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Psychiatry > Response to trauma > Flashcards

Response to trauma Flashcards

1
Q

what is type 1 trauma

A

single unexpected traumatic incident

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2
Q

what is type 2 trauma

A

ongoing, repetitive trauma
betrayal of trust
developmental trauma

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3
Q

severity of trauma is more important than the perception of that trauma, true or false

A

false

perception is more important

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4
Q

consequences of trauma

A

impact on mental health

leads to impact on physical health

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5
Q

antidepressants alone are effective for management of trauma, true or false

A

false

need additional psychotherapy

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6
Q

criteria for PTSD (NICE)

A

anyone who has witnessed a traumatic event
experience “reliving” of the situation
exhibit avoidance

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7
Q

what is the difference between normal and pathological responses to trauma

A

severity, duration and frequency of symptoms

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8
Q

RFs for PTSD

A 
severe acute stress reaction 
low serum cortisol increase acutely 
FH or personal history of mental disorder
serious physical injury 
loss of normal daily function 
extremes of age 
genetics
previous traumatic experiences
lifestyle
female
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9
Q

pre traumatic risk/resilience factors

A

person related

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10
Q

peri traumatic risk/resilience factors

A

trauma related

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11
Q

post-traumatic risk/resilience factors

A

environment related

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12
Q

normal reactions to trauma

A 
numbness, shock, denial
fear
depression/elation
anger, irritability
guilt
impaired sleep 
hopelessness, helplessness
avoidance
intrusive experiences - flashbacks
hyperarousal 
hypervigilance
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13
Q

psychological reactions after trauma

A 
depression 
grief reactions 
panic attacks +- agoraphobia
alcohol/drug dependence
brief hypomania
specific phobias
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14
Q

comorbidities of PTSD

A

depression
drug and alcohol misuse
anxiety disorders

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15
Q

what are intrusive phenomena

A

recurrent distressing collections

eg nightmares, flashbacks in any modality, distress accompanies reminders

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16
Q

what are avoidance symptoms

A 
avoidance of thinking or talking about the past, activities, places, people
amnesia for important aspect of trauma 
loss of interest in activities 
detachment 
emotional numbing 
sense of foreshortened future
17
Q

hyperarousal symptoms

A 
sleep disturbance
irritable/angry
concentration difficulties
hypervigilance
exaggerated startle response
risky and destructive behaviour
18
Q

association symptoms

A

dissociative: depersonalisation, derealisation, near death or out of body experiences
survivor guilt
performance guilt

19
Q

DSM 5 criteria for PTSD

A 
duration 1 month
intrusive symptoms
avoidance symptoms
hyperarousal symptoms 
association symptoms 
negative changes in cognition and mood 
impairs social functioning
20
Q

symptoms < 1 month

A

acute distressive disorder

21
Q

what is complex PTSD

A 
PTSD symptoms PLUS: 
cognitive disturbances 
identity disturbance
emotional dysregulation 
chronic interpersonal difficulties
dissociation 
somatisation 
tension reduction activities eg bing-purging, self harm, substance misuse
22
Q

role of hippocampus

A

memory forming and stress response

23
Q

role of amygdala

A

fear during trauma and its recollection

24
Q

receptors for cortisol are more sensitive in people with PTSD, true or false

A

true

25
Q

chronic PTSD has low/high serum cortisol levels

A

low

26
Q

is there is hippocampal atrophy in PTSD

A

yes

27
Q

there is increased/decreased activity of the amygdala

there is activation/deactivation of Broca’s areas

A

increased

deactivation

28
Q

what should be ensured before starting treatment

A

safety of the patient

29
Q

what are the main psychological therapies for PTSD

A

Trauma focussed:
Cognitive Behavioural Therapy CBT
Eye Movement Desensitisation and Reprocessing EMDR

30
Q

when should psychological therapies be offered

A

regardless of time lapse since traumatic event

31
Q

if there is failure to respond to psychological therapies, what should be done

A

augment with medication

32
Q

in the acute phase, medication can be considered for what?

A

symptomatic treatment

33
Q

what is first line management of PTSD

A

trauma focussed psychological therapies

CBT and EMDR

34
Q

what medications can be given 2nd line if psychological therapy does not work

A

SSRIs
tricyclics
mirtazapine

35
Q

PTSD is/isnt a normal adaptation to severe traumatic stress

A

isnt

36
Q

most trauma exposed people develop PTSD, true or false

A

false

37
Q

__ months after event = PTSD

A

6 months

Psychiatry (27 decks)

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