PTSD Flashcards
What is type 1 trauma?
A single instance of trauma
What is type 2 trauma?
Multiple traumas
Who distinguished the trauma types?
Terr (1994)
What is the difference between Type 2A and 2B traumas?
A - stable background, can talk about the multiple traumas separately
B - too many traumas, they merge into one, might start talking about one and then move on to the next
What will a person’s response to an event have involved if they have PTSD?
Fear
Helplessness
Horror
What are the three subsets of symptoms in PTSD?
Re-experiencing
Avoidance and numbing
Hyperarousal
For how long must PTSD symptoms be present for diagnosis?
Longer than a month
How long is chronic PTSD?
Longer than three months
What does the Ehlers and Clark (2000) model of PTSD involve?
Exposure
Cognitive processing
What is the difference between anxiety and PTSD?
Anxiety = future PTSD = past
What are the two processes which lead to a sense of current threat in PTSD according to Ehlers and Clark (2000)?
Idiosyncratic appraisals of the trauma and sequalae (own narrative of what happened)
Re-experiencing of disjointed memories
What are the maintaining factors in the Ehlers and Clark (2000) model of PTSD?
Thought suppression Rumination Hypervigilance Avoidance Safety behaviours Substance use
What may the appraisals involve in PTSD?
The fact that the trauma happened The meaning of the trauma Client's response Perceived response of others Physical consequences
What needs to be considered when investigating appraisals in PTSD?
Have they shattered or confirmed a person’s previous beliefs?
What are the possible forms of intrusive memories?
Rumination Pictures, sounds, smells, tastes Emotion without recollection Physiological sensations Dreams Flashbacks
Why is it important to investigate recall in PTSD?
Disjointed memory
Confusion about the order
Missing details
False information
What are the goals of treatment in Ehlers and Clark’s (2000) model?
Elaborate on the traumatic memory Identify and modify appraisals of the trauma Discriminate triggers Reduce symptoms Give up coping strategies
What is the acronym for treatment goals in Ehlers and Clark (2000)?
EIDRG
What areas need to be explored when assessing PTSD?
Content of the intrusions Worst moments Misinterpretations of symptoms Quality of the memory What do they do when memories pop into head? What do they avoid? What do they do instead?
What is the treatment plan for PTSD?
Cognitive assessment Revisit traumatic memory and ID hotspots Address hotspots one at a time Update hotspots Continue to work with cognitive appraisals and triggers
What techniques can be used for cognitive appraisals?
Evidence for/against Behavioural experiments Advantages/disadvantages Pie charts Surveys Info from other sources Guided imagery
What outcome measure can be used in PTSD?
Impact of Event Scale Revised
What is one of the common problematic goals in PTSD?
Wanting to go back to how they were before the trauma.
What is a way of overcoming the want to go back to how they were before the trauma?
Looking at what they have gained as trauma will always change you.
What can be a helpful thing to consider when looking at trauma and resilience?
A previously resolved trauma, how they coped and offer hope for this one.
How does trauma change autobiographical memory?
People will think that before the trauma everything was fine and they were happy-go-lucky and carefree. This is not usually the case and thought needs to be changed.
What might be helpful for someone to develop before addressing traumatic memories?
An anchor.
What is an anchor?
A safe subject with which someone can ground themself.
Give 2 grounding techniques.
Name and describe things in this room - use all senses.
Take shoes off and feel feet on the floor
What is BASICPH?
Behaviour Affect Somatic Information Cognition Physical
Why do we talk about trauma?
To give it new meaning
In what order do you discuss the trauma?
Start post-trauma and make clear that it has finished
Move closer to reinforce the ending
Proceed through the incident with caution
Normalise and be curious about the circumstances leading to the event
What are the two stages to trauma treatment?
Stabilisation
Processing
What is stabilisation?
An understanding of the body’s responses and how to manage them
What can be helpful for avoidance in PTSD?
Gradual exposure.
Outline the three stage to gradual exposure for PTSD.
Imaginal
In reality with therapist
In reality with supportive carer
List 4 stabilisation techniques.
Lightstream
Pendulating
Calm place
Resource installation
What is thought suppression and how could you explain it?
Don’t think of a pink elephant
What are some hints for hot spots?
Quiet
Very emotional
Gestures
Skipping
How can you update trauma memories?
Identify evidence against appraisals of worst memories
How do we work with triggers for intrusions?
Identify them
Stimulus discrimination - what is NOW and what was THEN? - self talk, behavioural experiments, practise
How can we work with appraisals related to guilt?
Pie charts of responsibility
Compassion
How can we work with appraisals related to anger?
Letter writing
Empty chair
Cost/benefit of being angry/forgiveness/letting go
