PTSD Flashcards
what part of the brain is responsible for active & passive defence responses?
midbrain Superior Colliculi & periaqueductal gray (PAG)
what are examples of defence responses?
o Fight, flight, freeze, hide, avoid, attach, submit, despair & uncontrolled activation states
what is the orientating response?
Arousal → Arrest - pause in or slowing of movement and activity → Alert → Muscular change - both flexion & extension → Orient/scan - search for the location → Locate - source of the stimulus is found → Identify - novelty is recognised &/or identified → Evaluate → Take action or not
what is the role of the 3 looping systems?
Defence activation
what are the 3 looping systems?
First loop – midbrain/brainstem origin
Peri-aqueductal Gray (PAG) & Superior Colliculi (SC)
Second loop – Mesolimbic- Dopamine System
Third loop – Stimulus-response learning system
acute stress response causes the release of which NT?
release of cortisol and catecholamines
what is PTSD?
Severe psychological disturbance following a traumatic event
what are the different types of risk-factors involved in PTSD?
Pre-traumatic
Peri-traumatic
Post-traumatic
what are the pre-traumatic risk factors in PTSD?
severe acute stress reactions, FH or PH of mental disorder, genetics, past experience of trauma, coping stupes, personality traits, lower educational or socioeconomic levels
what are the peri-traumatic risk factors in PTSD?
sudden, unexpected events, man made rather than natural, prolonged exposure, perceived threat to life, dose response, personal involvement
what are the post-traumatic risk factors in PTSD?
lack of support network, ongoing life stresses, reactions of others, economic resources, disadvantages, displacement
what pathophysiology of PTSD occurs during trauma itself?
high levels of stress hormones secreted suppress hypothalamic activity
what is the characteristic NT finding in PTSD?
• LOW LEVELS OF CORTISOL and high secretion of catecholamines in urine
what parts of the brain are implicated in PTSD?
Dysfunction of the amygdala, hippocampus, septum, and prefrontal cortex may lead to enhanced fear response.
what systems in the brain are implicated in PTSD?
abnormality in the hypothalamic-pituitary-adrenal (HPA) axis and locus coeruleus-noradrenergic system
what is the involvement of Brocas Area in PTSD?
decreased rCBF - fragmented memories, emotional memory on RHS brain
what is the onset of clinical features of PTSD?
arise within 6mths of the traumatic event or are present for at least 1mth, with clinically significant distress or impairment in social, occupational, or other important areas of functioning (DSM-IV).
what are the common clinical features in PTSD?
2 or more of increased psychological sensitivity and arousal’ o Difficulty falling or staying asleep o irritability or outbursts of anger o difficulty in concentrating o hypervigilance o exaggerated startle response.
what is DSM criterion A for PTSD?
The person was exposed to: death, threatened death, actual or threatened serious injury, or actual or threatened sexual violence, in the following way(s): Direct, Witnessing, Learning that a relative or close friend was exposed to a trauma, Indirect exposure to aversive details of the trauma, usually in the course of professional duties
what is DSM criterion B for PTSD?
o The traumatic event is persistently re-experienced in the following way(s): Unwanted upsetting memories, Nightmares, Flashbacks, Emotional distress after exposure to traumatic reminders, Physical reactivity after exposure to traumatic reminders
what is DSM criterion C for PTSD?
o Avoidance of trauma-related stimuli after the trauma, in the following way(s):
Trauma-related thoughts or feelings
Trauma-related external reminders
what is DSM criterion D for PTSD?
Negative thoughts or feelings that began or worsened after the trauma, in the following way(s):
Inability to recall key features of the trauma
Overly negative thoughts and assumptions about oneself or the world
Exaggerated blame of self or others for causing the trauma
Negative affect
Decreased interest in activities
Feeling isolated
Difficulty experiencing positive affect
what is DSM criterion E for PTSD?
o Trauma-related arousal and reactivity that began or worsened after the trauma, in the following way(s): Irritability or aggression Risky or destructive behavior Hypervigilance Heightened startle reaction Difficulty concentrating Difficulty sleeping
what is DSM criterion F for PTSD?
o Symptoms last for more than 1 month.
