Responses to Trauma Flashcards
What is a type 1 trauma?
single incident trauma, unexpected
What is a type 2 trauma?
repeitive trauma
What is the risk of PTSD in type 2 trauma compared to type 1?
x3 risk
What predicts the need for psychotherapy as well as pharmacotherapy in chronic dpression?
hx of early life trauma
How many patients with bipolar have a hx of childhood dperivation or abuse?
50%
What physical health problems is trauma exposure associated with?
infections; pain disorders; HT; DM; asthma and allergis
What physical health effects is post-traumatic stress disorder associated with?
excess all-cause mortality
What are the features of tonic immbolity?
decreased vocalisation; intermittent EC; rigdity and paralysis; muscle tremors in extremities; chills; unresponsiveness to pain
What occurs in response to an inescable threat?
tonic immobility- esp. when direct physical contact with aggressor
What is tonic immobility?
involuntary state of profound but reversible motor inhibition
What is the suggested neurobiology of PTSD?
deficiency in top-down modulation of amygdala acivation by the prefrontal cortex
What are the changes in the brain when feel under threat?
shift from prefrontal cortex to midbrain superior colliculi and periaqueductal gray
How do cortisol levels change in PTSD?
lower
What is the ICD definition of a traumtic event?
delayed and or protracted response which is exceptionally threatening or catastrophic and likely to cause pervasive distress in almost anyone
What are the risk
factors for developing PTSD
sudden, unexpected events; man-made; prolonged exposure; perceived threat to life; grotequesness; personally relevant factors
What are the characteristics of PTSD?
involuntary re-experiecing of elements of the event; hyperarousal; avoidance and emotional numbing
What are the symtpoms of increased psychological sensitivity and arousal?
difficulty falling/staying asleep; irritability or outbursts of anger; difficultiy concentrating; hypervigilance and exaggerated startle resposne
What are the psycholigical reactions after trauma?
depresssion; gried reactions; panic attacks +/- agoraphobia; alcohol/drug dependence; brief hypomania; specific phobias; PTSD
What is the association of suicide with PTSD?
risk is increased x6
What is the signifiacance of comorbidity with PTSD?
approx. 80% have 1 or more other psych conditions
What are the most common comorbid disorders with PTSD?
depression; drug and alcohol abuse; other anxiety disorders
What are intrusive phenomena?
recurrent distressing recollections; nightmares; flashbacks ; physiological reactions (flight or fight)
What are the associated symptoms of PTSD?
dissociative- depersonalisation and derealisation; survivor guilt and performance guilt
How long must someone have symptoms before PTSD can be diagnosed?
1 month
Where are defence and orientating responses like basica emotional systems generated?
midbrain
How does PTSD affect the brain?
PTSD symptom correlateds with hippocampal size
What causes a small hippocampus in PTSD?
small may be risk factor for lack of recovery or PTSD effects on vlume is reversible
What are the main trauma-focused psychological treatments?
CBT and EMDR
What is EMDR?
eye movment desensitisation and reprocessing
What is high arousal in PTSD mediated by?
anterior cingulate; medial prefrontal cortex and thalamus
What is the vulnerability risk factors for developing PTSD?
ow education; lower social class; afrocaribbean/hispanic; female; low self-esteem; prev (of family hx of psych problems or previous traumatic events
How does EMDR work?
uses voluntary mutli-saccadic eye movemtns to reduce anxiety assoc. with disturbing thoughts
What SSRIs are licensed for PTSD?
paroxetine and sertraline
