Trauma Flashcards
What are the three types of actual or threatened events that can constitute trauma in the DSM-5 definition?
- Death
- Serious injury
- Sexual violence
What are the three ways of experiencing a threat that can constitute trauma in the DSM-5 definition?
- Directly
- Witnessing in person as it occurs to others (especially primary caregivers)
- Learning that it occurred to a caregiver
What percentage of young people experience trauma before age 18?
31%
What is network trauma?
Trauma that occurred to someone you care about
How long after a traumatic event do most people have symptoms subside?
One month
How long after a traumatic event will a person who’s still experiencing symptoms probably not recover spontaneously?
Three months
What is the course of (untreated) PTSD?
Constant symptoms, not much fluctuation.
What symptom is in the DSM-5 PTSD criteria and not in the ICD-11 criteria?
Changes in cognitions and mood
What percentage of people who experience trauma will develop PTSD?
Less than 30%
What type of traumatic event is most likely to result in PTSD?
Directly experienced interpersonal assault or threat
Which gender is more likely to develop PTSD after trauma?
Women
In what direction does SES affect the likelihood of developing PTSD after trauma?
Lower SES means more likely to develop PTSD
In what direction does IQ affect the likelihood of developing PTSD after trauma?
Lower IQ means more likely to develop PTSD
Does trauma only affect people who develop PTSD?
No
Do most people who experience trauma develop a mental disorder?
No
Do all children in OOHC have mental health difficulties?
No
What is the relationship between PTSD and other mental health conditions?
High comorbidity. PTSD increases risk for mental health conditions more so than trauma exposure alone. Especially psychosis, substance use, suicide, and self-harm.
What did Ehlers and Clark do?
Created the model of PTSD that we use
How does avoidance prevent change in PTSD?
When you avoid a trigger, you can’t learn that the feared thing doesn’t happen.
Explain how the nature of the trauma memory can cause PTSD
When the memory is laid down, it’s fragmented, distorted, and disjointed without a narrative structure. The brain can’t file it away properly and keeps bringing it up as it tries to process it. This makes the threat feel ongoing, not in the past.
What is the goal of trauma therapy?
To bring the memory out, update it to be accurate, and give it a narrative structure with a beginning, middle, and end. This lets the brain file it away properly so you can move forward.
Why is avoidance less relevant for PTSD in kids?
They often don’t get the option to avoid triggers.
Is medication recommended for PTSD?
No
What is the front-line (best) treatment for PTSD?
Trauma-focused CBT
What is the second best treatment for PTSD in children?
EMDR
What is the front-line (best) treatment for C-PTSD?
Trauma-focused CBT
How do you do trauma therapy when someone is still in an actively threatening situation?
Don’t try to unpack memories. Don’t discourage behaviours like avoidance (which are adaptive and important). Try to make sure basic needs are met, create space for finding positive connections and sources of security.
Should caregivers be involved in trauma therapy for children?
Case-by-case basic, no significant difference in evidence. Consider the caregiver’s own possible trauma and reactions to child’s trauma.
If a child wants to talk about their trauma, should you talk about it with them?
Yes
What four things can adults do to support children exposed to trauma?
- Listen and talk about the trauma if the child raises it
- Be aware of triggers
- Be consistent, predictable, and give clear boundaries and routine
- Support emotional regulation
How appropriate are traditional PTSD criteria for identifying PTSD in young children?
Very poor - use the criteria for 6 years and under.
What are the three Ms for trauma therapy in children?
Memory, meaning, management
How do you do CBT-3M with young children?
Exposure work, often through play (lego, stuffed animals) and drawing
How effective is exposure-based trauma therapy compared to non-exposure therapy?
Huge difference in effectiveness (85% vs 7%)
What are the three main symptoms of PTSD (ICD-11)?
- Avoidance
- Re-experiencing in the present
- Sense of current threat
What are the three additional symptoms of C-PTSD beyond PTSD alone? (ICD-11)
- Affect numbing (dissociation) or over-reactivity
- Persistent negative self-concept
- Difficult interpersonal relationships
How well-established is the existence of C-PTSD?
Very contentious, medium evidence. In ICD-11 but not DSM-5. Supported by factor analysis but needs more work on validity and reliability.
Name an example of affect numbing?
Dissociation
What is dissociation?
Feeling detached from your body, like you’re observing yourself. World feels unreal or dreamlike.
What is the key distinction (symptom) between PTSD and C-PTSD?
Affective numbing/ dissociation
What types of trauma usually cause C-PTSD?
Repeated trauma or an experience that involves various types of trauma
Do you need to do any preparatory/ stabilisation work before doing trauma work?
No
How young can children experience PTSD?
As young as one year old, according to DSM
How do you determine whether an event might be a trauma for young children?
It’s the perception of threat that causes trauma, not the facts of the event.
What are the three common/ core themes of trauma appraisals for children?
- Feeble person in a scary world
- It’s my fault
- I couldn’t protect my loved one
