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Psyc337 - Psychopsthology > PTSD > Flashcards

PTSD Flashcards

1
Q

When did PTSD first appear

A

1980 in the DSM-III

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2
Q

What started the interest in studying PTSD

A

Trying to understand what soldiers were exhibiting
Previously known as shell-shock, war neurosis, combat fatigue etc.

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3
Q

How was PTSD conceptualized in the DSM I and II

A

Stressors were seen as triggers of a pre-existing diathesis
Forms of dysfunction that are now known as PTSD were classified in other categories according to presenting symptomatology

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4
Q

Which war led to the study of PTSD

A

Vietnam war

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5
Q

In the Vietnam war high rates of disorder was seen in soldiers. Similar patterns of dysfunction were also seen in survivors of _____ and ______

A

Rape and natural disasters

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6
Q

Why is PTSD considered a departure from other DSM categories

A

Trauma is the presumed common etiological factor (etiology is known) and the disorder is organized around it which is not seen in other psychopathologies

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7
Q

What is criterion A of PTSD

A

Exposure to actual or threatened death, serious injury, or sexual violence

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8
Q

What is criterion B of PTSD

A

Re-experiencing the event in some way (flashbacks, dreams, intrusive thoughts etc.)

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9
Q

What is criterion C of PTSD

A

Persistent avoidance of stimuli associated with the traumatic event (behavioural or cognitive avoidance)

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10
Q

What is criterion D of PTSD

A

Negative alterations in mood and cognitions

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11
Q

What is criterion E of PTSD

A

Marked alterations in arousal and reactivity associated with the traumatic event

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12
Q

What is criterion F of PTSD

A

Duration of the disturbance is more than 1 month

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13
Q

True or false: before the DSM-III, PTSD was thought to be rare with a prevalence of about 3%

A

True

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14
Q

What is the prevalence of PTSD

A

7-8%

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15
Q

What is the gender difference in PTSD

A

2F:1M

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16
Q

True or false: the same rate of men and women who experience trauma, go on to develop PTSD

A

False: 60% of men and 51% of women experience a trauma but prevalence rates are only 7-8%

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17
Q

What is a potential explanation for the discordance between the rates of trauma and the rates of PTSD

A

Some types of trauma might be more likely to lead to PTSD than others

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18
Q

Following trauma, what proportion of people will develop PTSD

A

9%

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19
Q

The highest risk associated with developing PTSD is _____ and ____

A

Assault and violence

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20
Q

What is the proportion of people who get kidnapped and raped that go on to develop PTSD

A

Kidnapped: 54%
Rape: 49%

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21
Q

What do cross-cultural studies reveal about PTSD

A

Rates of PTSD are much higher in developing non-western countries
Many of these studies were done following periods of turmoil - may not be representative prevalence rates
Symptoms vary across cultures

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22
Q

What are some symptoms that were seen in non-western cultures following a trauma that we would not expect to see in a western culture

A

Intense internal pressure (like a bomb is about to go off within the person)
Intense body heat
Concern about social roles

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23
Q

What are some predictors of PTSD following trauma

A

Gender
Familial psychopathology in general, not PTSD specific
Preexisting psychopathology especially depression
Childhood trauma/history of earlier traumas
Having a lower IQ
Social support after trauma

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24
Q

What is it about the nature of the trauma that can predict the onset of PTSD

A

Proximity
Duration
Level of risk
Intention
Psychological processes occurring during and after the trauma - intense sense of helplessness, guilt, shame etc.
Dissociation during the trauma = bad prognosis

