PTSD Lecture 1

Question 1

Prevalence trauma

Answer 1

Lifetime prevalence trauma:
- Traffic accident: 18%
- Non-sexual violence: 10.7%
- Sexual violence: 6.7%
- Other: 40%

Prevalence PTSD: 7.1 %

Question 2

Outcome of Psychological trauma

Answer 2

• Posttraumatic growth
• Natural recovery
• Trauma-related complaints or disorders

Question 3

DSM Trauma exposure (criterion A)

Answer 3

Exposure to actual or threatened death, serious injury or sexual violence in one or more of the following ways:

1. Directly experiencing the traumatic event
2. Witnessing, in person, the event as it occured to others
3. Learning that the traumatic event occurred to a close family member or friend.
4. Experiencing repeated or extreme exposure to aversive details of the traumatic event. (e.g. First responders collecting human remains.)

Question 4

Sternocostoclavicular hyperostosis and PTSD

Answer 4

SCCH is a disease that often takes long to diagnose. Because of this, patients often have more PTSD symptoms with this illness compared to other illnesses.

Question 5

Conclusions on the A-criterion of PTSD

Answer 5

• Relationships between severity of event and symptoms
• Events are distant causes, true causes lie within the person (vulnerability, processing) and person environment interaction
• Demarcation is arbitrary/practical/political rather than objective/scientific
• We don’t do this in other disorders

Question 6

Problems with A-criterion

Answer 6

• Medicalizes normal stress
• A-criterion doesn’t suffice: demarcation trauma, reliable reporting/measurement of trauma and emotions, relation trauma to PTSD and other disorders.
• Overlap with other disorders: reeexperiencing, avoidance, negative thoughts and emotions, hyperarousal

Question 7

Proposed changes to PTSD criteria

Answer 7

• Abolish Criterion-A
• Less (and most characteristic/specific) symptoms

Question 8

Reexperiencing intrusion criteria according to Brewin

Answer 8

• Recurrent distressing dreams related to an event now perceived as having severely threatened someone’s physical or osychological well-being, from which the person wakes with marked fear or horror, or
• Repeated daytime images related to an event now perceived as having severely threatened someone’s physical or psychological well-being, experienced as recurring in the past and accompanied by marked fear or horror.

Question 9

Avoidance criteria according to Brewin

Answer 9

Avoidance should be present in the past month. Either:
- Efforts to avoid thoughts, feelings, conversations, or internal reminders associated with the reexperienced event, or
- Efforts to avoid activities, places, people, or external reminders associated with the reexperienced event.

Question 10

Arousal criteria according to Brewin

Answer 10

Hyperarousal should be present most days in past month. Either:
- Hypervigilance, or
- Exaggerated startle response.

Question 11

Comorbid disorders or problems with PTSD

Answer 11

• Depression
• Substance use disorders
• Anxiety disorders
• BPD
• Mourning
• Burnout
• Relational problems

Question 12

DSM-5 PTSD criteria

Answer 12

A: one stressor
B: intrusion symptoms
C: avoidance
D: negative alterations in mood or cognition (2 required)
E: alterations in reactivity or arousal
F: 1 month
G: functional significance
H: not due to medication or other disorder