Responses To Traumatic Stress Flashcards
What is a type 1 traumatic event?
Single incident trauma, unexpected
What is type 2 traumatic event?
Complex : Repetitive trauma Ongoing abuse, hostage taking, genocide Betrayal of trust in primary care giving relationship Developmental trauma Attachment disruption
What happens in neurobiology of threat?
Increasing proximity to a predator shifts brain activation rom prefrontal cortex to the midbrain superior colliculi and periaquiductal gray (PAD)
Does acute stress increase or decrease cortisol levels?
Increase
Levels of cortisol in PTSD?
Low
How does cortisol mediated the stress response?
Through negative feedback acting on the pituitary, hypothalamus, hippocampus and amygdala - sites responsible for stimulation of cortisol release
Psychological reactions after trauma?
Depression Grief reactions Panic attacks +/- agoraphobia Alcohol/ drug dependence Brief hypo mania Specific phobias PTSD
PSTD association with suicide?
X6
Examples of intrusive phenomenas
Recurrent distressing recollections Nightmares Flashbacks Distress accompanies reminders Physiological reactions
Examples of avoidant or emotional numbing symptoms?
Avoidance of thinking or talking about event
Avoidance of reminders like activities, places and people
Amnesia for important aspect of trauma
Loss of interest in activities
Detachment
Emotional numbing
Sense of foreshortened future
Examples of hyperarousal symptoms
Sleep disturbance Irritability/ anger Concentration difficulties Hypervigilance Exaggerated startle response
Examples of associated symptoms
Dissociative symptoms - depersonalisation, derealisation, awareness of surroundings. Near death or out of body experiences
Survivor guilt
Performance guilt
Is treatment different for complex and simple PTSD?
No
What is treatment for PTSD?
CBT or EMDR
Offer regardless of time lapse since trauma
Treatment long enough, regular and with same therapist
Augmentation with meds if failure to respond
