Trauma Flashcards
1
Q
Epidemiology
A
- Trauma is common (61% men 51% women but not all trauma —> PTSD)
- PTSD (5% men 10% women)
- Women more likely sexual
- Men more likely physical
- 3% cont to have PTSD symptoms 5+ years out
2
Q
DSM Criteria for PTSD
A
- 1- Must have exposure to traumatic event
- Directly experience it, witness someone else experience it, learn about trauma occurring to someone close to you OR repeated exposure to aversive details of a traumatic event
- 2- At least 1-2 from each category below for 1 mo or more…
- Re-experiencing - intrusive memories, flashbacks, nightmares, distress at reminders
- Symptom Cluster
- Avoidance - forget details, avoid people/places/things, feel detached, restrict range of affect
- Cognition/Mood - memory gaps, blames self or others, negative beliefs, diminished interest, negative emotions, etc
- Hyperarousal - sleep disturbance, impulsive, inattentive, hyper vigilant, exaggerates startle response, self-destructive behavior
**Considered Acute Stress Disorder if 9 of above w/in 1 mo of exposure; after 1 mo of symptoms it becomes PTSD
3
Q
Type I v Type II Trauma
A
- Type I - single event, sudden or unexpected (ex- natural disaster, car accident)
- Type II - early in life, long term (multiple events), interpersonal (abuse from caregiver)
- HIGHER RISK OF PTSD
4
Q
3 Stages of Recovery
A
- Safety - establish therapeutic relationship and eliminate dangerous behaviors
- Remembrance/Mourning - explore, process, master trauma and grieve consequences
- Reconnection - resume old relationships, jobs, functions
5
Q
Therapy Tx (6)
A
**Generally better than meds
- Exposure Therapy - repeatedly imagine event or describe trauma BUT therapist helps make them fully aware that event is not actually happening
- Cognitive Processing Therapy - recall trauma in writing form
- CBT - restructure maladaptive interpretations
- Stress Inoculation Training - inc awareness of triggers and form coping skills
- Eye Movement Desensitization and Reprocessing - real traumatic event while completing side-to-side saccades; AKA distract self while going through memory
- Seeking Safety - program for ppl w/ PTSD and substance abuse
6
Q
Pharm Tx (+ what to avoid)
A
- SSRIs - help w/ associated depression/anxiety
- paroxetine, sertaline
- Prazosin (alpha 1 adrenerguc antagonist) - helps w/ nightmares, improves sleep
- Clonidine too - (alpha 2 agonist)
- Propanolol - dampen noradrenergic signaling BUT worsen nightmares
** Do not use opiates, benzos, barbiturates b/c chance of addiction AND disrupt exposure therapy
