Trauma disorders Flashcards
How are memories formed?
Perception and Experience
How are memories retained?
Reinforcement – repetition and reward (so kulang mag 1 read lang)
How are memories recalled?
Context
Three types of memory according to retention duration
Immediate, working, and long-term memory
Type of memory according to retention duration that is just usually a snapshot or point in the environment. In milliseconds.
Immediate Memory
Type of memory according to retention duration where you remember an event and this include facts, observation, and information useful for a particular task. In minutes.
Working memory (Ang gina muno ni Doc Licup nga dapat ang mga basics mangin part don kadaya hay gamiton ta on a daily basis.)
Where does working memory get consolidated?
Hippocampus
The more emotionally uninvolved you are on a certain experience, the more you will recall it.
False (Must be more emotionally involved)
Type of memory according to retention duration that is the consolidation of working memory. Hours to many years.
Long-Term Memory
Which structures do storage of long-term memory depend on?
Prefrontal Cortex and Inferior Temporal Cortex
Two types of memory according to function
Declarative and Procedural
Type of memory according to function which is memory in words and is a conscious recall.
Declarative
Type of memory according to function which is memory in pictures, might be unconscious, preconscious, subconscious and is involved in skills and habits.
Procedural
Why is there infantile amnesia?
There is a lack of words to describe experiences during ≤2 y.o.
It is the link between emotion, stress, and memory.
Memory Modulation
It happens during recall and is the chance to change the memory everytime it is recalled.
Reconsolidation
Emotion or feeling is evoked to stimulate recall of memories long ‘forgotten’ by an individual.
Unconscious Recall
Primary neurotransmitter that helps store memories in a way that they are easy to remember.
Glutamate/Glutamic Acid
Neurotransmitter present during hyperarousal.
Glutamate/Glutamic Acid
Block the action of glutamate thus calms and makes an individual sleep
GABA
GABA receptor that works in tandem with glutamate receptors to balance the excitation of the brain in response to external events such as stress.
Synaptic GABA receptor
GABA receptor that is internally modulated and ignore glutamate. Involved in memory in dream states.
Extra-Synaptic GABA receptor
GABA receptor that changes the brain’s state to make us aroused, sleepy, alert, sedated, inebriated or even psychotic
Extra-Synaptic GABA receptor
GABA receptor that helps encode memories of fear-inducing event and stores them away from consciousness.
Extra-Synaptic GABA receptor
If a traumatic event occurs when extra-synaptic GABA receptors are activated, the memory of this event can be accessed unless these receptors are activated once again.
False (memory of event can’t be accessed)
Critical for retrieval of intermediate-term contextual and spatial memories but not necessary for retrieval of consolidation of memories in general.
Adrenergic signaling (Epinephrine and Norepinephrine)
Role of Norepinephrine in retrieval of memory requires signaling through which receptor in the hippocampus?
β1-adrenergic receptor
Disorder based on narrower trauma criteria that focus on acute life threatening situation, serious injury, or sexual violence by way of direct or indirect confrontation.
PTSD
It refers to a great misfortune causing great amount of material damage and human suffering and overwhelms the coping mechanism.
Disaster
Which is more traumatizing, natural vs. human caused?
Human caused
Which is more traumatizing, visible impact vs. low point (no physical evidence)?
Low point
Duration before post traumatic stress response is considered a disorder?
~ 8 weeks
Prevalence of PTSD on general population?
5 – 10%
It is a fight or flight or freeze response.
Trauma
Duration of acute stress syndrome.
3 days to 1 month
T or F: Younger age group is less prone to PTSD.
False (more prone)
In which level of the brain do differences in person’s responses to trauma could be seen?
Limbic System
T or F: Main problem in trauma is separating feelings from event or thought because it is difficult to deal with.
True
Trauma and stressor related disorder where child is more withdrawn, isolated, and regressed. He/she is internalizing.
Reactive Attachment Disorder
Trauma and stressor related disorder where child is more aggressive and violent and is prone to risk taking behaviors which is a result of social or parental neglect.
Disinhibited Social Engagement Disorder
These are thought processes referable to the cortex which includes flashbacks, nightmares, and recurrent dreams and are involved in the repetition of an event.
Intrusion Symptoms
These are symptoms referable to the limbic system and is the avoidance of stimuli triggering flashback
Avoidance Symptoms
In DSM 5, what are the other responses to trauma aside from anxiety
Anhedonia, dysphoria, externalizing angry and aggressive behaviors, and dissociative symptoms
What are the only symptoms in response to trauma that can be treated with SSRI?
Anxiety, anhedonia, fight or flight response
T or F: Acute stress disorder requires acute treatment during the late course after traumatic event.
False (early course)
Symptoms persist ≥1 month.
