PTSD Flashcards
DSM-5 Part A symptoms
Exposure to actual or threatened death, serious injury, or sexual violence
DSM-5 Part B symptoms
Recurrent involuntary and intrusive distressing memories of traumatic event
DSM-5 Part C symptoms
Avoidance of or efforts to avoid distressing memories, thoughts, or feelings about or closely related with the traumatic event
Who created the cognitive model of PTSD
Ehlers and Clark (2000)
Key claims of cognitive model of PTSD
Pre existing traits and cognitive processing during trauma influence the nature of the memory and the appraisal of trauma
What is the nature of trauma memory?
Experiencing dissociation during traumatic event means likely to develop unusual atypical memory of trauma.
What does the filling system do?
Elicited by putting together complex cues in the episodic memory. Trauma gets paired with sensory info which triggers memory
Appraisal of trauma and its consequences
Low self esteem and high self blame
Maladaptive strategies
Avoiding activities and areas related to the trauma creates a vicious cycle - suppressing emotions
Supporting evidence for Ehlers and Clark (2000) model
Ehring et al (2008)
What did Ehring et al (2008) do?
Assessed 147 A&E admissions following road traffic accidents on the day, 2weeks later, 1month later, 3months later and 6months later
What did Ehring et al (2008) find at 2 weeks?
At 2 weeks 33 ppt met PTSD criteria
What did Ehring et al find at 6 months?
At 6 months, 17 ppt still met the criteria for PTSD
What were related to symptoms at 6 months (Ehring et al, 2008)?
Interviews on cognitive processing during trauma, memory disorganisation, negative appraisal & consequences, safety behaviours, rumination, thought suppression + ongoing dissociation.
What is a psychological therapy of PTSD
Trauma focussed cognitive therapy (CBT)
Evidence of CBT for PTSD
Ehlers et al (2005) + Cusak et al (2016)
What did Ehlers et al (2005) aim to do?
They aimed to identify and modify hotspots and appraisal of memory
What is a hotspot
The most traumatic moment of the memory
What is an appraisal
For example being in a car accident and telling yourself your a terrible dad for putting kids at risk
How did Ehlers et al (2005) aim to identify and modify?
Reducing re experiencing by elaborating trauma memory, identifying triggers and breaking link with trauma memory = drop dysfunctional behaviours and cognitive strategies
Supporting evidence of Ehlers et al (2005)
Cusak et al (2016)
What did Cusak et al (2016) do?
Meta analysis showing CBT is effective
Data from 9 studies with range of different controls used
What was the overall effect size found in Cusak et al (2016) meta analysis?
Effect size = 1.36
Confidence intervals = 0.94 - 1.77
This is a very large effect
Limitations of Cusak et al (2016) meta analysis
While used a mix of controls most often was waiting list.
While cognitive therapy is effective, this study found exposure therapy to be the most effective
What is a biological intervention of PTSD?
Pharmacotherapy - SSRIs
What did Ipser and Stein (2012) find in their review?
SSRIs have a small effect on PTSD symptoms compared to the placebo
Who ran an SSRI meta analysis for PTSD?
Hoskins et al (2015)
How many studies did Hoskins et al (2015) use in their meta analysis?
21 studies with 3,930 ppt
How many studies reported no significant effect of SSRIs on PTSD (Hoskins et al, 2015)
13 studies
What was the effect size of Hoskins et al (2015) meta analysis
Effect size = 0.23
Confidence intervals = 0.12 - 0.33
Overall found small statistical significance of SSRIs on PTSD
