTSD

A
  1. family psychiatric history
  2. intergenerational trauma
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20
Q

What are the environmental risk factors for the development of PTSD

A
  1. childhood abuse
  2. exposure to violence
  3. adverse childhood experiences
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21
Q

What are pre-traumatic risk factors

A

characteristics of the individual and their environment that preceded the trauma and impact their response to it

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22
Q

What are peri-traumatic risk factors

A

characteristics of the trauma, the individual, and their environment that impact the response to the trauma

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23
Q

What are post-traumatic risk factors

A

characteristics of the individual and their environment that occur after the trauma and impact their response to it

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24
Q

What are examples of per-traumatic risk factors

A
  1. assault
  2. sudden death of a loved one
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25
Q

What are examples of post-traumatic risk factors

A
  1. lack of social support
  2. additional stressful life events
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26
Q

What are resilience factors related to PTSD

A
  1. spirituality
  2. connections to family and friends
  3. close bonds as a result of shared history and experiences or culture
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27
Q

How does the Nonadrenigc system act as a risk factor for PTSD

A

heightened norepinephrine reactivity is an important marker for PTSD

28
Q

How does the HPA axis act as a risk factor for PTSD

A
  1. those with PTSD have higher corticotrophin-releasing factors in spinal fluid
  2. promotes the release of cortisol (more stress)
29
Q

How is GABA a risk factor for PTSD

A
  1. those with PTSD were found to have reduced benzodiazepine receptor density in the prefrontal cortex
  2. lower plasma GABA levels
30
Q

How is Serontonin a risk factor for PTSD

A

those with PTSD found to have decreased platelet serotonin uptake

31
Q

How is Dopamine a risk factor for PTSD

A

those with PTSD found to have excessive dopamine release

32
Q

What brain regions were implicated in PTSD

A
  1. amygdala
  2. medial prefrontal cortex
  3. anterior cingulate cortex
  4. hippocampus
33
Q

How did PTSD impact amygdala responsiveness

A

positive correlation between the structures with heightened activity in the amygdala

34
Q

How did PTSD impact mPFC responsiveness

A

negative correlation with less activity in the mPFC

35
Q

What brain structures showed decreased volume in PTSD

A

hippocampus

36
Q

What is the dual representation theory of PTSD

A

accounts for the phenomena of flashbacks, intrusive memories and fragmented memory

37
Q

What does the dual representation theory of PTSD say about memory storage

A

memories of a traumatic experiecne can be stored in two ways:
1. verbally accessible memories
2. situationally accessible memories

38
Q

What are verbally accessible memories

A

Information the individual can attend to before, during and after the trauma & can be transferred into long term memory

39
Q

What are situationally accessible memories

A

memories that contain nonconscious and nonverbal information about the trauma & cannot be accessed or altered deliberately

40
Q

How are situational accessible memories triggered

A

flashbacks, nightmares, intrusive images

41
Q

What are primary emotions? provide examples

A

emotions conditioned during the traumatic event

Examples:
1. fear
2. helplessness
3. horror

42
Q

What are secondary emotions? provide examples

A

emotions that result from remembering the event

examples:
1. anger
2. shame
3. sadness

43
Q

What is the apparent paradox of memory

A

Memory that is encoded during the trauma is integrated poorly with other memories. This explains why people with PTSD have poor autobiographical memory of the event but may be triggered to have memory fragments

44
Q

What are memory fragments

A

Memories that have a her-and-now quality (no time context) and do not have appropriate post-trauma appraisals

45
Q

Why does the paradox of memory occur

A

Intentional memory recall is poor, so it is hard to recall a complete trauma memory.

But unintentional recall is vivid, so an individual may have flashbacks that feel as though they are occurring in the present - not reliable and may contradict learned information.

46
Q

What are maladaptive coping strategies

A

coping strategies that increase symptoms, prevent change in negative appraisals, and prevent change in trauma memory

47
Q

What are examples of maladaptive coping strategies

A
  1. though suppression
  2. safety behaviours
  3. avoidance
  4. drugs and alcohol
  5. rumination
  6. dissociation
48
Q

What are altered cognitions

A

When trauma victims integrate their traumatic events into their overall conceptual systems (schemas, scripts, etc.)

49
Q

what are the three major assumptions that may be shattered in the face of a traumatic event

A
  1. personal invulnerability
  2. the world as a meaningful and predictable place
  3. self as positive or worthy
50
Q

what are six major areas of functioning that can be disrupted by traumatic victimization

A
  1. agency
  2. safety
  3. trust
  4. power/control
  5. esteem
  6. intimacy
51
Q

What is the two-factor theory?

A

Proposed that anxiety is first acquired through classical conditioning

anxiety is then maintained because the person escapes or avoids the conditioned stimuli in an attempt to stop the negative emotions

52
Q

What is the pathological fear structure theory of PTSD

A

Following traumatic events, a fear structure develops that is composed of fear stimuli and responses

the structure can be activated by the environment and trigger false alarms and axiety. fear of false alarms ignites avoidance behaviour

53
Q

What is the conservation of resources theory

A

Stress occurs when resources are threatened. Traumatic stress results in the sudden and rapid loss of resources

54
Q

What is the goal of CBT of PTSD

A
  1. restructure maladaptive thoughts
  2. integrate trauma memory into autobiographical memory
  3. replace maladaptive behaviours with adaptive ones
55
Q

what is prolonged exposure treatment

A

involves both imaginal and in vivo exposure techniques

56
Q

What is imaginal exposure

A

exposure of the trauma memory through story telling

57
Q

What are the mechanisms of imaginal exposure

A
  1. promote habituation
  2. reduce anxiety
  3. confront memory blocks
  4. incorporate safety information
  5. differentiate memory
  6. modify negative evaluations
58
Q

What is in vivo exposure

A

exposure to trauma-related stimuli in the environment

59
Q

What are the mechanisms of in vivo exposure

A
  1. emotional engagement
  2. habituation
  3. cognitive restructuring
60
Q

how does prolonged exposure treatment work

A

A person much activate the trauma, block the negative reinforcement, habituate to anxiety, and disconfirm maladaptive beliefs

Through this, anxiety diminishes - as anxiety diminishes, they can change their beliefs

61
Q

What is cognitive processing therapy

A

uses cognitive approaches with progressive worksheets to teach clients to become their own therapists

62
Q

What is critical incident stress debriefing

A

group intervention to educate individuals about stress reactions and ways of coping

63
Q

What are the tenets of psychological first aid

A
  1. victims demonstrate resilience and services should be provided to those requesting assistance
  2. for those who ask for help the provision of basic support might help reduce distress
64
Q

What are the components of psychological first aid

A
  1. contact and engagement
  2. stabilization
  3. needs assessment
  4. safety planning
  5. practical assistance
  6. connection with social support
  7. information on coping
  8. linkage with professional services
65
Q

What is the frontline pharmacological treatment for PTSD

A

SSRIs

336: Clinical Psychology (4 decks)

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