ptsd Flashcards
exposure to trauma
General pop- 89.6% will experience at least 1 traumatic event- 4.8 trauma
single incident traumatic injury- 2.8 million people traumatically injured each year
Adults 18 and older 7% will get PTSD, men 3.6 % , Women 10%
rape 46% will get and 65% men PTSD
Other outcomes of trauma
increased physical comorbidity
Increased psychiatric comorbidity
substance use, depression- highlt comorbid with PTSD, low mood, changes in appetitie and sleep, low energy, difficulty concentrating, lack of enjoyment, suicidal ideation, hopelessness
PTSD diagnosis
trauma- exposure to actual or threatened death, serious injury, or sexual violence through
direct experience, witnessing in person, learning it happened to close friend or family, experiencing repeated exposure
Must have trauma and…
recurrent, involuntary, and intrusive distressing memories of the trauma
recurring distressing dreams in which the content and or affect of the dream are related to trauma
Dissociative reations –flashbacks in which the individual feels or acts as if the trauma were recurring
intense or prolonged psychological distress at exposure or external cues that symbolize or resemble an aspect of trauma
marked physiological reactions to internal or external cues that symbolize or resemble an aspect of the trauma
AVOIDANCE-
Avoidance
of distressing memories thoughts, or feelings about or closely associated with the trauma
avoidance of external reminders - that arouse distressing memories, thoughts or feeling about or closely associated with the trauma
Negative alteration in cognition or mood
inability to remember an important aspect of the trauma
persistaent and exaggerated negative beliefs about oneself, others, or the world, I am bad, no one can be trusted, the world is completely dangerous
Persistent, distorted cognitions about the cause or conswequence of the trauma that lead the individual to blame himself or others
persistenet negative emotional state
kinda depression
hyper–
arousal , super vigilant
hard to concentrate, and sleep
course of PTSD
can occur at any age, onset usually within 3 months of trauma, but can be months or years later
duration varies, longer without treatment
some show waxing and waning course
Reactivation can occur- symptoms initially get betterbut reminders of original trauma, life stressors, and or new traumas trigger a recurrence and PTSD symptoms increase and or intensify
etiology of diagnosis
fear conditioning, social cognition models, moral injury
operant conditioning via avoidance
social cognition model- preexisting shcemes, traumas shatter these schemes, rebuilding meaning
moral injury model- committing acts that defy one’s own morals, self blame, guilt, shame, withdrawal
neurobiology of PTSD
hippocampus- reduced hippocampal volumes, amygdala PET imaging shows amygdala activation to traumatic vs neutral stimuli
Prefrontal cortex- LESS activiation
Hippocampus highlighs
the hippocampus contextualizes fear and regulates it on the basis of the situation wer are in lion in the zoo cool lion in the street scared
Twin studies show lower hippocampal volume may be a risk facotr
amygdala
amygdala is responsible for pairing of fear with previously neutral stimuli
Once these are paired, the CS alone leads to the amygdala activating a species- specific defense response
Quick and dirty route vs cortical route makes processing implicit (no conscious effort required)
extinction involves a progressive reduction in SSDR when exposed to CS without US
prefrontal cortex
the behavior of animals with PFC damage is similar to humans with PTSD: they develop fear reactions that are highly unregulated
PFC and amygdala are reciprocally related, when PFC is activated the amygdala is inhibited, making it harder to express fear
Extinction of fear response involves PFC actively inhibitning the amygdala
treatment
prolonged expsure- educational , rational, breathing, invivio imaginal exposure
CPT- cognition, witten trauma narrative, id and challenging of maladaptive cognition, safety, trust, esttem
MEDs (fluoxetine, paroxetine, prazozin), support therapy, support groups, community organizations, hotlines,
