PTSD Flashcards
What are the time constraint differences for acute stress disorder and PTSD?
ASD is the diagnosis until the symptoms last over 1 month, then it’s pTSD
in what gender is PTSD more prevalent?
females
Describe an infant with reactive attachment disorder?
- emotionally withdrawn behavior toward adult caregivers
- persistent social and emotional disturbance (either minimal responsiveness or unexplained emotionality)
- child experienced a pattern of extremes of insufficient care (like in foster care)
Describe disinhibited social engagement disorder.
It’s a pattern of behavior that involves culturally inappropriate, overly familiar behavior with relative strangers
What are adjustment disorders?
they are stress-response syndromes occurring after exposure to a distressing event
WHat are the timing aspects of adjustment disorders?
the disturbance begins within 3 months of the osnet of the stressor and lasts no longer than 6 months after the stressor/consequences have ceased
What is the essential feature of PTSD?
significant reaction to serious traumatic event that involves actual or threatened death, serious injury or sexual violation
What are the 4 ways in which a stressful event can be experienced for a PTSD diagnosis?
directly experiencing
witnessing in person
learning the event happened to a close family member/friend
repeated exposure to aversive details of event
What are the 4 general groups of symptoms for PTSD?
- intrusive symptoms
- avoidance of reminderss
- negative alterations in cognitivon and mood
- alterations of arousal and reactivity
What are the two specifiers that can be used with a PTSD diagnosis?
- with dissociative symptoms
2. with delayed expression
What are the 4 clinical factors of PTSD?
- re-experiencing symptoms (intrusive memories, nightmares)
- protective reactions (emotional numbing, amnesia, cognitive avoidance)
- Negative emotions and cognitions (sadness, anger, guilt)
- arousal symptoms (startle response, hypervigilance)
Describe disinhibited social engagement disorder.
It’s a pattern of behavior that involves culturally inappropriate, overly familiar behavior with relative strangers
What are adjustment disorders?
they are stress-response syndromes occurring after exposure to a distressing event
WHat are the timing aspects of adjustment disorders?
the disturbance begins within 3 months of the osnet of the stressor and lasts no longer than 6 months after the stressor/consequences have ceased
What is the essential feature of PTSD?
significant reaction to serious traumatic event that involves actual or threatened death, serious injury or sexual violation
What are the 4 ways in which a stressful event can be experienced for a PTSD diagnosis?
directly experiencing
witnessing in person
learning the event happened to a close family member/friend
repeated exposure to aversive details of event
What are the 4 general groups of symptoms for PTSD?
- intrusive symptoms
- avoidance of reminderss
- negative alterations in cognitivon and mood
- alterations of arousal and reactivity
What are the two specifiers that can be used with a PTSD diagnosis?
- with dissociative symptoms
2. with delayed expression
What are the 4 clinical factors of PTSD?
- re-experiencing symptoms (intrusive memories, nightmares)
- protective reactions (emotional numbing, amnesia, cognitive avoidance)
- Negative emotions and cognitions (sadness, anger, guilt)
- arousal symptoms (startle response, hypervigilance)
What two5HT - mediates the aggression, vio NTs are likely involved in PTSD?
Too much NE - moderates the hypervigilance, autonomic arousal, flashbacks and intrusive memories
Too little 5HT - mediates the aggression, violence, impulsivity, dep and anx
Why should PTSD really be evaluated within 1 month of return and then again every 3 months?
PTSD has an on-again-off-again symptom cycle that can be exacerbated by triggers, so you have to continue evaluating
What traumatic event has the highest risk for PTSD?
rape (followed by severe beating or physical assault, serious accidents, shooting, etc)
What percentage of PTSD patients will have a comorbid mental illness?
80% - anxiety, depression, bipolar, SUD, somatization, psychosis, etc
What is the DREAMS questionnaire for PTSD?
Detachment 2Reexperiencing the event Event had emotional effects Avoidance Month in duration Sympathetic hyperactivity (hypervigilance)
What is “secondary stress”
it’s the idea that partners will develop symptoms that mirror the PTSD without any primary trauma experience
What is the model for partner’s developing secondary stress?
the trauma transmission model - they use not only sympathy but also empathy, resulting in a realistic experience of the trauma themselves
What percentage of all sodiers receive needed mental health assessments?
only 12.5%!
What is a step the primary care doc can take to make it more likely that a patient will actually use their mental health referral?
physically introduce the patient to the mental health provider
Why should PTSD really be evaluated within 1 month of return and then again every 3 months?
PTSD has an on-again-off-again symptom cycle that can be exacerbated by triggers, so you have to continue evaluating
what do you start with in PTSD therapy? meds or psychotherapy?
psycotherapy
What are the 3 general treatment therapies used for PTSD?
- exposure therapy
- cognitive therapy
- stress inoculation training
Describe exposure therapy?
training the individual to deal with the physical symptoms of stress and then re-exposing them to their trigger
Describe cognitive therapy for PTSD?
CBT involves separating the instrusive thoughts form the associated anxiety so they can be thought of without causing the symptoms
Describe stress inoculation training?
it’s an exposure variant that just teaches the patient to relax
WHat meds are used most often for PTSD?
SSRIs (affects the serotonin aspect)
TCAs
What are ultimately the 2 goals of any treatment for PTSD?
decondition the anxiety and re-establish feelings of integrity and/or control
What is critical incident stress debriefing?
the military has started this program where soldiers undergo group therapy and CBT almost immediatly after the trauma, so you forestall the emergency of disabling symptoms
What treatments are more effective for PTSD?
they’re all about equally effective
