PTSD Lecture 2

Question 1

Complex PTSD

Answer 1

1. Problems in affect regulation.
2. Beliefs about oneself as diminished, defeated or worthless, accompanied by feelings of shame, guilt or failure related to traumatic event.
3. Difficulties in sustaning relationships and in feeling close to others.

Question 2

Lifetime prevalence of psychotrauma and PTSD in the Netherlands

Answer 2

Psychotrauma: 80.7%
PTSD: 7.4%

Question 3

Predictors of PTSD

Answer 3

• Family history of psychopathology
• Perceived life threat
• Low perceived support
• Peritraumatic emotions
• Peritraumatic dissociation
• Life stress

Question 4

Predictors of PTSD in children and adolescents

Answer 4

In order of effect size:

• Thought suppression
• Blame others
• Distraction
• Poor family functioning
• Comorbid psychological problem

Question 5

Conclusions across 3 meta-analyses about PTSD

Answer 5

1. Despite heterogeneity/complexity, developing PTSD is not random
2. Effect sizes for several predictors are not trivial
3. A distinction emerges between distal vs proximate predictors…
4. … with the latter showing larger effect sized and possibilities for intervention
5. Nevertheless, most variance unexplained

Question 6

Negative trauma-related cognitions

Answer 6

Danger -> fear
Violation of rules/norms/values -> anger
Responsibility -> guilt
Violation of internal norms -> shame

Question 7

Dysfunctional strategies to cope with PTSD

Answer 7

• Trying hard not to think about the trauma, keep mind occupied at all times, control feelings, substance use. Patients think they will go mad or lose control if they think about trauma too much
• Numb emotions, avoid anything that could cause positive or negative feelings. Patients do this because they think that if they don’t control their feelings that they will lose temper/not be able to work.
• Ruminate about how event could have been prevented. Patients do this because they think if they don’t find out how it could have been prevented that it may happen again.
• Ruminate about how to get even with the assailant. They feel if they don’t do this then the assailant has won and they don’t feel worthy.
• Avoid site of the event/avoid wearing similar clothing. They feel that if they do these things it could happen again.

Question 8

Cause of delayed onset of PTSD

Answer 8

1. Later event gives original event new meaning
2. Trauma reminders only become available after some time.

Question 9

Cause of anniversary reactions

Answer 9

1. Increased external and internal reminders
2. Negative appraisals

Question 10

Cause of frozen in time PTSD

Answer 10

1. Negative appraisals
2. Disconnect from reality through continuous reexperiencing
3. Abandoning/avoiding activities

Question 11

Cause of sense of impending doom PTSD

Answer 11

Nature of trauma memory

Question 12

Cause of talking or thinking about trauma doesn’t help PTSD

Answer 12

1. Ruminating
2. Emotional avoidance