Trauma Response Flashcards
List some risk factors for heightened responses to trauma
Sudden, unexpected event Man-made rather than natural Prolonged exposure Threat to life, death Personal factors (family)
What is associated with the highest incidence of post-traumatic stress disorder?
Rape
What is the freeze response?
Body goes into shutdown with TONIC IMMOBILITY in the presence of “inevitable” danger (think of a deer on the road)
List some clinical features of complex PTSD
Low self-esteem, self-blame Hopelessness Somatisation Mood disturbance Self-harm
Give examples of neurobiological changes in PTSD
Increased activity of PAG
Increased activity of amygdala (emotional memory)
Increased activity of limbic system
Hippocampal atrophy (stress response)
Deactivation of Broca’s area when individual access’ trauma memories
Right hemispheric lateralisation (‘timeless’ memory)
List the main features of PTSD (FAANDER)
Flashbacks Nightmares Avoidance Arousal (increased) Emotional numbness Dissociation Re-enactment
How long after a traumatic event can PTSD be diagnosed?
3 months after
If trauma symptoms are mild and present for less than 4 weeks, what is the treatment?
Watchful waiting with support
List some psychotherapy that may be used for PTSD
CBT
EMDR (eye movement desentisation and reprocessing sensorimotor psychotherapy)
Media therapy
Mindfulness
Which antidepressant is licensed for use in PTSD in primary care?
Paroxetine (SSRI)
Mirtazapine (SNRI)
What is post-traumatic stress disorder?
Anxiety developed on the back of exposure to traumatic situations
List the medications used for PTSD
SSRI/ SNRI Amitrypitline, phenelzine Prazosin Atypical antipsychotics Anticonvulsants (carbamazepine)
What management is first line in PTSD?
Psychotherapy
How do we classify traumatic events?
TYPE 1: Single incident trauma
TYPE 2: Repetitive, ongoing abuse
Early life trauma is strongly linked to which mental health disorder?
Depression
A history of childhood abuse or deprivation is strongly linked to which mental disorder?
Bipolar disorder
Which part of the brain is involved in ‘freeze or flee’ response?
PAG or ventral tegmental area
List features of tonic immobility
Reduced vocalisation Intermittent eye contact Rigidity and paralysis Muscle tremors in extremities Chills Unresponsive to pain
How are risk or resilence factors classified in trauma? Give examples of each
Person-related: history of mental disorder, physical injury, age, history of trauma, coping styles
Trauma-related: man-made, prolonged exposure, perceived threat
Environment-related: lack of support, ongoing life stress, reaction of others, disadvantage
List diagnostic criteria for PTSD
Traumatic event Intrusive symptoms (1 or more) Avoidance symptoms (3 or more) Increased arousal (2 or more) \+/- associated dissociative symptoms (depersonalisation, derealisation, awareness of surroundings, out of body experiences)
List classifications of PTSD
Acute
Chronic (>3 months)
Delayed (present after 6 months)
List intrusive symptoms in PTSD
Recurrent distressing recollections Nightmares Flashbacks Distress Psychological reaction (fight or flight)
List avoidance symptoms in PTSD
Avoid thinking/ talking about event Avoid reminders Amnesia Loss of interest in activities Emotional numbing Sense of shortened future
List symptoms of increased arousal in PTSD
Sleep disturbance Irritability/ anger Concentration difficulties Hypervigilance Exaggerated startled response
