PTSD Flashcards
how does PTSD develop?
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
what kind of symptoms do youth develop?
children/adols may show various symptoms:
- physical (stomach aches)
- emotional (fear, sadness, anger)
- behavioural (nightmares, repetitive play, aggression)
what symptoms are typically seen in each age group?
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
DSM diagnostic criteria: A
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
DSM diagnostic criteria: B symptom clusters
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)
DSM - what is needed for a diagnosis?
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
prevalence rates
4-5% of school-aged children and adols; many others experience PTSD symptoms w/o diagnosis
sex differences
higher rates in girls starting at school-age and adols
- inc likelihood w/ exposure to trauma like SA
age differences
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
comorbidity
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
3 types of trauma factors
pre-trauma factors
peri-trauma factors
post-trauma factors
pre-trauma factors examples
previous trauma exposure, chronic negative life events, psych probs/diagnoses, poverty, loss of parent, family history of psychopathology
peri-trauma factors examples
things that happened around time of trauma: perceived threat, personal injury
post-trauma factors examples
disability/pain, poor parent/family functioning, low social support, maladaptive coping strategies
how do disruptions in emotion regulation following experiences of trauma contribute to adjustment after trauma?
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
describe how disruptions in view of self and others following experiences of trauma contribute to adjustment after trauma
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
describe how disruptions in neurobiological changes following experiences of trauma contribute to adjustment after trauma
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
describe the four possible outcomes of children’s and adolescents’ reaction to trauma
1) no ill effects
2) symptoms are temporary
3) 1+ disorders temporarily
4) ongoing problems
describe the rates at which the four patterns of PTSD outcomes occurred for the young children who had experienced unintentional burns
- 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
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)
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
