PTSD

Question 1

What are the 6 groups of criteria for PTSD?

Answer 1

A. Trauma
B. Re-experience
C. Avoidance / Numbing
D. Arousal
E. Duration > 1mo
F. Distress or Impairment

Question 2

5 forms of re-experience? How many must one have for PTSD diagnosis?

Answer 2

Must have at least one of the following:

1. intrusive recollections
2. nightmares
3. flashbacks
4. emotional reactions to trauma reminders
5. physical reactions to trauma reminders

Question 3

7 types of avoidance? How many must one have for PTSD diagnosis?

Answer 3

Must have at least 3 of the following:

1. Avoiding thoughts/feelings related to trauma.
2. Avoiding associated activities/places/people.
3. Psychogenic amnesia
4. Diminished interest in activities
5. Detachment/estrangement from others
6. Restricted affect
7. Sense of a foreshortened future

Question 4

5 signs of increased arousal? How many must one have for PTSD diagnosis?

Answer 4

Must have 2 or more of the following?

1. Difficult falling/staying asleep.
2. Irritability / angry outbursts
3. Poor concentration
4. Hypervigilance
5. Exaggerated startle response

Question 5

What percentage of men and women will experience PTSD in the US?

Answer 5

5% of men, 10% of women.

Question 6

Two major brain areas involved in fear conditioning relevant to PTSD?

Answer 6

Amygdala and hippocampus.

Question 7

What happens to learned fear when the CS is presented in the absence of the noxious US? How does this relate to the current model for conceptualization of PTSD?

Answer 7

Fear extinction.

PTSD is thought to be caused by a defect in fear extinction.

Question 8

What is meant by impaired “extinction recall”?

Answer 8

Yesterday you learned that a “That was easy.” sound won’t be followed by a sting, but today you flinch again when you hear it. (You have to remember that you learned that a stimulus is not dangerous.)

Question 9

Lesioning what part of the brain will cause impaired recall of fear extinction in non-human animals? Is this supported with fMRI data in humans? What happens in PTSD?

Answer 9

ventromedial PFC.
Yeah, the vmPFC lights up during extinction recall.
PTSD patients have less vmPFC activity (and more amygdala).

Question 10

How does hippocampus size compare in patients with [trauma w/ PTSD] vs. [trauma w/o PTSD]? Possible role for the hippocampus here?

Answer 10

In PTSD, the hippocampus is smaller, and thus might be less able to limit the fear learning to a specific context.
PTSD patients have “overgeneralization of fear learning.”

Question 11

Do SSRIs work for PTSD? Do they affect any of the above-mentioned brain areas?

Answer 11

Yes. They increase hippocampus volume (which… doesn’t seem to me to be proven to be meaningful…).

Question 12

What’s considered the most effective form of psychotherapy for PTSD?

Answer 12

Prolonged Exposure

Question 13

3 aspects of prolonged exposure for PTSD?

Answer 13

Imaginal exposure.
In vivo exposure (to feared, but safe situations).
Discussing one’s reactions to these exposures.

Question 14

How does the brain change after CBT for PTSD?

Answer 14

Less amygdala activity to response to fearful faces…. and stuff.