Response to trauma

Question 1

Freeze response

-what happens to body?

Answer 1

-bdy goes into shutdown with an altered state of reality, body immobile and pain sensations reduced

Question 2

Traumatic stress

-contributing factors? (4)

Answer 2

trauma overwhelming
When there is a threat to body integrity/safety
witnessing death/injury to a loved one
when experience intense fear, hopelessness or horror

Question 3

Give the 2 types of trauma?

Answer 3

simple and complex

Question 4

Complex PTSD

-features? (8)

Answer 4

PTSD symptoms +
cognitive disturbance (low self esteem etc)
mood disturbance
somatisation 
identity disturbance
Chronic interpersonal difficulties 
dissociation 
tension reducing activities (binge-purging)

Question 5

How is the body stress response usually resolved?

-what is the emotional centre of the brain?

Answer 5

parasympathetic system:
muscles relax
skin warms
pupils return to normal 
attention refocused
HR slows
Blood pressure reduced

-Amygdala

Question 6

Trauma memories

• give features of these?
• what 5 types of trigger are there?

Answer 6

easily triggered
difficult to translate into words
Fragmented
Affect laden 
inability to recall some aspects of the trauma 

-Visual, auditory, smell, taste, kinaesthetic

Question 7

Features of PTSD

what are they?

Answer 7

NOT DIAGNOSED TILL 3 MONTHS AFTER EVENT!!
-flashbacks
(intrude, lead to fear, panic, anger sadness, guilt)

nightmares
(delayed sleep, no sense of safety)

avoidance
(won’t talk about it, avoid people involved)

increased arousal i.e. hyper vigilance
(exaggerated startle response)

emotional numbing
(detached, can’t feel loving)

dissociation
(walls off painful experience)

re-enactment
(recreating trauma, risk taking behaviour)

Question 8

Indicators of dissociation? (6)

Answer 8

Things look strange, colours may appear brighter or faded, tunnel vision

Sounds may appear muted or far away or Louder

The person may be rocking, tapping, twitching or grimacing

Things seem to move in slow motion

Feeling like a robot- functioning but not feeling

Feeling like a observer than a participant

Question 9

Acute stress disorder

• occurs when?
• components? (3)

Answer 9

within 1 month of the trauma and lasting 5 days

-dissociative symptoms
persistant re-experiencing
In arousal

Question 10

Treatment

• what should NOT be done?
• if mild?
• psychotherapeutic models? (2)
• if persistent?
• common components? (2)

Answer 10

• debriefing
• watchful waiting with review in 1 month

-trauma focused CBT
EMDR

-Paroxetine (SSRI)
Mirtazepine, amitriptyline, phenelzine if ^ doesn’t work

-remove survivor form crisis
educate survivors and families