PTSD and adjustment

Question 1

PTSD DSM-5 criteria?

Answer 1

*DIRECTLY experiencing or witnessing a traumatic event (near-death, serious injury, sexual violence etc)
*reexperiencing event through memories, flashbacks, or nightmares, resulting in intense distress and physiological symptoms
*avoidance of any triggering stimuli relating to the trauma (people,feelings,memories,places,objects)
*at least two negative symptoms: self-blame, dissociative amnesia, anhedonia, inability to experience positive emotions, negative emotions (fear, guilt, sad, horror)
*at least two increased arousal: hypervigilance, irritability, anger outbursts, increased startle response, impaired concentration, insomnia
*causes significant impairment
*not due to substance or another medical condition

Question 2

PTSD vs acute stress disorder?

Answer 2

PTSD: symptoms occur at any time and MUST last for at least a month or longer

ASD: symptoms must occur within a month of the traumatic event but last LESS than a month

Question 3

PTSD prevalence?
gender?
course?
risks?
comorbidity?

Answer 3

> 8%
females more than males
50% will recover within 3 months
prior trauma esp during childhood
80% have comorbid MDD, bipolar, anxiety, substance disorders

Question 4

PTSD tx?

Answer 4

meds: SSRI / SNRI esp prazosin for nightmares/hypervigilance and atypical antipsychotics for severe or resistant cases

psychotherapy: CBT, psychodynamic psychotherapy, family therapy

Question 5

what medication to avoid in PTSD?

Answer 5

benzos due to high rates of comorbid substance abuse and lack of efficacy

Question 6

adjustment disorder dsm-5?

Answer 6

development of emotional or behavioral symptoms within 3 months following a non-life threatening life event (divorce, loss of a job) that cause:
*significant impairment
*excessive distress in relation to the event

symptoms not of normal bereavement and resolve within 6 months of the event and the criteria does not meet those for other mental disorders

Question 7

adjustment disorder subtypes?

Answer 7

based on predominance of either depressed mood, anxiety, or mixed anxiety and depression. or disturbance of conduct or mixed disturbance of conduct and emotions

Question 8

adjustment tx?

Answer 8

supportive psychotherapy
meds if clinically indicted (for insomnia, anxiety etc)