Task 2 - PTSD Flashcards
Traumas leading to PTSD
- natural disasters
- human-made disasters (wars, terrorist attacks, torture)
- sexual assault
environmental/social factors
- strong predictors of reaction to events: severity, duration, individual proximity
- social support -> the more the better
Psychological factors
- if experiencing anxiety/depression already before trauma -> PTSD more likely
- style of coping:
- self destructive/avoidant coping -> more likely
- dissociative -> those who do shortly after trauma are more likely
gender
- women more likely
- may experience triggers for anxiety disorders more often (rape)
- types of trauma frequently experienced are stigmatized -> decreases social support
Cultures
- more pressure in Mexico than US for women to be passive, self-sacrificing, compliant and for men to be dominant, fearless and strong
- > mexican women feel more helpless than men following a trauma
- > tendency to dissociate greater among latinos
Neuroimaging findings
- > brain regions regulating emotion, fight or flight response and memory
- Amygdala: more actively responding to emotional stimuli
- Medial PFC: modulates activity of Amygdala -> less active in people with severe symptoms -> less able to dampen reactivity
hippocampus
- shrinkage
- > possibly due to overexposure to neurotransmitters and hormones in stress response
- > may lead to memory problems
cortisol
- released as fight flight response
- resting levels of cortisol tend to be lower! among people with PTSD
- those who developed: lower levels after trauma
-> lower levels may result in prolonged activity of sympathetic NS following stress
cortisol
- released as fight flight response
- resting levels of cortisol tend to be lower! among people with PTSD
- those who developed: lower levels after trauma
- > lower levels may result in prolonged activity of sympathetic NS following stress
- > cortisol breaks down stress-related substances in your body -> so with lower amounts of cortisol -> body will stay ‘stressed’ for a longer time
Hypothalamic-pituitary-adrenal (HPA) axis
- unable to shut down response of sympathetic NS by secreting necessary levels of cortisol
- overexposure of brain to epinephrine, norepinephrine
- > cause memories to be ‘overconsolidated’ or planted more firmly in memory
Genetics
- vietnam veterans: if one identical twin had PTSD, other one was more likely than if fraternal twins
- adult children of holocaust survivers with PTSD -> 3x more likely to also develop it
- abnormally low cortisol levels may be one heritable risk for PTSD
CBT
- systematic desensitization
- relaxation techniques
- imagine event vividly
- help client to habituate to anxiety and distinguish memory from present reality
Stress-management interventions / stress- inoculation therapy
- teach clients skills for overcoming problems in their lives that increase their stress and may result form PTSD
- when patient cannot tolerate exposure to traumatic events as in exposure or cbt
- example: marital problems, social isolation
Biological Therapies
- selective seretonin reuptake inhibitor
- benzodiazepines (but less effective)
conditioning theory
- Trauma (US) associated with situational cues (CS)
- when cues encountered again -> arousal and fear
- conditioned responses do not extinguish bc of avoidance responses
- theory doesn’t explain why some people develop it and other don’t
- cannot explain symptoms like dissociation
Emotional processing theory
- severe traumatic experiences are of such major significance to individual
- > lead to formation of representations and associations in memory
- > quite different to those formed as a result of everyday experience
-Individuals who prior to trauma have fixed views about themselves and world are more vulnerable to PTSD.
Mental defeat theory
- negative frame of thinking
- process info about trauma negatively and view themselves as unable to act effectively as well as victims
- negative approach ads to distress and influences way individual recalls trauma
Evidence for mental defeat theory
- PTSD sufferers have negative views of self and world
- > negative interpretations of trauma, PTSD and of responses of others
- > belief that trauma has permanently changed their life
Dual representation theory
hybrid disorder involving two separate memory systems
1) Verbal Accessible Memory (VAM): registers memories consciously processed at the time, narrative, contain info about event, context, personal evaluations
- > can be easily retrieved
2) Situationally Accessible Memory (SAM): records info of trauma too brief to take in consciously, info about sight and sound, extreme bodily reactions
- > responsible for flashbacks
-> memory systems linked to amygdala
Intrusions
- flashbacks
- a scream for example > reminds you of war
- > assume there must be threat
Intrusion based reasoning (IR)
-tendency to interpret distressing intrusions themselves as evidence that danger is impending, regardless of objective danger information
Article: intrusion based reasoning and PTSD after exposure to a train disaster - findings
- when having intrusions about train disaster (e.g. sight of blood, sounds of crying)
- > situation is held to be more dangerous than without cues
- correlation of IR with acute and chronic PTSD was quite robust -> suggest strong relationship
Article: intrusion based reasoning and PTSD after exposure to a train disaster - method
- 4 descriptive scenarios
- objective danger info , distressing intrusions, no distressing intrusions etc
- > identify themselves as well as possible with main character of each scenario
- > rate perceived danger and trauma exposure scale
Article: Emotion- and Intrusion based reasoning in Vietnam veterans with and without PTSD -findings
- veterans without PTSD: inferred danger from objective information
- with PTSD: higher danger ratings on scenarios with anxiety info ( ER-> larger effect) and with intrusions (IR-> smaller effect)