PTSD Flashcards

1
Q

DSM 5 criteria for PTSD

A

Exposure to actual or threatened death,serious injury, or sexual violence (1 or more)

Directly experiencing the traumatic event

Witnessing in person, the event(s) as it occurred to others

Learning that it occurred to close family member or close friend (event must be violent or accidental)

Experiencing repeated or extreme exposure to aversive details of the traumatic event(s)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Traumatic event is persistently reexperienced
1) recurrent and intrusive distressing recollections

2) recurrent distressing dreams
3) Dissociative reactions: acting or feeling as if reliving the event. Continuum: to complete loss of awareness of the present
4) intense psychological distress at exposure to internal or external cues
5) physiological reactivity to exposure to cues

A

Intrusions

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

How does Avoidance have a role in PTSD

A

Persistent avoidance of stimuli associated with the trauma

1) efforts to avoid distressing memories, thoughts, feelings, about the
traumatic event

2) avoid external reminders activities, places or people, conversations, objects, situations that arouse recollections

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Ways in which Avoidance leads to numbing

A

Negative alterations in cognitions and mood

1) inability to recall important aspects of the trauma
2) Persistent and exaggerated negative beliefs or expectations about self, others or world
3) Persistent, distorted cognitions about the cause or consequences of the event
4) Persistent negative emotional state (fear, guilt, shame, anger)
5) markedly diminished interest or participation in activities
6) feeling of detachment or estrangement from others
7) Persistent inability to experience positive emotions

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

1) Sleep Disturbance, difficulty falling or staying asleep
2) Irritability or outbursts of anger

3) Difficulty concentrating
4) Hypervigilance
5) Exaggerated startle response

6) Reckless or self-destructive behaviors

A

Hyperarousal seen in PTSD

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Explain Horowitz Theory of Integration

A

It’s being on a continuim:

Over control: numbing/denial/dissociation leading to negative alterations in mood

to

Under-control: flashbacks/nightmares/hyperarousal which are intrusive

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

PTSD:

  • Duration of symptoms is more than ____
  • Disturbance causes significant distress or impairment in :
A

1 month

social, occupational, or other important areas of functioning

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

How prevalent are traumatic events

A

80% of population exposed to traumatic event

Disasters may create significant impairment in 40% to 50% of those exposed

Up to 45% of those exposed to natural disastermay develop PTSD or major depression or other psychiatric symptomotology

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

How prevelant is PTSD in population; what about veterans

A

• Adults 18 and older – 6.8%

  • Men – 3.6%
  • Women – 9.7%

vs Veterans

  • Men – 30.9%
  • Women – 26.9%
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What are crisis related synmptoms

A

Anxiety, Panic, Elevated Startle Response, Insomnia, Anger, Helplessness, Depression
Suicidal Ideation, Impulsivity, Violence, Self-Medication

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What are the Three Key brain areas involved in PTSD and how are they affected?

A

Amygdala: activation

Hippocampus: reduced volume

Prefrontal cortex:Less activation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Set of nuclei at the center of each temporal lobe; – dozen distinct areas, two involved in fear conditioning

A

Amygdala

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Amygdala Receive inputs from ___and____;

has_____and____ outputs

A

senses and memory

physiologic and behavioral

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What routes do the amygdala take when processing information

A

Quick and dirty route” vs. cortical route makes processing implicit (no conscious effort required)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What part of the amygdala receives inputs from the autidory coretx and auditory thalamus

A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What part of Amygdala gives output to the Central gray, Lateral hypothalamus, adn Paraventricular hypothalamus

A

Central Amygdala

17
Q

The following areas receive input from Central Amygdala and are responsible for what fnx?

