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RB Y3 2 Psychiatry > PTSD > Flashcards

PTSD Flashcards

1
Q

what are the 4 groups of symtpoms according to DSM 5

A
  • intrusion symptoms
  • avoidance
  • negative alterations in cognition and mood
  • alterations in arousal and reactivity
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2
Q

how severe must the symtoms be for diagnosis

A

enough to impair function

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3
Q

how common are comorbid conditions in PTSD

A

very common - 80%

eg depression, anxiety, anger and substance misuse

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4
Q

is PTSD related to suicide

A

it has a stronger association than any other anxiety disorder - x6

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5
Q

what is the difference between centrifugal and centripetal disasters

A
  • Centrifugal disasters are where the people are together only at the moment of disaster (e.g. plane crash), centripetal disasters are in an existing community
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6
Q

who is more likely to be exposed to trauma

A
  • Certain groups are more likely to be exposed to trauma, e.g. refugee, military, police, emergency service workers
  • Higher frequency exposure in inner cities and where natural disasters occur
  • The poor and marginalized are more likely to be victims
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7
Q

what is type 1 trauma

A

single incident trauma, unexpected

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8
Q

what is type 2 trauma

A

complex, repetitive trauma eg ongoing abuse, betrayal of trust relationship

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9
Q

does type 1 or 2 trauma have a higher risk for PTSD

A

type 2

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10
Q

in which type of trauma does the victim often ‘freeze’ - tonic immobility

A

sexual assault

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11
Q

what is tonic immobility

A

an involuntary state or profound, reversible motor inhibition

a survival instinct when the threat is decieded to be inescapable

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12
Q

what is peri traumatic dissociation

A

disturbed awareness, impaired memory or altered perceptions during and immediately after a traumatic experience

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13
Q

what does peri traumatic dissociation increase the likelihood of

A

PTSD

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14
Q

which brain areas are responsible for actions during threat and fear

A

the amygdala, hippocampus and midbrain areas (superior colliculi and PAG)

shift away from pre frontal cortex - reasoning and making integrated decisions

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15
Q

what are the 2 types of memory

A
  • conscious memory - hippocampus
  • emotional memory - amygdala
    • can recognise and remember danger
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16
Q

what is wrong with memory of the traumatic event in PTSD

A
  • improper storage of traumatic event in implicit memory
  • cant remember key features about event
  • memories are based on fear and emotional memory (amygdala)
17
Q

what is different about the hippocampus in PTSD

A

smaller

18
Q

which side of the hippocampus is damaged in adult and childhood trauma

A

right in adult and left in childhood

19
Q

when do hippocampal changes occur

A

from 6 months after trauma

20
Q

what does current hippocampal size correlate to

A

current severity of PTSD

  • small hippocampus could be a risk factor for lack of recovery
  • or PTSD effects on hippocampal size could be reversible as PTSD recovers
21
Q

what happens to amygdala activity in PTSD

A

increased - failure of the prefrontal networks to regulate it - hyperreactivity to threat

22
Q

what can the timeless quality of traumatic memory be attributed to

A

right hemispheric lateralization

23
Q

what are cortisol levels like in PTSD

A

low !

24
Q

what happens to the cortisol feedback system in PTSD

A
  • normally puts a stopper on the stress adrenaline release response
  • however in PTSD, the negative feedback system is oversensitive so low levels of cortisol inhibit the production of ACTH and CRH - failure to contain sympathetic response - consolidation of traumatic memories
25
Q

what changes occur in Brocas area in PTSD

A

decreased regional CBF when individuals access personal traumatic memories - this means that emotional memories are stronger than higher cortical memories

26
Q

is inidividuals having negative views of themselves pre trauma a risk factor PTSD

A

yes. conversly strong optimisic beliefs can act as a buffer to developing PTSD

27
Q

is thre a diference inhow males and females cope with trauma

A

males cope better

28
Q

do different ages cope with trauma better or worse

A

extremes of age and development are pre traumatic risk factors

29
Q

are behavioural problems pre traumaic risk factors

A

yes

30
Q

which types of event are more likely to cause PTSD

A

human made, not natural

31
Q

does event duration affect development of PTSD

A

prolonged exposure is a risk factor

32
Q

management of someone with mild/moderate symptoms presenting <3 months after trauma

A

watchful waiting

33
Q

what psychological treatments are indicated

A
  • trauma focused CBT
  • eye movement desensitization and reprocessing
  • non trauma CBT
34
Q

is there an indication for pharamcotherapy

A

can be used symptomatically for acute phases

ADs can be used to reduce the severity of core symptoms

35
Q

what are the first and second line agents

A

1 - paroxetine and mirtazapine

2 - amitriptyline or phenelzine

RB Y3 2 Psychiatry (12 decks)

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