PTSD

Question 1

1. Utilize the PTSD screen in the CU Log of Common Psychiatric Problems.

Answer 1

cannot find it in there.

Question 2

2. Describe the diagnostic criteria for PTSD (DSM5) [A-E]

Answer 2

A. Exposure to trauma
B. Intrusions
C. Avoidance of stimuli
D. Negative alterations in mood/cognition
E. Hypervigilance

**Must persist for more than 1mo, must cause clinically significant distress or social impairment, the distress is not attributable to another medical condition or substance (eg drugs, alcohol)

Question 3

What are the specific circumstances under which exposure to significant trauma can lead to PTSD? [4]

Answer 3

1. Direct experience of trauma
2. Firsthand witness to trauma
3. Learning of trauma to close family/friends (violent/accidental)
4. Repeated exposure (police officers, crime scene investigators)

**TV/Media doesn’t count

Question 4

What do intrusion symptoms look like (relative to diagnostic criteria)? [5]

Answer 4

1. Recurrent, involuntary memories of the traumatic event(s)
2. Recurrent distressing dreams in which the content and/or affect of the dream are related to the traumatic event(s)
3. Dissociative reactions (flashbacks)
4. Psychological distress to cues
5. Physiological distress to cues

**In children over 6, the memories may be re-enacted as play, and dreams may have frightening but formless content

Question 5

What does avoidance of stimuli look like (relative to diagnostic criteria)? [2]

Answer 5

1. Avoidance of or efforts to avoid distressing memories, thoughts, or feelings about or closely associated with the traumatic event(s)
2. Avoidance of or efforts to avoid external reminders (people, places, conversations, activities, objects, situations) that arouse distressing memories, thoughts, or feelings

Question 6

What do negative alterations in mood/cognition look like (relative to diagnostic criteria)? [7]

Answer 6

1. Inability to remember an important aspect of the traumatic event(s) (typically due to dissociative amnesia and not to other factors such as head injury, alcohol, or drugs).
2. Persistent and exaggerated negative beliefs or expectations about oneself, others, or the world (eg “No one can be trusted”)
3. Persistent, distorted cognitions about the cause of the event
4. Persistent negative emotional state
5. Diminished interest/participation in activities
6. Feelings of detachment/estrangement from others
7. Persistent ability to express positive emotions

Question 7

Relative to the diagnostic criteria, what might “marked alterations in arousal and reactivity associated with the traumatic event(s)” look like? [6]

Answer 7

1. Irritable behavior/outbursts
2. Reckless/destructive behavior
3. Hypervigilance
4. Exaggerated startle response
5. Problems with concentration
6. Sleep disturbance