Task 6 Flashcards
PTSD
-DSM criteria
A. person exposed to death, threathened death, actual or threathened serious injury
-direct exposure, witnessing the trauma, learning that close friend was exposed to trauma, indirect exposure to aversive details of the trauma (medics, first responders)
B. persistently re-experienced
-intrusive thoughts, nightmares, flashbacks, emotional distress after exposure, physical reactivity after exposure
C. avoidance of trauma-related stimuli
-thoughts or feelings, reminders
D. negative thoughts began or worsened after trauma (min 2)
-inability to recall key features of trauma, overly negative thoughts, blame of self or others, negative affect, decreased interest activities, feeling isolated, difficult experiencing positive affect
E. arousal and reactivity that began or worsened after trauma (min 2)
-irritability, risky behavior, hypervigilance, heightened startle reaction, difficulty concentrating, difficulty sleeping
F. more than 1 month
G. cause impairment
H. not due to substance
Epidemiology PTSD
- men more warzone and combat traumas, physical assaults and accidents
- women more child sexual abuse, molestation, rape and intimate partner violence
- 2x hoger voor vrouwen
PTSD
-four symptom trajectories
- resilience: maintain their low levels over time
- recovery: moderate disruptions which decrease
- chronic: severe disruptions and maintained these
- delayed: moderate disruptions which increase
3 subtypes of PTSD
- internalizing PTSD: tendency to direct distress inwardly with shame, anxiety and avoidance
- externalizing PTSD: tendency to direct distress outwardly with hostile interactions, other blame and acting out
- simple PTSD: low on both levels
PTSD
-DD
- ASD: diagnosed within 1 month of trauma ptsd after 1 month, ptsd certain symptoms in each category ASD 9 symptoms in total
- MDD: ptsd sleep disturbance because avoiding nightmares or due to hyperarousal symptoms (always insomnia) with mdd insomnia and hypersomnia
Trauma exposure and PTSD 9/11
-pollio
- geographical distance did not predict PTSD symptom criteria beyond a short distance from the towers
- substantial proportion of people in study who were directly exposed or exposed through close associates developed PTSD
PTSD and memory
- characteristics involuntary re-experiencing
- ehlers
- consists of sensory impressions, rather than thoughts
- feels like happening now
- re-experienced even when you know its not true
- re-experience sensations without recollection of event
- triggered by wide range of stimuli that do not have strong semantic relationship to trauma
PTSD and memory
-strong s-s and s-r associations
- particulary strong for traumatic material
- bv. hearing footsteps before sound of knocking when kidnapped
- explain the persistence of PTSD
- stimuli that were present before or during event become associated with prediction of danger to self
- affect without recollection
PTSD and memory
-strong perceptual priming
- car accident and vivid intrusion of seeing headlight in sunlight on his lawn
- reduced perceptual treshold for stimuli resuling that cues associated more likely to be noticed and trigger re-experience even if context is different
EMDR
-hypothesis 1 works by recalling aversive memories and eye movements do not contribute anything
- eye movements matter, the effects cannot be explained by exposure alone
- hypothesis dismissed
EMDR
-hypothesis 2 works by stimulating interhemispheric communication
- interhemispheric communication is stimulated by horizontal eyemovements and not by vertical eye movements
- hypothesis accepted
EMDR
-hypothesis 3 works by taxing working memory during recall
- recalling an episode depends on working memory resources
- if a secondary task is executed during recall that shares this dependence, fewer resources will be available for recalling an episode and the memory will be experienced as less vivid and emotional
- accept hypothesis
EMDR
-counter-effective
-when making eye movements during activation of positive thoughts rendered these thoughts less vivid and less positive, irrespective whether the movements were horizontal or vertical
EMDR
-effect of beeps
- binaural stimulation: beeps alternating left-right thought a headphone
- in line with interhemispheric theory
- however according wm theory, very little can be expected from beeps (registering beeps is passive task that may not even tax wm)
- patients prefere beeps relative to eye movements
Degrading flashforwards related to performance anxiety
- eye movements decreased image vividness and tended to decrease emotional intensity of future-oriented mental images related to performance anxiety
- reject that extinction due to exposure reduced this
