PTSD

Question 1

how does PTSD develop?

Answer 1

development of symptoms after exposure to traumatic event(s); involves actual/threatened death or injury (most common are MVA, natural disasters, war/combat, kidnapping, physical/SA)
- diagnostic criteria has widened, now includes witnessing/hearing about death/harm to loved ones

Question 2

what kind of symptoms do youth develop?

Answer 2

children/adols may show various symptoms:
- physical (stomach aches)
- emotional (fear, sadness, anger)
- behavioural (nightmares, repetitive play, aggression)

Question 3

what symptoms are typically seen in each age group?

Answer 3

young/school-aged - experience more nightmares, repetitive play (reenact traumatic event w/ toys), show age inappropriate behs (traumatic sexualization, afraid of strangers, etc)

older children - may have difficulties in school, engage in aggressive/reckless behs

Question 4

DSM diagnostic criteria: A

Answer 4

A. a person 7 or more years old experienced/witnessed/ learned about/repeatedly exposed to traumatic event PLUS symptoms from B.
- symptoms usually begin within 3 months after trauma, although a delay for months/years is not uncommon

Question 5

DSM diagnostic criteria: B symptom clusters

Answer 5

1) intrusion symptoms (memories, dreams, flashbacks)
2) avoidance of things linked to trauma
3) changes in thoughts/mood (elevated fear, inability to feel pos. emotions, self-blame, guilt), and
4) changes in arousal and reactivity (on alert, angry outbursts, sleeping probs)

Question 6

DSM - what is needed for a diagnosis?

Answer 6

PTSD (0-6 years old - NEW): must have A, B1, B4, and B2 OR B3
- across age, symptoms must persist for one month+ and cause sig impairment
- specify w/ delayed expression if diagnostic criteria are not met until 6+ months after event

Question 7

prevalence rates

Answer 7

4-5% of school-aged children and adols; many others experience PTSD symptoms w/o diagnosis

Question 8

sex differences

Answer 8

higher rates in girls starting at school-age and adols
- inc likelihood w/ exposure to trauma like SA

Question 9

age differences

Answer 9

PTSD can be reliably diagnosed in young children after age 1 year
- there is a belief that infants lack cognitive maturity to be effected by trauma –> NOT TRUE!
- under age 3 can remember events
- young children DO NOT outgrow PTSD symptoms

Question 10

comorbidity

Answer 10

children show a variety of symptoms/disorders after a trauma, PTSD is only one possibility
- PTSD co-occurs w/ ODD , separation anxiety (young); depression, anxiety, CD and substance use (school-age and adols)
- higher risk for suicidal and NSSI behs

Question 11

3 types of trauma factors

Answer 11

pre-trauma factors
peri-trauma factors
post-trauma factors

Question 12

pre-trauma factors examples

Answer 12

previous trauma exposure, chronic negative life events, psych probs/diagnoses, poverty, loss of parent, family history of psychopathology

Question 13

peri-trauma factors examples

Answer 13

things that happened around time of trauma: perceived threat, personal injury

Question 14

post-trauma factors examples

Answer 14

disability/pain, poor parent/family functioning, low social support, maladaptive coping strategies

Question 15

how do disruptions in emotion regulation following experiences of trauma contribute to adjustment after trauma?

Answer 15

w/o consistent comfort/ routine to create secure attachments, children may show insecure-disorganized attachment, which leads to avoidance, helplessness, etc. causes inc. risk in falling behind in cog and social dev., and probs in regulating emots + behs

Question 16

describe how disruptions in view of self and others following experiences of trauma contribute to adjustment after trauma

Answer 16

children w/ history of maltreatment are likely to have emot and beh probs. Representation models of self and others are sig because we use experience and expectations to guide us in new situations
- abused children will have neg representation models because they will lack core pos beliefs

Question 17

describe how disruptions in neurobiological changes following experiences of trauma contribute to adjustment after trauma

Answer 17

brain goes through most rapid growth and development from birth to 2 years old. Changes that occur during this sensitive period may become permanent
- experience to trauma may have lasting effects –> accel. neuronal loss, myelination delays, inhibition of neurogenesis, etc

Question 18

describe the four possible outcomes of children’s and adolescents’ reaction to trauma

Answer 18

1) no ill effects
2) symptoms are temporary
3) 1+ disorders temporarily
4) ongoing problems

Question 19

describe the rates at which the four patterns of PTSD outcomes occurred for the young children who had experienced unintentional burns

Answer 19

• comorbidity high, 18% showed recovery from PTSD, 8% showed ongoing problems
• none had no ill effects; all had some distress for period after trauma, most recovered

Question 20

describe the probable diagnosis of PTSD rate patterns for (1) youth present during Fort McMurray wildfire vs not present; (2) youth who saw the fire in person vs didn’t see fire; and (3) youth who had home destroyed vs did not have home destroyed (Brown et al., 2019)

Answer 20

present during fire vs not present: no sig diffs in rates of probable diagnoses

saw the fire in person vs did not see it: higher rates of probable diagnoses in the saw the fire group

home destroyed by fire vs not destroyed: higher rates of probable diagnoses in the home destroyed group