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Psychiatry > Responses to Trauma > Flashcards

Responses to Trauma Flashcards

1
Q

What are the two types of traumatic event?

A

Type 1 - single incident that is sudden and unexpected
Type 2 - repetitive almost expected (abuse, genocide, betrayal), developmental trauma associated with attachment and attunement

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2
Q

What percentage of people will bipolar will have suffered childhood abuse/deprivation?

A

50%

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3
Q

Describe immune response to orthopaedic trauma

A

Unhealed fractures have altered IL6 receptor and psychologically PTSD

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4
Q

What is the significance of neuropeptide Y?

A

Higher in those with special forces training and it is protective against PTSD

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5
Q

Where do freeze/flee responses originate?

A

Periaqueductal grey area or ventral segmental area in midbrain

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6
Q

Why do you not feel pain in trauma?

A

Dissociation - the insula in the limbic system cuts off the rest of the body - improving chances of survival

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7
Q

What area of the brain shuts down in fear response?

A

Broca’s area

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8
Q

Describe a freeze response

A

Tonic immobility - involuntary state of profound motor inhibition

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9
Q

How does the brain activity change as a predator approaches?

A

Predator distant - activity in frontal lobe

Predator close - activity in PAG

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10
Q

What is the difference in structural findings between childhood and adult trauma?

A

Adult - reduction of hippocampal volume on right side

Childhood - reduction of hippocampal volume on left side

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11
Q

What is neuroception?

A

Allows us to distinguish between safe/dangerous/life threatening stimuli. Takes place in primitive parts of the brain without conscious awareness, triggers prosocial or defensive behaviours

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12
Q

Which two parts of the brain are involved in healing?

A

Superior colliculus

PAG

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13
Q

What are the risk factors for post traumatic reactions?

A

Manmade trauma, prolonged trauma, perceived threat to life, proximity to danger, personal factors and environmental factors

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14
Q

How are physiological reactions distinguished from pathological reactions?

A
  • severity
  • frequency
  • duration
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15
Q

What are the symptoms of clinical trauma?

A

Numbness, shock, denial, depression, anger, impaired sleep, hopelessness, avoidance, perceptual changes, guilt

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16
Q

What disease can manifest as a result of trauma?

A 
Acute stress disorder (<4weeks)
PTSD
Depression 
Grief 
Panic attacks
Hypomania 
Specific phobias
17
Q

What is the diagnostic criteria for PTSD?

A

Traumatic event
<1 intrusive symptoms
1 or 2 avoidance symptoms
>1 negative alterations in cognition and mood
>2 increased arousal and reactivity
Functional impairment and symptoms present for 1 month

18
Q

What are intrusive symptoms?

A

Nightmares, flashbacks, physiological reactions, distress when remembering

19
Q

What are avoidance symptoms?

A

Avoid talking about trauma

Avoid external reminders (seeing people or doing certain things)

20
Q

What are negative alterations in mood and cognition?

A

Amnesia, loss of interest, negative affect, isolation, lame, negative thoughts

21
Q

What are symptoms of increase arousal and reactivity?

A

Sleep disturbance, aggression, hyper vigilance, startle, destructive behaviour

22
Q

What is complex PTSD?

A

Core PTSD symptoms plus

  • negative self concept
  • emotional dysregualtion
  • chronic interpersonal difficulties
23
Q

How is PTSD treated?

A 
Psychological therapies (CBT and 3MDR)
Pharmacological (symptomatic)
24
Q

What drugs can help in the management of PTSD?

A

Antidepressants (venlafaxine/SSRI)
Antipsychotic (rispiredone)
Prazosin (alpha agonist)
Mood stabilisers - carbamazepine

25
Q

How is complex PTSD treated?

A
  • stabilisation and safety
  • trauma treatment
  • reintegration
26
Q

What is the problem with CBT?

A

It does not address brainstem response to trauma, reactivation does not require speaking and CBT may be too activating

27
Q

Describe the summary of PTSD treatment

A
  1. Mild or <4 weeks since trauma - watchful waiting
  2. Within 3 months - CBT or hypnotic medication
  3. More than 3 months - CBT or EMDR
  4. Limited evidence for drug treatment

Psychiatry (18 decks)

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