PTSD Flashcards
What are the trauma and stressor-related disorders?
Acute Stress Disorder
Adjustment Disorders
Posttraumatic Stress Disorder
What is the worse trauma and stressor-related disorder?
PTSD
What is adjustment disorder?
not coping well with home, work etc… not necessarily physical nature
What is PTSD?
Exposure to actual or threatened death, serious or sexual violence in which the sense of personal safety is threatened:
- Direct experiencing of traumatic event(s)
- Witnessed in person the events as it occurred to others
- Learning that the traumatic events occurred to person close to them
- Experiencing repeated or extreme exposure to aversive details of trauma
Is PTSD uniquely for threat to physical self?
yes
List of Presence of 1 or more intrusive ex after the event in PTSD:
- Recurrent, involuntary and intrusive memories of event
- Recurrent trauma-related nightmares
- Dissociative reactions
- Intense physiologic distress at cue exposure
- Marked physiological reactivity at cue exposure
List of Persistent avoidance by 1 or both in PTSD:
- Avoidance of distressing memories, thoughts or feelings of the event(s)
- Avoidance of external reminders of that arouse memories of event(s) e.g. people, places, activities
what is a key criteria of PTSD?
re-experiencing involuntary of the events (nightmares, flashbacks)
- Flashbacks : where the person re experiences the event even tho they are not there, something triggers the memory, but it doesn’t feel like a memory they feel like they are back there.
Flashbacks uniquely related to PTSD.
Internal experienced, might not see them reliving it.
- Waking nightmares- while they are awake. Can get these without PTSD.
What is complex PTSD:
kids with trauma, developed permanent physiological high arousal. Ex: huge startle reflex. Ends up in neurological disorders later in life.
what is a theory about PTSD?
always in flight or flight mode
What are the PTSD Changes in Cognitions and Mood?
- Inability to remember an important aspect of the traumatic event(s)
- Persistent distorted cognitions about cause or consequence of event that lead to blame of self or others
- Persistent negative emotional state
- Marked diminished interest
- Feeling detached from others
- Persistent inability to experience positive emotions
What makes it more likely to get PTSD?
- Not processing what happened. People who look like they’ve got nothing, no trauma, seem fine- ones we worry about the most.
- PTSD can start even one year after the trauma.
- Idea that they should’ve been able to prevent it (blaming self)
Is everyone with PTSD angry?
- Not everybody with PTSD becomes angry, but they become emotionally intense in some way.
- Cops scared of them bc they don’t know how they will react.
- Symptoms like depression (diminished interest, detached, no positive emotions)
What are the PTSD Changes in Arousal and Reactivity?
- Irritable behavior and angry outbursts
- Reckless or self-destructive behavior
- Hypervigilance (always imagining its gonna happen again)
- Exaggerated startle response
- Problems with concentration
- Sleep disturbance
What is the epidemiology in PTSD?
- 7-9% of general population
- 60-80% of trauma victims
- 30% of combat veterans
- 50-80% of sexual assault victims
- Increased risk in women, younger people
- Risk increases with “dose” of trauma, lack of social support, pre-existing psychiatric disorder
When is there greater risk to get PTSD?
- Risk is greater the more severe the trauma.
- Greater risk for women bc more vulnerable to assault.
- Men tend to be in situations where more likely to experience trauma (war).
What are the comorbidities of PTSD?
- Depression
- Other anxiety disorders
- Substance use disorders
- Somatization
- Dissociative disorders
What is Acute Stress Disorder?
- Similar exposure as in PTSD
- Presence of >9 of 5 categories of intrusion, negative mood, dissociation, avoidance, and arousal related to the trauma.
- Duration of disturbance is 3 days to 1 month after trauma
- Causes significant impairment
- Does not last anything longer than a month.
Less severe in time and a little bit in symptoms (but symptoms could still be severe)
-prob won’t get flashbacks
-it does cause a significant impairment for the month.
What are the Critics of the PTSD definition?
- PTSD as a homogenous response to trauma BUT not all individuals will develop PTSD.
