PTSD Flashcards
key characteristic of PTSD
occurrence of preceding traumatic event which symptoms are related to or in the context of
main criteria for PTSD
person exposed to actual/threatened death, serious infjury, sexual violence in follwoing ways
- direct expsoure
-witnessing trauma
- learning a close other was exposed to trauma
- indirect exposure in course of profession
most common triggers for men
military trauma
most common triggers for women
rape
intrusion criteria for PSTD
unwanted memories, nightmares, flashbacks, distress, physical reactivity when exposed to reminders
avoidance criteria for PTSD
avoiding places, people, thoughts, feelings that remind them of the event
- interferes with functioning in a way that is important to them
negative mood and cognitive problems for PTSD
recall failures (blackouts)
detachment
anhedonia
lack of interest in activity
distrust of others
blame of self or others
negative affect
increased arousal and reactivity for PTSD
hyper vigilance
startle response
irritability
poor concentration
difficulty sleeping
self destructive behaviour
how long must symptoms occur for diagnosis
1 month minimum
pstd comorbidity
high comorbidity
93% have another disorder
66% have anxiety disorder
sex differences and PTSD
women 2x more likely to develop PTSD
trauma and PTSD
more trauma/higher degree of trauma - more chance of PTSD
risk factors of PTSD
fear conditioning
amygdala reactivity (excessive)
attentional bias to threat
neuroticism
prominent psych model of PTSD
2 factor theory
- fear must come from somewhere
- challenge of healing comes from avoidance and safety behaviours which prevent fear extinction
neurobiology of PTSD - amygdala and PFC
overactive amygdala makes afraid and determines reactions
PFC is under-active in mitigating this
neurobiology of PTSD - hippocampus
sensitivity of hippocampus is sensitive to stress and cortisol
smaller hippocampal volume
dysfunction in hippocampus
failure to organise and separate memories, leads to overgeneralisation of fear
smaller hippocampus - worse at functioning in segregating memories
dissociation in PTSD
lack of connectedness
experiences of derealisation and depersonalisation
protects people from trauma
more dissociation =>
greater chance of PTSD
more unclear aspects of memory which affects how it can be treated
most important approach to PTSD
cbt and exposure
- involves reminders of event to extinguish anxiety
cogntive restructuring - PTSD
reduce blame
establish coping beliefs
- attrition is high
drugs which help with exposure therapy
MDMA
d-cycloserine
propranolol
MDMA - PTSD
acts on monoamines (serotonin) induces euphoria
- speeds up recovery
d-cycloserine - PTSD
enhances glutamate activity in subregions of amygdala
- improves extinctin learning and efficacy of exposure
Propranolol - PTSD
beta-adrenergic blocker
- stop physical reaction to stress
- interferes with memory reconsolidation
- treats anxiety
