PTSD Flashcards
what are physical reactions to trauma
muscle tension headaches nausea shake and tremors choking sensation palpitations dizziness
what is the most common cause of PTSD in UK
rape
what happens if the flight or fight is not possible
FREEZE response
When the limbic brain judges that neither is possible
and death or severe injury is inevitable it will evoke
what happens during a freeze response
The body goes into a ‘Shut Down’
There is an altered state of reality
The body becomes immobile
Pain sensations are reduced
how is trauma differentiated
Type 1 = Simple trauma
Type 2 = complex trauma
what is complex PTSD Sx
PTSD symptoms
AND
-Cognitive disturbances-low self-esteem, self-blame, hopelessness, helplessness, pre-occupation with threat
- Mood disturbances / Emotional dysregulation
- Somatisation
- Identity disturbance
- Chronic interpersonal difficulties
- Dissociation
- Tension reduction activities (binge-purging, self mutilation, substance misuse etc)
what is the role of the hippocampus in the limbic brain
locating memories in the right time, place and context
what is the role of the amygdala in the limbic brain
stores emotionally charged memories = connects to Medial prefrontal cortex
what is the role of the Medial prefrontal cortex
regulates emotional and fear responses
what does the amygdala control
autonomic emotional and sexual behaviour
what are features of trauma memories
Easily triggered Difficult to translate into words Fragmented Affect laden Inability to recall some aspects of the trauma
how can people be triggered into trauma memories
visual auditory smell taste kinaesthetic
what are key features/symptoms of PTSD
flashbacks nightmares avoidance increased arousal emotional numbing dissociation
what can trigger a flashback
insomnia
tiredness
stress
how do people with PTSD wake up from nightmares
shouting
screaming
drenched in sweat or hot and trembling
what are features of increased arousal
hyper-vigilance can appear threatening to others exaggerated startle response to sounds irritability, burst of anger/aggression feeling vulnerable inability to sleep poor concentration poor memory
what are features of emotional numbing
Feeling detached from the world
Unable to have loving feelings, feeling removed and alone
Loss of interest in hobbies, family and friends
Inability to look beyond the event or look forward to a future
Often the sufferer detaches himself/herself from loved ones
what is dissociation
Offers temporary relief to the individual
The person may feel like they are observing themselves
from above
Or they may feel like it is not really happening
what can dissociation present with as well
Dissociative flashbacks
Fugue states (when you dissociated so completely you have a temporary amnesia)
Dissociative Identity Disorder
when is dissociation likely to happen
More likely to occur if trauma is
- severe
- Prolonged
- Repeated or horrific or shaming
- If the victim is very young
what are some indicators of dissociation
Things look strange, colours may appear brighter or faded, tunnel vision
Sounds may appear muted or far away or Louder
The person may be rocking, tapping, twitching or grimacing
Things seem to move in slow motion
Feeling like a robot- functioning but not feeling
Feeling like a observer than a participant
what are the responses over time that happens after trauma
48hrs = Acute stress reaction
up to 4 weeks = acute stress disorder
up to 3 months = acute PTSD
over 3 months = Chronic PTSD
what is the time scale for acute stress disorder
occurring within 1 month of the trauma and lasting at least 2 days
what are the Sx of acute stress disorder
Dissociative symptoms
- Emotional numbing
- Depersonalisation
- Derealisation
- Detachment
- Amnesia
Persistent re-experiencing
- Intrusions
- Nightmares
Increased arousal
- Anxiety
- Alertness
- Poor sleep
what is the Tx for acute stress disorder
Debriefing should NOT be undertaken
If trauma symptoms are mild and present for less than 4 weeks – “watchful waiting”
Trauma focused CBT
EMDR (Eye Movement Desensitistaion and re-programming)
when should PTSD specific treatment be done
only when the survivor is safely removed from the crisis