- Looks at the event, and not at the individual himself
- Not everybody exposed to the trauma get PTSD. Individual differences
What are the PTSD Risk Factors Pre trauma?
- Genetic Predisposition
- Neurological Vulnerabilities
- Developmental Factors
- Psychological Vulnerabilities
- Cognitive Vulnerabilities
What are the PTSD Risk Factors During Trauma?
- Peritraumatic Dissociation
- Cognitive Appraisal
- Biological Reaction
What are the PTSD Risk Factors Post Trauma ?
- Coping
- Social Support
What are the genetic predispositions of PTSD?
Twin study of Vietnam veterans: heritability of .40 (True et al., 1999, 1993)
What is inherited? We don’t rly know, prob arousability. Small component of variability, nothing major.
What are the Neurological vulnerabilities in PTSD?
- Low cortisol levels
- Increased blood flow in left hippocampus
- Amygdala activation with PTSD
- Smaller hippocampal volume as a vulnerability factor for developing PTSD symptoms.
What are the Developmental Risk Factors in PTSD?
Stress sensitization
- Childhood adversity
Attachement styles
- Secure vs Insecure
- If grew up in secure home, less likely to developed
PTSD (ptsd is when event makes u feel the world is
very unsafe- if had unsafe parents, you’ll think you
were right abt the world being unsafe)
History of psychiatric illness
- Family & personal
Does Past trauma predict PTSD of new trauma?
yes
What are the personality factors in PTSD?
Neuroticism
- More intense reactions to stress
- personality traits of anxiety
Impulsivity
- Likelihood of experiencing trauma
- Psychopathology
- more likely to put themselves in harmful situations
Resilience
- Self-efficacy, problem-solving, coping abilities
Optimism
What are the Psychological vulnerabilities in PTSD?
Lack of Social support :
- perception
- availability
- satisfaction
External Locus of control :
- less able to endure stressfull events
- attribution of responsability : Role of responsability and self-blame
What are the Cognitive vulnerabilities in PTSD?
- Negative attributional style
- Problem vs Emotion Focused Coping
- Rumination
- Looming cognitive style (overestimation of the intensity of the threat)
- Cognitive schemas about self, world and future
*this is all before the trauma even happens
What are the Risk Factors During Trauma in PTSD?
Peritraumatic Disassociation
- Altered Sense of Self
- Cause Unclear
- During the trauma, they dissociate, looking at the body from above, Anxiety response
Cognitive Appraisal
- Evaluation of the Situation
- Altered Assumptions
Biological Reaction
- “HPA Deregulation”
What is the Cognitive Appraisal in PTSD?
- “The World is a Safe Place”
- Traumatic Event
- Assumption Shattered
- Generate New Assumption / Integrate Event
- Difficulty
- PTSD
Does assumptions of safety of the world are irrational or feel world is not safe confirm belief?
yes
What are the Post Trauma Risk Factors in PTSD?
- Lack of Social support
- Maladaptive Coping
Has both anxiety & depression components. Neither of it.
Does this apply to one with PTSD, “Anywhere where I think im going to die, or I could die,” ?
yes
How do people with PSTD cope with the event?
- Anger, shame
- Negative appraisals of event, self, others, and world, continues to make nervous, overthinking and hypervigilence
- Avoidance/attempts to suppress thoughts
- Rumination
- Attention bias for trauma-related stimuli
- Experiential Avoidance
What is the experiential avoidance theory in PTSD?
- trauma
- avoidance (physiological, behavioural, cognitive, affective)
- gives temporary relief
- re-experiencing trauma/poor coping
How to treat PTSD?
- Exposure to trauma is a necessary but insufficient condition for the development of PTSD
- Retrospective vs. prospective
Will never forget what happened but should not relive it all the time
Need to acknowledge part of ur life
What are the most consistent risk factors of PTSD?
- Neuroticism
- History of psychiatric illness
- Perceived threat
- Social support
What approach does PTSD treatment need?
Treatment of PTSD requires a multimodal approach that considers
biological predispositions
Personality/psychological factors
Social factors