Post Traumatic Stress Disorder
Symptoms persist 3 days to 1 month.
Acute Stress Disorder
Disorder where patient exhibits all symptoms of trauma but there is no actual threat.
Adjustment Disorder
T or F: Early intervention after extreme and widespread disaster is not recommended.
False (recommended)
T or F: Treat patients after disaster even if they seem okay or has no symptoms.
True
T or F: Family context is central to understanding and meeting patient’s needs.
True
T or F: There is no close connection between psychological aspects of human experience and his social experiences.
False (there is close connection)
This refers to the non biological local and outside support and aims to protect or promote psychosocial well-being. Its goals are preventive.
Psychosocial Intervention
T or F: Psychosocial intervention has to be done by specialists only.
False (even students can do it)
Five empirically supported intervention principles at early to midterm stages promote
Sense of safety, calming, sense of self and community efficacy, connectedness, hope
Most acute stress problems during acute emergencies are best managed with medication.
False (do not immediately give benzodiazepines, numbing the patient dissociates his affect to the event and disrupts normal reactions further increasing PTSD)
Principles of psychological first aid
Non intrusive emotional support, coverage of basic needs, protection from further harm, and organization of social support and networks
It is important that patients are consulted and involved in important decisions.
True
T or F: Some dangers of one session debriefing are: non homogenous group, vicarious traumatization, readiness to disclose, confidentiality
True
T or F: Provide psychological first aid prior to provision of basic needs.
False (basic needs provided first)
T or F: Psychological first aid provides opportunity for survivors to talk about the events but without pressure, convey genuine compassion to survivors, asking for concerns, discouraging negative ways of coping, encourage participation in daily routines, encourage company from family or friends, and offering possibility to return for further support.
True
T or F: Physician must listen intently in an accepting and non judgmental manner in doing psychological first aid.
True
T or F: Psychological first aid is professional counseling and psychological debriefing.
False (it is neither of the two)
T or F: Psychological first aid prevents PTSD.
True
PTSD patients can be given with what medications toaddress physiological/sympathomimetic symptoms?
Dopaminergic or serotonergic drugs
It is antipsychotic and is recommended patient with PTSD especially patients with flashbacks and intrusive thought.
Quetiapine
Given to PTSD patients that have more mood symptoms.
SSRIs
It has quick adrenergic effect such as palpitation.
SNRI (venlafaxine)
T or F: Addressing psychosocial stressors involve offering an opportunity to talk in private, asking for current stressors, assessing any form of abuse, brainstorming for solutions or coping, identifying support from family, involving px in self-help, and not giving advice but helping them come up with a solution for themselves.
True
Primary problems for those who experienced trauma
Disempowerment and disconnection
This happens when patient feels helpless during the abuse.
Disempowerment
This happens when Patients are able to control when they want to remember or not and the emotions that go with it.
Empowerment
This happens when the traumatic memory is separate from all other events in the life of the patient.
Disconnection
The goal of therapy in trauma
Social connectedness
A sense of separateness, flexibility and self possession sufficient to define one’s self interest and diminishes feeling of helplessness
Autonomy
Basic capacities to build
Trust, autonomy, initiative, competence, identify, intimacy
T or F; Survivor must be the author and arbiter of her own recovery
True
Three stages of recovery
- Establishing safety,
- reconstructing traumatic history,
- restoring connection between survivor and community
T or F: Because recovery occurs in stages, intervention and management must be appropriate at each stage
True
This begins by focusing control of the body and gradually moves outward toward controlling the environment
Establishing safety
No single dramatic event marks the completion of the first stage of recovery
True
The stage of recovery where traumatic memory transformed and integrated into the survivor’s life
Reconstructing
Avoiding the traumatic memory leads to stagnation while approaching prematurely leads to fruitless and damaging reliving of the trauma
True
This is the most difficult period of recovery
Reconstructing
The second stage is completed when the telling of the trauma story no longer arouses such intense feeling
True
Stage of recovery where the traumatized person recognizes the effects of the trauma, now he/she is ready to incorporate the lessons of her traumatic experience into her life
Reconnection
T or F: It is important that the therapist have the same outlook with the patient
True
The impact of a traumatic event does not continue to reverberate throughout the survivor’s life cycle
False (it continues)
Best indices of resolution are the survivor’s restored capacity to take pleasure in life and to engage fully in relationships with others
True
Rapes are committed by people from all economic levels, all races, all occupation
True
T or F: Incest is rare
False (not rare)
T or F: Sexual molestation occurs at the highest rate among school age group
True
T or F: Rape is sex
False (it is not sex)
T or F: While sexual attraction may be influential, power, control and anger are the primary motives.
True
It is doing something or failing to do something that results in harm to a child or puts a child at risk of harm
Child abuse
