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Psychiatry > Responses to Trauma > Flashcards

Responses to Trauma Flashcards

1
Q

What is a type 1 trauma?

A

single incident trauma, unexpected

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2
Q

What is a type 2 trauma?

A

repeitive trauma

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3
Q

What is the risk of PTSD in type 2 trauma compared to type 1?

A

x3 risk

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4
Q

What predicts the need for psychotherapy as well as pharmacotherapy in chronic dpression?

A

hx of early life trauma

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5
Q

How many patients with bipolar have a hx of childhood dperivation or abuse?

A

50%

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6
Q

What physical health problems is trauma exposure associated with?

A

infections; pain disorders; HT; DM; asthma and allergis

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7
Q

What physical health effects is post-traumatic stress disorder associated with?

A

excess all-cause mortality

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8
Q

What are the features of tonic immbolity?

A

decreased vocalisation; intermittent EC; rigdity and paralysis; muscle tremors in extremities; chills; unresponsiveness to pain

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9
Q

What occurs in response to an inescable threat?

A

tonic immobility- esp. when direct physical contact with aggressor

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10
Q

What is tonic immobility?

A

involuntary state of profound but reversible motor inhibition

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11
Q

What is the suggested neurobiology of PTSD?

A

deficiency in top-down modulation of amygdala acivation by the prefrontal cortex

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12
Q

What are the changes in the brain when feel under threat?

A

shift from prefrontal cortex to midbrain superior colliculi and periaqueductal gray

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13
Q

How do cortisol levels change in PTSD?

A

lower

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14
Q

What is the ICD definition of a traumtic event?

A

delayed and or protracted response which is exceptionally threatening or catastrophic and likely to cause pervasive distress in almost anyone

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15
Q

What are the risk

factors for developing PTSD

A

sudden, unexpected events; man-made; prolonged exposure; perceived threat to life; grotequesness; personally relevant factors

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16
Q

What are the characteristics of PTSD?

A

involuntary re-experiecing of elements of the event; hyperarousal; avoidance and emotional numbing

17
Q

What are the symtpoms of increased psychological sensitivity and arousal?

A

difficulty falling/staying asleep; irritability or outbursts of anger; difficultiy concentrating; hypervigilance and exaggerated startle resposne

18
Q

What are the psycholigical reactions after trauma?

A

depresssion; gried reactions; panic attacks +/- agoraphobia; alcohol/drug dependence; brief hypomania; specific phobias; PTSD

19
Q

What is the association of suicide with PTSD?

A

risk is increased x6

20
Q

What is the signifiacance of comorbidity with PTSD?

A

approx. 80% have 1 or more other psych conditions

21
Q

What are the most common comorbid disorders with PTSD?

A

depression; drug and alcohol abuse; other anxiety disorders

22
Q

What are intrusive phenomena?

A

recurrent distressing recollections; nightmares; flashbacks ; physiological reactions (flight or fight)

23
Q

What are the associated symptoms of PTSD?

A

dissociative- depersonalisation and derealisation; survivor guilt and performance guilt

24
Q

How long must someone have symptoms before PTSD can be diagnosed?

A

1 month

25
Q

Where are defence and orientating responses like basica emotional systems generated?

A

midbrain

26
Q

How does PTSD affect the brain?

A

PTSD symptom correlateds with hippocampal size

27
Q

What causes a small hippocampus in PTSD?

A

small may be risk factor for lack of recovery or PTSD effects on vlume is reversible

28
Q

What are the main trauma-focused psychological treatments?

A

CBT and EMDR

29
Q

What is EMDR?

A

eye movment desensitisation and reprocessing

30
Q

What is high arousal in PTSD mediated by?

A

anterior cingulate; medial prefrontal cortex and thalamus

31
Q

What is the vulnerability risk factors for developing PTSD?

A

ow education; lower social class; afrocaribbean/hispanic; female; low self-esteem; prev (of family hx of psych problems or previous traumatic events

32
Q

How does EMDR work?

A

uses voluntary mutli-saccadic eye movemtns to reduce anxiety assoc. with disturbing thoughts

33
Q

What SSRIs are licensed for PTSD?

A

paroxetine and sertraline

Psychiatry (20 decks)

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