Central Gray:

Lathera Hypothalamus:

Paraventriclar Hypothalamus:

A

Central Grey: freezing

Latheral Hypothalamus: Blood Pressure

Paraventricular Hypothalamus: Hormones

18
Q

The_____ contextualizes fear and regulates it on the basis of the situation we are in (i.e. a lion in the zoo fascinates; a lion on the street invokes fear)

• Context is a psychological construction…a memory created on the spot about the various factors involved in a situation

A

hippocampus

19
Q

What is the difference between a health and unhealthy hippocampus

A

Reduced hippocampal volume may be related to memory dysfunction in PTSD:

debate is do people have premorbid hippocampus, thus are predisposed to PTSD

20
Q

What is the relationship between the Prefrontal cortex and the Amygdala

A

PFC and Amygdala are RECIPROCALLY related…when PFC is activated, the Amygdala is inhibited, making it harder to express fear.

(behavior of animals with PFC damage is similar to humans with PTSD: they develop fear reactions that are highly unregulated)

21
Q

How is the Amygdala connected to the PFC

A

Amygdala is only connected to the Medial part of PFC

while Lateral and medial are connected, only Medial goes to amygdala

22
Q

Describe three main brain areas that are related to PTSD

A

Dysfunction in 3 main brain areas related to PTSD

  • Hyperactivity of the A has been shown in neutral conditions
  • PFC and A activation are inversely related
  • H decreased volume
23
Q

Traumatic memories are stored in a state of high physiologic arousal.

Traumatic events are state dependent thus how do we access them?

A

Traumatic memories must be accessed in a state of similar emotional arousal.

24
Q

Describe behavioral treatment for PTSD

A
  • Anxiety attempts to avoid fear-evoking stimuli
  • PTSD (avoidance) blocks exposure that promotes extinction
  • Focus on exposure treatments to facilitate extinction
25
Q

What method is this:

Flooding (implosive therapy)

balanced with:

Systematic Desensitization

A

Behavioral Deconditioning

26
Q

What is the structure of Cognitive Behavioral Therapy

A

Look at the Fear structure:

Physiological responses + Ascribed meaning

27
Q

What brain pathways are involved in Talk therapy?

A

PFC-Lateral: not directly connected to the AMygdala

28
Q

What brain pathways are involved in CBT?

A

PFC-Medial; directly connected to amygdala

29
Q

What brainpathways are invovled in drug therapy:

A

Drug (directly connected to A and other brain areas)

30
Q

What types of Cognitive Behavioral Therapies are the most effective?

A

Stress Innoculation Training

Imagery Rescripting and Reprocessing Therapy

Cognitive Restructuring Within Reliving

Imaginal/In Vivo Exposure

Prolonged Imaginal Exposure

Cognitive Processing Therapy

31
Q

Physician Screen tool for Type I trauma

A
  • Have you experienced any vivid thoughts about the accident/injury?
  • What do you believe is the cause of the accident/injury?
  • Are you able to return to the place of the accident/injury?
  • What do you think could be done to prevent the accident/injury?
32
Q

What types of changes do we look for when screening individual who experienced a traumatic event?

A
  • Problems with concentration
  • Sleep disturbances
  • Hypervigilance/increased startle response
  • Increased irritability
  • Changes in mood
  • Changes in appetite
33
Q

What changes are suggesting and used in the Physician Screening tool for Type II trauma (multpile/prlonged)

A
  • Somatic complaints; all diagnostic testing is negative
  • Chronic depression and/or anxiety
  • Difficulty sleeping
  • Difficulty concentrating

• Memory problems: chunks of time during childhood that are not remembered

34
Q

Flashback, nightmares or images of the past that continually intrude

Startle response greater than witnessed in others

Difficultwithappetite/foodortexturesthatare unappealing

Difficultyidentifying,experiencing,toleratingor expressing anger

Problems knowing who to trust

A

suggestive of Type II trauma

35
Q

Comorbidities associated with PTSD

A
  • Panic Disorder
  • Agoraphobia
  • OCD
  • Social Phobia
  • Specific Phobia
  • Major Depressive Disorder • Somatization Disorder

• Substance-Related Disorders