Responses to Trauma Flashcards
What are the different classes of trauma?
Intentional = assault, robbery, rape
Unintentional = motor accident, industrial accident
Community disasters may be natural or man made
What is type 1 trauma?
Single incident trauma
What is type 2 trauma?
Repetitive trauma = usually a betrayal in trust in primary caregiver, 3x higher risk of PTSD than type 1
What people are more likely to experience trauma?
The poor and the marginalised
What is needed to treat patients with chronic depression who have a history of early life trauma?
Need psychotherapy as adjunct to medication
How common is early trauma in patients with bipolar disorder?
50% of bipolar patients have history of childhood deprivation or abuse
Dysregulation of what systems has been linked to how patients respond to trauma?
Catecholamine system, serotonin system, HPA axis, endogenous opioid system, immune response to trauma, glutamate system, GABA-benzodiazepine system, thyroid function, neuropeptide Y
What are anxiety and fear?
Genetically ingrained functions of nervous system = not weaknesses, promote survival
What causes emotion to arise during fear and anxiety?
Emotions arise from neural processes that prompt us to freeze (distant threat) or to flee (near threat)
Where do anxiety and fear responses originate from?
In the PAG or ventral tegmental area
What are some features of the freeze response?
Can be voluntary when distant threat
Types = tonic immobility, frozen fight/flight/attach/hide, attention or attentative freeze, low arousal freeze
What is the response to an inescapable threat?
Tonic immobility = involuntary state of profound motor inhibition, occurs especially when direct physical contact with threat is present
What changes can be seen in descendants of those exposed to trauma?
Have altered cortisol responses and are more likely to suffer from PTSD
What effect does trauma have on the brain?
Adult trauma reduces brain volume on right side
Childhood trauma reduces brain volume on left side
What does hippocampal size correlate to?
Severity of PTSD
Where is activity seen in the brain when a threat is near?
The PAG in the midbrain
Where is activity seen in the brain when the threat is far?
Rostral anterior cingulate cortex and medial prefrontal cortex
What is neuroception?
How neural circuits distinguish whether situations or people are safe or life threatening
Where does neuroception take place?
In primitive parts of the brain = not under conscious control
What does neuroception trigger?
Neurobiologically determined prosocial or defensive behaviours = not aware of threat on cognitive level but neuronal processes have already started reacting
What is the superior colliculi responsible for?
Basic urge of actions is orienting towards or away from
Responsible for orientation to social information
What is the PAG responsible for?
Generates emotional response to traumatic event = extensively linked to superior colliculi
Where does healing of deep wounds take place?
On the level of the superior colliculi and PAG
What are some trauma related risk factors for PTSD?
Man-made events, prolonged exposure, perceived threat to life, exposure to grotesque scenes, proximity, personally relevant factors
