PTSD/Trauma (Lauren and Annie 🌭👵🏻) Flashcards
After a traumatic event, “acute stress” lasts up to ________.
After that, it is PTSD
1 month
What are some of the long term physiological, emotional, and cognitive effects of Trauma?
Sensitized to threat- easily startled
Intense, all-or-nothing emotional reactions
Disruption of what we previously believed to be true about the world
Memory and cognitive impairments
All-or-nothing thinking
What areas of life does trauma disrupt?
Safety
Trust
Power and control- feel powerless
Esteem- self worth decreases
Intimacy
In sexual trauma, the perpetrators is frequently_____________
Someone you know and trust
True or false:
The younger you are when you are the victim of sexual trauma, the worse you’ll be affected for the rest of your life
True
PTSD is a ________
Sexual trauama is an ______________
Diagnosis
Experience
After a sexual trauma, what other conditions might someone be diagnosed with?>
PTSD
Depression
Substance abuse
Eating disorders
Dissociative disorders (out of body experiences)
Physical health problems (pelvic pain, back pain, headaches, etc)
What is the NUMBER ONE protective/resiliency factor to prevent the development of PTSD after a trauma?
SUPPORT SYSTEM ⭐️⭐️⭐️⭐️
Other than a strong support system, what are some other protective/resilience factors may prevent PTSD after a trauma?
Emotional regulation skills
Religion
High achievement/high self-regard
Being smart
Mobilization after a threat (getting away from a bad situation?)
What are the risk factors for developing PTSD?
SEVERE trauma
Physical injury
Ongoing stress
Stressful occupation!!!👮🏼♂️👩🏽🚒🚑
Young age
Psychiatric comorbidities
Shaming, blaming
Poor coping skills
Low SES, education, intelligence
Lack of social support
How will someone who is wearing the PTSD dinosaur suit act?🦖
They feel threatened all the time. They see everything as life or death. They always feel rage or terror.
Their reptilian brain is overactive
What is the name of the screening test you can use in Primary Care to screen for PTSD?
PC-PTSD lol
What are the 4 questions that are on the PC-PTSD?
In you life have you ever had an experience that was so awful, that in the past month you:
- Have had nightmares about it or thought about it when you didnt want to?
- Tried hard not to think about it or went out of your way to avoid situations that reminded you of it?
- Were constantly on guard, watchful, or easily startled?
- Felt numb or detached from others, activities, or your surroundings?
What are the criteria for PTSD that can be remembered by the mnemonic DREAMS?
Detachment
Re-experiencing the event
Event had Emotional Effects
Avoidance
Month in duration
Sympathetic hyperactivity/hypervvigilance
Wanna see the DSM5 criteria for PTSD just for kicks?
ALL of the following must be met:
Exposure to a traumatic stressor (Index Event)
Re-experiencing symptoms (dreams, flashbacks)
Avoidance of memories or reminders
Negative alterations in cognition and mood
Alterations in arousal or reactivity (irritable, outbursts, reckless, startled, sleep problems)
Duration of ONE MONTH
If someone seems to check off all the symptoms for PTSD, but its only been going on for 3 weeks, what is their diagnosis?
Acute Stress Disorder
**
How long must someone experience PTSD symptoms to get a diagnosis of PTSD
ONE MONTH
What is the name of the screening test used to screen for depression?
PHQ9
What is the name of the screening test used to test for generalized anxiety?
GAD7
What is the name of the screening test used to screen for bipolar?
MDQ
Mood Disorder questionnaire
What are the 2 most common psych comorboties that come along with PTSD?
Major depression 😰
Substance abuse 🥃
What are some common health conditions that go along with PTSD
(No surprises here)
Heart disease
Autoimmune disease
Hyperlipidemia
Interstitial cystitis
Dementia
Fibromyalgia/chronic fatigue
Chronic pain
How might a patient with PTSD present in the clinical setting?
NO-SHOWING APPOINTMENTS***
Not completing therapy assignments
Resisting therapy
Not taking meds/forgetting to take them
Labile mood, difficulty self-regulating
What are some tips for PAs who are treating PTSD patients?
Introduce yourself to them🤝
Ask for permission before touching them👋🏻
Dont stand behind them or out of their sight 🕴
Let them choose the gender of their provider 🕺🏼💃
Dont ask them nosy questions about what happened 👃
VALIDATE VALIDATE VALIDATE
Should you validate the feelings of people with PTSD?
YES
VALIDATE VALIDATE VALIDATE
What are the 4 steps to treating PTSD?
- Educate them
- Treatment options (therapy +/- pharm)
- Develop common goals
- Develop a treatment plan
What is the treatment goal with PTSD?
You have to take care of the TRAUMA and treat the comorbid conditions
Which will lead to less symptoms, improved functioning, etc.
What is the initial treatment step for PTSD?
Psychotherapy + SSRI/SNRI
Most important treatment for PTSD!!!!!
You’ve already tried psychotherapy and an SSRI/SNRI for a patient’s PTSD. What’s your next option if it isn’t working?
Switch the drug for something else
You’ve already tried treating your patient’s PTSD with psychotherapy and all the SSRIs out there. What is the next option available to try?
Mirtazapine
Nefazodone
Or a TCA
+ psychotherapy
What is the last-ditch options to treat PTSD when all previous treatment has failed?
Alternative med + TCA or phenelzine
+ psychotherapy
For psychotherapy for PTSD it lists some options for treatment. What are the top 2 types of therapy that should be utilized?
What did Dr. Stoehr say you should probably do before just jumping into trauma therapy?
CBT and EMDR
Just talk therapy first to ease them in without traumatizing them over again
What are the 2 SSRIs that are FDA approved for PTSD?
Sertraline
Paroxetine
What 2 classes of drugs are NOT recommended for PTSD?
Antipsychotics
Benzos
What drugs can help PTSD patients with the following symptoms?
Insomnia
Nightmares
Hyperarousal
Insomnia = trazodone
Nightmares = Prazosin
Hyperarousal = B Blockers
What are the 3 scenarios where you WOULDN’T immediately refer for trauma therapy because you’d need to treat these first?
- Primary active substance abuse
- Cognitive impairment
- Intrusive/untreated psychosis
What should you do if a PTSD patient just wants med increases during therapy?
Consider if it’s clinical necessary
They need to be able to learn coping skills without just medicating every time it gets uncomfortable
