Trauma Flashcards
define trauma
“an inescapably stressful event that overwhelms peoples existing coping mechanisms”
- an event that poses a threat to life of the person or someone else
according to NICE traumatic events associated with dev of PTSD include experiencing or witnessing event(s) could include:
- serious accidents
- physical and sexual assault
- serious health problems and childbirth experiences
- war and conflict
- torture
- abuse
- work-related exposure to trauma
state common diagnosis’s of trauma.
- PTSD
- complex PTSD
- bipolar
- emotionally unstable personality disorder
- psychosis
name symtoms from the DSM-5 of PTSD.
- intensive distress following reminders
- negative beliefs
- flashbacks/ nightmares
- physical sensations
- intrusive thoughts or images
- alterness/ on-edge
- avoidance of reminders
- emotional numbing
- repeated re-experincing of event
how many criterias of the DSM-5 does it have for trauma?
A-H (eight)
state the criteria’s from DSM on trauma.
A - exposure to trauma B - intrusion symptoms C - avoidance symptoms D - negative alterations in cognition and mood E - alterations in arousal and reactivity F - duration G - functional significance H - attribution
in order to be diagnosed with PTSD what criteria do you need to meet?
- criteria A
- one+ symptom from B+C
- three+ symptoms from D+E
- criteria F through H
what is the prevalence of trauma?
- 70.4% of people will experience at least one traumatic event in their lifetime, average 3.2 events per person
- majority recover naturally, but minority dev PTSD .
define complex PTSD.
series of event or events of an extremely threatening or horrific nature, commonly prolonged or repetitive, escape is difficult or impossible.
give diagnosis for CPTSD.
- all requirements of PTSD, plus:
- severe and pervasive problems affect regulation
- persistent beliefs about oneself as diminished, defeated or worthless
- feelings of shame, guilt or failure related to traumatic event
- persistent difficulties in sustaining relationships and feeling close to others.
name one difference between PTSD and CPTSD.
early experiences are generally ok in PTSD, whereas early life experiences in CPTSD are ongoing traumatic events.
what is the puzzle to PTSD? what is the solution?
anxiety is about future threat, PTSD is to do with memory, but PTSD is classed as an anxiety disorder…
the solution is that individuals are remembering the trauma in a way that poses current threat, in the here and now.
what brain areas are associated with PTSD.
- amygdala
- hippocampus
how is the amygdala involved in trauma?
- part of threat system
- when threat occurs, a amygdala triggers adrenaline response getting out body ready to ‘fight or flight’.
- amygdala cannot discriminate between ‘real’ and ‘perceived’ danger.
how is the hippocampus involved in trauma?
- helps store and remember information
- during traumatic event hippocampus doesn’t work well, this is why event is often re-experienced, Brian feels as though trauma is happening again here and now.
state aspects to the trauma memory.
- fragmented and not organised
- recalled involuntarily
- triggered by reminders
- not time-tagged
- frozen in time
= opposite for everyday memory
name aspects to compassioned focussed therapy.
- goal-directed system
- recharge system
- threat system (threat can keep us safe, tells us to get away)
how does trauma effect the window of tolerance?
- shrinks the window, making in harder to stay calm and focussed due to hyperarousal and dysregulation.
define dissociation.
- the brains way of coping with emotions that are too intense
- during a traumatic event, in attempt to keep us ‘safe’, the brain ‘cuts off’ so we can survive the horror of the event.
what is the effect of dissociation?
- feel disconnected from the world or from yourself
- adaptive response
- can happen during trauma but also in here and now (e.g. flashback)
- can be unhelpful if happening too often as it prevents processing of memory.
true or false: debriefing in therapy should be offered.
false - should not be offered
how long before people are treated with PTSD?
watched for 4 weeks
name treatment interventions of PTSD.
- TF-CBT
- narrative exposure therapy
- prolonged exposure therapy
- cognitive processing therapy
when is EMDR considered for treatment?
- if person experiences clinical symptoms of 3+ months after event
what identifies the client as ‘ready’ for treatment?
- current safety factors
- dissociation
- self-harm and suicidal thoughts
- substances
- avoidance
describe aspects to the cognitive model of PTSD? Ehlers and clark
- characteristics of trauma and negative beliefs
- cognitive processing during trauma
- negative appraisal of trauma
- matching triggers
- nature of trauma memory
- sense of current threat
- strategies intended to control threat symptoms
define treatment goals.
- elaborate nature
- identify and modify negative appraisal
- discriminate matching triggers
- reduce sense of threat
- give up or modify strategies intended to control threat
name steps and goals in TF-CBT.
1 - thorough client history and treatment planning
2 - reduce re-experiencing symptoms
3 - modify negative appraisals of trauma and its consequences
4 - drop maintaining behaviours
- reclaiming life!!
name phases in EMDR.
1 - client history and treatment planning 2 - preparation 3 - assessment 4 - desensitisation 5 - installation 6 - body scan 7 - closure 8 - re-evaulation
state considerations of TF-CBT and EMDR.
- asses for dissociation, if highly dissociative, develop skills to manage this
- offered for at least 8-12 weekly sessions, around 90 minutes long
