PTSD Flashcards
DSM-5 PTSD
Traumatic Event
+
*Intrusive thoughts, recurrent memories, images
- Hyperarousal
- Avoidance
- Mood/ Cognitive Symptoms
- **Changes in cognition and mood new to DSM-5
Hyperarousal and Reactivity
Irritable behavior and angry outbursts
*with little or no provocation
Reckless or self-destructive behavior
Hypervigilance
Exaggerated startle response
Problems with concentration
Sleep disturbances
e.g. difficulty falling or staying asleep, or restless sleep
Intrusive/avoidance behavior
Related to behavior that is similar to the traumatic event
But is usually generalized
Changes to mood/cognitions
New perceptions that the world is less-trusting and (s)he is more vulnerable than originally believed
Includes depression, anxiety, shame, fear, and anger
A combination of strong, negative, emotions
One-Trial Learning
It is the only disorder that requires an event-based prerequisite – i.e. trauma
But only requires one specific (traumatic )event
in contrast to learning theory
Acute stress disorder
A common prerequisite to PTSD, experienced by most people
Only a few are unable to overcome this and then develop PTSD
Dx: 3 days to 1 month
PTSD: Loss of Anxiety
In rare cases, PTSD involves a complete loss in the ability to experience anxiety
Think as if the anxiety-producing systems are “burned-out”
Some argue this burn-out is what leads to suicidal behavior
• These individuals are trying to feel something
May explain adrenaline junkies
PTSD considerations: The Iraq and Afghanistan Wars
The next large-scale military conflicts post-Vietnam
20% - 40% of all soldiers display PTSD-like behavior
• Up to 1 million cases
• Estimated cost of treatment: $750 billion
• Includes treatment, disability, and lost wages
Includes secondary trauma
• Such as therapists developing PTSD after hearing multiple cases of traumatic moments
Why the elevated PTSD rates?
• Desperate need of soldiers lead to the use of those who are inappropriate to serve, such as the National Guard
Actions in the war often did not make the front page – little national support/attention
As well as a new restriction of showing military action in the media
Aggression and violent behaviors are addicting and pleasurable
o However the consequences are traumatizing
Suicide rates in military veterans with PTSD
Drastic increase over the past 15 years
Typically the suicide rate of this population is smaller than the civilian rate
Has since become significantly higher
More soldiers now die via suicide than in combat
From 2005 to 2011, service members have killed
themselves approximately once every 36 hours. For
veterans, the rate is estimated at once every 80
minutes.
PTSD: Development
Most individuals simply develop acute stress disorder, which eventually fades
• So who develops PTSD?
A previous diagnosis of an anxiety disorder increases one’s chance of developing PTSD
Those with PTSD typically do not discuss underlying emotions of the trauma
Soldiers and law enforcement officers are specifically trained not to discuss individual expression and/or emotions
• These individuals, therefore, need to be “retrained”
Those who hid or fail to act out against a traumatic event tend to feel worse than those who do act out in an attempt to stop it
o e.g. the man who fails to subdue an active shooter
o e.g. the woman who fails to fight off a rapist
Tonic mobility is a natural response to extreme anxiety – it’s a defense mechanism
• But the consequences may include PTSD
Treating PTSD
Goal: address the underlying anxiety
Target narrative of the trauma and the client’s role during the event
PTSD does not arise simply from experiencing a trauma
• It stems from one’s reaction (physically and mentally) and interpretation of the trauma
Treating PTSD: Gender Considerations
For males: PTSD often arises due to a violation of providing, protecting, or procreating
For females: PTSD can arise for failure to protect children
Women are significantly more protective of their children than men
DSM 5 PTSD: Specifiers
With dissociative symptoms
• Depersonalization
• Derealization
With delayed expression (if criteria is not met until at least
six months after the trauma)
Prevalence
General Population:
10% of men and 20% of women exposed to a TE will
develop PTSD
Factors associated with increased
risk of PTSD in combat veterans
Multiple deployments
Chronic stress (no safe zone)
Close combat (urban warfare)
Lack of social support (does anyone really care?)
