Trauma Flashcards
What is special about the diagnostic criteria of PTSD?
It references a specific aetiology
What was the first country to officially recognise PTSD-like disorders?
Russia 1904-5
Do you have to personally experience the traumatic event in order to get the diagnosis of PTSD?
Nope - apart from experiencing it, you can either
- witness it
- learn about it happening to someone close to you
- experience repeated exposure to aversive details (eg a cop taking in child abuse stories)
Can you have a diagnosis of PTSD without reoccurring experiences of the trauma?
No
Reoccurring experiences of the trauma must be present to obtain the diagnosis
What are the two specifiers for PTSD?
DISSOCIATIVE SYMPTOMS
DELAYED EXPRESSION (diagostic criteria not met until 6 months after)
How many different symptom mixes to have a diagnosis for PTSD?
636,120
How many different symptom symptom mixes to have a diagnosis for MDD?
227
How many different symptom symptom mixes to have a diagnosis for Panic Disorder?
23,442
What is Lisa’s PTSD mnemonic?
T - Traumatic event R - Re-experience A - Avoidance U - Unable to function M - Month (at least) A - Arousal
What is ACUTE STRESS DISORDER?
Basically PTSD for less than a month
What is the treatment response rate of PTSD?
50%
What percentage of road accident survivors end up with ACUTE STRESS DISORDER? (Dai et al 2018)
~16%
What do we learn about diagnostic flux in PTSD diagnosis over time from Bryant
How many passages there are from trauma to PTSD and to wellness
After experiencing trauma, what are the most common trajectories? (Galatzer-Levy, Hyang and Bonanno)
Four trajectories
1 - NO PTSD (66%)
2 - BAD, THEN BETTER (21%)
3 - DELAYED ONSET PTSD (11%)
4 - FULL BLOWN PTSD (9%)
How common are traumatic experiences (lifetime prevalence)?
Splits by gender
For men - 65%
For women - 50%
…and most report 2+ events
Prevalence is higher in clinical populations (up to 80%)
Do men and women experience the same forms of trauma?
Actually no,
Males - violence stuff basically
Women - sexual stuff, childhood neglect
Gender differences in probabilities of developing PTSD after a traumatic event
Men - 8-13%
Women - 20-30%
What types of trauma is most related to PTSD?
Trauma inflicted by a person, relative to trauma from say a natural event
What PRE-trauma factors predispose to PTSD? There are 8. Name a couple.
- Being female
- Being neurotic
- Being young
- Low IQ
- Unstable family
- Pre-existing mood/anxiety disorder
- Family history of mood/anxiety disorder
- Biologically attenuated cortisol levels (HOLOCAUST SURVIVORS)
What trauma-related factors predispose to PTSD?
- Type (interpersonal)
- Perceived degree of life threat
- Predictability/controllability
- Duration and frequency
What PERI-trauma factors predispose to PTSD?
- Arousal-HR in acute post trauma phase
2. Dissociation at time of trauma
What POST-trauma factors predispose to PTSD?
- Level of support
- Validation of experience
- Opportunity to ‘process’
In terms of psychological processes associate with PTSD, what do we know about recall?
Contradictory…
High/vivid recall + vague and error prone memories
Flashbacks - different to normal episodic memory b/c dominated by sensory detail, but disjointed
Poor working memory
Describe the most popular CB model of PTSD (Ehlers and Clark 2000)
Predisposing factors»_space; trauma
Negative appraisals of stress and traum
Trauma memory (fear conditioning)
Have a look at the slide
What is the aetiology of COMPLEX PTSD
Chromic and repeated trauma
Mostly child sex above survivors or family violence
What did Cloitre (2013) in relation to COMPLEX PTSD?
Divided up study into the three groups, one of which aligned with complex PTSD symptoms (not just BPD either)
What is ADJUSTMENT DISORDER?
Basically PTSD but without the event classifying as ‘trauma’
How common is ADJUSTMENT DISORDER in acutely ill medical in-patients?
More common than depression (14% vs 5%)
How common is ADJUSTMENT DISORDER in people experiencing a recurrence of cancer?
1/3
What is the challenge in diagnosing ADJUSTMENT DISORDER?
There is no standardised diagnostic assessment tool
In terms of psychological processes associate with PTSD, what do we know about cognitive appraisal?
A sense of responsibility for safety of self and loved ones
Some guilt and shame
In terms of psychological processes associate with PTSD, what do we know about inner beliefs/schemas
Destroys trust in the world
What’s the name of the disorder where you basically experience PTSD, but for less than a month?
ACUTE STRESS DISORDER?
