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Psychiatry Year 3 Dundee > Response to Trauma - PTSD > Flashcards

Response to Trauma - PTSD Flashcards

1
Q

How are traumatic events broken up?

A

Type 1

Type 2

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2
Q

Describe Type 1 traumatic events

A

Single sudden event

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3
Q

Describe Type 2 traumatic events

A

Repetitive trauma

Ongoing abuse

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4
Q

Which type of trauma is most likely to develop into PTSD?

A

Type 2 is 3x more likely to develop into

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5
Q

Where in the brain does Fear and anxiety arise from?

A

Peri-aqueductal Region

Ventral Tegmental area

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6
Q

What is fear?

A

Genetically ingrained function that promotes survival

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7
Q

Freeze - focus of fear is distant

A

Stop Watch Listen - voluntary

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8
Q

Freeze - focus of fear is inescapable

A

Tonic immobility

Involuntary but reversible motor inhibition

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9
Q

Activity in the Periaqueductal Grey Matter relates to what?

A

Dread

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10
Q

What can result in right sided hippocampal volume reduction?

A

Adult trauma

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11
Q

What can result in left sided hippocampal volume reduction?

A

Childhood trauma

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12
Q

What region of the brain relates to Desire and seeking?

A

Ventral tegmental

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13
Q

What region of the brain is related to Rage and Anger?

A

Dorsal PAG

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14
Q

What region of the brain is related to Lust?

A

Ventral and Dorsal PAG

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15
Q

Where does neuroception occur?

A

Within the primitive brain

Midbrain Medulla Pons

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16
Q

What is Neuroception?

A

Unconscious system that determines whether situations are safe or dangerous.
Activates prosocial or defensive behaviours
Means when we become consciously aware i.e we hear see or feel it we are able to react to it faster.

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17
Q

What is the job of the superior colliculi?

A

Orientates us towards or away from the stimuli

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18
Q

What is the job of the PAG?

A

Generation of an emotional response to the information supplied by the Superior Colliculi

19
Q

Based on the regions of the brain associated to stimuli and emotional response which area is focused on when healing?

A

PAG and Superior colliculi likely best area to try and “rewire” as this is the basis of underlying fear.
Conscious awareness only occurs when at cortical level

20
Q

What region of the brain is deactivated when exposed to current or the memory of trauma?

A

Brocas Area

21
Q

Which protein is known to be protective against PTSD?

A

Neuropeptide Y - Gamma

22
Q

What are some trauma related Risk factors for developing PTSD?

A 
Man made
Prolonged exposure
Perceived threat to life
Grotesque scenes
Proximity to course
Personally relevant i.e children involved
23
Q

What are some patient related Risk Factors for developing PTSD?

A

Serious physical injury

FH or PH of mental disorders

24
Q

What some environmental risk factors for developing PTSD?

A

Lack of support network

Ongoing life stresses

25
Q

What percentage of patients recover psychosocial from their experience with no need of specialist care?

A

50%

26
Q

What is the normal acute response to a traumatic event?

A 
Numbness
Shock
Fear
Depression 
Guilt 
Anger
Impaired sleep
Helplessness
Aviodance
27
Q

What makes it a pathological response to a traumatic event?

A

Severity and duration is beyond what is expected

>4 weeks

28
Q

How long does acute stress disorder last for?

A

Less than 4 weeks

29
Q

What are main symptoms of PTSD?

A

Depression
Panic attacks
Phobias

30
Q

What are the five categories of PTSD symptoms

A 
Intrusive
Avoidance
Negative Alterations
Increased Arousal and reactivity
Functional impairment
31
Q

In order to be diagnosed with PTSD what intrusive symptoms do you need?

A 
More then 1 of the 5 
Recurrent recollections
Nightmares
Flashbacks
Distress from reminders
Physiological reactions
32
Q

In order to be diagnosed with PTSD what avoidance symptoms do you need?

A

One or both of
Thoughts and feelings
External reminders i.e locations people

33
Q

In order to be diagnosed with PTSD what Negative alterations do you need?

A

More than 1 of the 7

Negative alterations in cognition and mood

34
Q

In order to be diagnosed with PTSD what increased arousal and reactivity symptoms do you need?

A 
More than 2 of the 6
Sleep 
Irritable
Concentration
Vigilance
Startled
Destructive
35
Q

How long does the functional impairment have to last to get a diagnosis of PTSD?

A

Over 1 month

36
Q

What are some Negative alterations?

A

Amnesia for key aspects
Loss in interest in activities
Negative affect
Overly negative thoughts and assumptions about self and world
Exaggerated blame to self and others
Feeling isolated
Difficulty experiencing positive emotions

37
Q

Alongside the usual symptoms what is required for a diagnosis of Complex PTSD?

A

Negative self concept - low self esteem, hopelessness, pervasive shame and/ or guilt
Emotional dysregulation - violent or emotional outbursts, reckless behaviour

38
Q

What are some tension reducing activities seen in complex PTSD cases?

A

Binging then purging
Self mutilation
Substance misuse

39
Q

Why is there a decreased focus on Top down therapies such as CBT for the treatment of PTSD?

A

CBT focuses on the conscious cortex regions of the brain, these regions are not the source of the issue they simply interpret it. The mammalian brain is the driver behind fear.

40
Q

What therapies focus on rewiring the mammalian brain i.e superior colliculus and the PAG?

A

Eye Movement Desensitisation and Reprogramming EMDR

41
Q

What is the role of pharmacotherapy in PTSD?

A

Symptomatic treatment for acute

2nd line or augmenting Therapy

42
Q

What antidepressants are used?

A

Venlafaxine

SSRIs i.e sertraline

43
Q

What Antipsychotics are used?

A

Risperidone ( severe hyperarousal )

44
Q

What are some alternative medications used?

A

Mood stabilisers e.g. carbezamapine

Prozosin Alpha 1 Antagonists

Psychiatry Year 3 Dundee (21 decks)

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