25
What is the bi-directional relationship that is implied between social support and the onset of PTSD
PTSD could have caused the erosion of the social support or the lack of social support could have led to the PTSD
26
What are the controversies in defining and classifying
Most common controversy: what constitutes a trauma? - is PTSD a normal response to an abnormal event or is it an abnormal response to a normal, if stressful event In the DSM-III the event had to be outside the range of usual human experience - an extreme response was acceptable What events are outside the range of normal human experience? - rape, murder, torture can be common in some places Can PTSD result from events within a normal range like a car accident Is diathesis more important than the stressor Depression is as likely an outcome following a trauma as PTSD
27
Why did the DSM-IV get rid of “normal human experience”
It was leading to “conceptual bracket creep” - the concept of trauma was getting too broad, too many things were being included
28
Recent studies have looked at the rates of PTSD following traumas, compared to rates of PTSD following stressful life events. What were the results and what controversy does this give rise to?
Rates of PTSD symptoms were higher after life stressors than for traumas. Controversy: Do you need a full-blown trauma for PTSD
29
A study was done on the Vietnam twin registry. Describe it and what did they find
They controlled for combat exposure and even without combat there was some vulnerability to PTSD Same registry: Identical twins (MZ) one server in the war and one did not Results: - Twins who served in the war were much more likely to have PTSD than those who did not - Evidence for genetic factors and etiological events
30
What is the major biological abnormality observed in PTSD
Hippocampus abnormalities
31
What is the hippocampus’ role
Explicit memory processes and encoding of context during fear conditioning Interacts critically with the amygdala during encoding of fear memories
32
What are the hippocampal abnormalities observed
Reduced volume Reduced neuronal integrity reduced functional integrity
33
What is a smaller hippocampus associated with
Verbal memory deficits, combat exposure sensitivity (overgeneralization of fear) Dissociative symptom severity, depression severity, PTSD symptoms severity
34
What is the main problem with the research that has been done on hippocampal volume and PSTD
It is correlation
35
If brain abnormalities observed in PTSD are caused by generative trauma, what should we expect to see?
They would represent a “scar” of the trauma and may still be useful in etiological explanations
36
What is the evidence from animal research that severe stress can damage the hippocampus
Neurotoxicity effects of cortisol: can cause atrophy and cell death of hippocampal neurons The hippocampus is dense with receptors
37
True or false: there is evidence that hippocampal volume is heritable
True
38
If the hippocampal abnormality is an antecedent risk factor for exposure to a traumatic event that could cause PTSD, in who should it be observed?
In people drawn to situations associated with higher probability of trauma
39
If the hippocampal abnormality is an antecedent vulnerability (diathesis) factor for developing PTSD upon exposure to a traumatic event, when should it be observed?
Prior to the exposure to independent acute stress
40
Hippocampal abnormalities may be the consequence of exposure to the traumatic event alone. What would we expect from this?
It should only be observed in individuals who develop PTSD, not other trauma-exposed individuals - associated with the illness itself, not so much the trauma
41
If the hippocampal abnormality is the product of a sequel or complication of PTSD would should be observed?
Should be observed only individuals with PTSD and should exhibit a worsening course; should be associated with more severe course/symptoms
42
What is a prospective design trying to measure in PTSD
Biological factor in individuals prior to traumatic event and then again afterward
43
What is the main issue with prospective designs - give an example
The sample needed is extremely large EX: For a sample of 100 people that develop PTSD and that will not drop out of the study, your starting sample should be a minimum of 1000 people
44
How do twin discordant help us to study PTSD
Identify surrogates for what the trauma-exposed person would be like but for the experience of the traumatic event
45
How is the non-trauma-exposed, identical twin useful to study PTSD
Serves as a comparison point, shares all the genes of exposed twin and much of the exposed twin’s early developmental environment
46
What were the 4 groups in Pitman et al., (2006) study looking at twins’ hippocampal volume
17 combat exposed vietnam veterans with PSTD (ExP+) 17 non-combat exposed co-twins of ExP+ (UxP+) 23 combat-exposed Vietnam veterans without PTSD (ExP-) 23 non-combat exposed co-twins of ExP- (UxP-)
47
If ExP+ were completely different in hippocampal abnormality compared to ExP-, UxP+ and UxP-, what theory of abnormalities would this support
Decreased hippocampal volume may be a PTSD sign or sequel
48
If Exp+ and ExP- were the same and UxP+ and UxP- were the same what theory of hippocampal abnormality would this support
Exposure to the trauma is responsible for the hippocampal abnormalities
49
If ExP+ and UxP+ were the same but ExP- and UxP- were the same what theory of hippocampal abnormality would this support
Genetic abnormality - vulnerability factor to developing PTSD
50
What were the results of the study by Pitman et al., (2006) regarding the demographics of the twins who developed PTSD and those who did not
There were no differences among all participants regarding age and education
51
What was the main result of the Pitman et al. (2006) study regarding MRI brain volumes
The hippocampal volume of the set of twins who one developed PTSD was significantly smaller than the set of twins who did not develop PTSD Total brain volume and total amygdala volume is not significantly different
52
In the Pitman et al. (2006) study, the volume of the hippocampus correlates with ___________ for _______ twins
Post-traumatic stress symptoms; both
53
True or false: in the Pitman and colleagues study (2006), combat severity was significantly associated with hippocampal volume
False: it was not significantly associated
54
What can we conclude from the Pitman and colleagues study
Smaller hippocampal volumes in trauma-exposed individuals diagnosed with severe, unremitting PTSD - consistent with previous research Non-combat-exposed co-twins show comparable hippocampal volumes Suggest smaller hippocampi in PTSD represent a pre-existing, familial vulnerability, not the result of neurotoxicity events Combat-exposed veterans showed higher rates of MDD and more severe alcohol histories but the combat unexposed twin did not
55
True or false: the hippocampal morphology implicated in conditioning and extinction of fear responses in animals may be involved in the contextual processing of fear
True
56
What is the effect hippocampal lesions in rodents
They show stronger fear conditioning
57
What is the relationship between a smaller hippocampal volume and the neuroendocrine regulation of the HPA axis?
There is a diminished neuroendocrine regulation of the HPA axis
58
Smaller inherited hippocampal volumes may predispose individuals to:
Acquire stronger and/or more persistent conditioned emotional responses or a stronger hormonal stress response or both when exposed to a traumatic event

Psyc337 - Psychopsthology (15 decks)

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