PTSD Flashcards
On Exam 3 (Apr. 22) - at least it should be
What is the main criteria for PTSD?
Exposure to an external traumatic event, either directly experienced or witnessed (either one time or repeated)
What are the four domains of PTSD symptoms and what falls under each of them?
1- Intrusion: persistent memory of the trauma, nightmares, flashbacks, and intense response to cues
2- Avoidance: avoidance of internal cues and avoidance of external reminders such as people or places
3- Negative alteration in cognition and mood: numbing, amnesia, strong negative emotions like guilt, unwarranted blame for oneself or others, and negative beliefs about self and the world
4- Arousal and reactivity: sleep difficulties, concentration impairment, overactive startle response, hypervigilance, and reckless or aggressive behavior
What three subtypes of PTSD did Miller and colleagues identify and what were the symptom profiles associated with each?
1- subtype of simple PTSD: displaying low internalizing and externalizing behaviors
2- Externalizing type: tendency to outwardly express distress through negative interactions with others (more anger + aggression; impulsive; manipulative; feeling chronically stressed or betrayed; blaming others)
3- Internalizing type: tendency to direct distress inward through shame, self-deprecation, anxiety, avoidance, depression, and withdrawal (describe themselves as unenthusiastic and fatigued; anhedonia; aloof and hypersensitive to criticism; feeling inadequate)
According to Brewin, what are the two ways in which traumatic memories are thought to be stored?
Which one is thought to account for the presence of nightmares, flashbacks, and intrusive thoughts within PTSD?
Dual Representation Theory
1- Verbally Accessible Memories: information that was sufficiently processed and stored in long-term memory
2- Situationally Accessible Memories: nonconscious and nonverbal information that cannot be deliberately accessed or altered - are thought to be triggered in flashbacks, nightmares, or intrusive images
According to Ehlers and Clark (2000) what is paradoxical about memories of trauma? What do they suggest accounts for this?
People have trouble intentionally accessing memories of the event but have involuntary intrusions of it
This is because the memory is poorly integrated with others, which makes it hard to recall, but it can be triggered by inaccurate appraisals of serious current harm
According to Janoff-Bulman, what are the three major assumptions that may be “shattered” by a traumatic event?
1- Personal invulnerability
2- The world as a meaningful and predictable place
3- The self as positive and worthy
What did Ramage et al. (2016) find with respect to the different types of emotions that are associated with different types of trauma?
Different types of trauma lead to different emotions, which have different neural pathways
For example, disgust, shame, guilt, and sadness are different than fear and may even be more predictive of PTSD later on
What did Kessler et al. (1995) mean by “personal” versus “impersonal” traumas and what did they find with respect to the development of PTSD?
Personal: rape, molestation, assault, and combat
Impersonal: disasters or accidents
Personal traumas are more likely to result in PTSD, with rape being the most likely cause in both men and women
What, in general, is the impact of PTSD on marital status?
What symptoms in particular may be particularly relevant to this phenomenon?
Those with PTSD are more likely to divorce and to do so multiple times. It’s also associated with domestic violence and relationship dissatisfaction
- Avoidance and numbing symptoms may negatively impact relationship satisfaction
- Hyperarousal may be associated with violence perpetration
What are the different types of traumatic events that may cause PTSD?
Natural disaster, abuse, war/combat, common traumas (accidents, death of a loved one, etc.)
What is a traumatic event (as defined by the DSM)?
An event involving actual or threatened death, serious injury, or threat to physical integrity to self or others in a way that causes fear, helplessness, or horror
This is the only DSM diagnosis where etiology is a criteria
What are schemas? What are some fundamental ones?
Internalized cognitive frameworks for organizing, processing, and understanding the self, others, and world
Potential Fundamental Ones: personal invulnerability, the world as a meaningful/predictive place, self as positive and worthy
What is schema disconfirmation? What does it lead to?
When our experiences are inconsistent with what would be expected based on our schemas
We can either change the schema to fit the new information (accommodation) OR maintain the schema and alter our understanding of the inconsistency, often using denial (assimilation)
How are schemas and trauma related? What about schema confirmation vs disconfirmation?
With trauma, the way that people integrate the experience into their worldview may determine symptom profile
Trauma is so salient that it requires some degree of accommodation, but symptoms will differ depending on what cognitive schemas are shattered
Trauma can also be caused by schema confirmation: when something you feared comes true and confirms negative beliefs held about the world
What dimension of PTSD symptoms arise as a result of accommodation (changing our schemas)?
Hyperarousal and reactivity including hypervigilance, exaggerated startle response, sleep difficulties, and concentration impairments
What dimension of PTSD symptoms arise as a result of assimilation (keeping the schema)?
Strong negative emotions including guilt, distorted self-blame, responsibility for outcome, and shame about behavior during the event
These feelings can also lead to self-destructive behavior
What are the other consequences of trauma (i.e. the other dimensions of PTSD symptoms)?
Intrusions: intense physiological and psychological responses when exposed to trauma-related cues (e.g. nightmares and flashbacks)
Avoidance of cues related to the event, such as people, places, or situations
Negative alterations in cognition and mood
What is emotional numbing?
Feeling distant from others, lacking positive emotions, or the inability to express feelings of happiness or love
Not everyone that’s exposed to trauma will get PTSD. What are the risk factors that make someone more likely to get it?
Demographics, Characteristics of the trauma, Cognitive factors, Coping styles, Personality, Pre-trauma psychopathology, and Social factors
What are Demographic risk factors for PTSD?
Men more likely to experience trauma; women more likely to develop PTSD
Findings here are inconsistent
What characteristics of the trauma are risk factors for PTSD?
Personal trauma (assault, abuse, war, combat, etc.) is more likely to cause PTSD than impersonal trauma (accidents, disasters, grief, etc.)
Multiple traumas = “complex” PTSD
What are Cognitive risk factors for PTSD?
Lower cognitive abilities (like verbal communication, processing speed, and retrieval of memory) are a risk factor
We also see negative self-evaluation, issues with extinction learning, and problems with military trainability
What coping styles are risk factors for PTSD?
Negative cognitive bias, rumination, and avoidance
What personality traits are risk factors for PTSD?
Neuroticism, trait anger, harm avoidance, trait dissociation
