w1 Psychological impact of trauma

Question 1

What is the statistical likelihood of experiencing any type of trauma?
What is the most common trauma?

Answer 1

90% probability that a person will experience any trauma at some point in their life.
Females most common trauma is assault
Males most common trauma is conflict related

Question 2

What is the link between wellbeing, trauma and illness?

Answer 2

Trauma unbalances wellbeing, injury is sudden and unexpected changing the illusion of wellbeing, this alters how we react to physical injury and how quicky we are likely to recover.

Question 3

What are some of the immediate responses to trauma or serious injury?

Answer 3

Pyschological shock
Distress - often related to event rather than severity of injury
Anger
Inappropriate calmness
Denial.

Question 4

What are some immediate responses to traumatic events/injury that can influence the degree to which a person feels they have suffered trauma?

Answer 4

Physical treatment/ pain relief
Referal to ICU - patients referred to ICU are more likely to have PTSD regardless of injury.
Explanation and reassurance of treatment
Information to and support from relatives
Advice about activities and return to work
Provided with information for support services

Question 5

What influences our responses to injury?

Answer 5

Our behaviour in response to injury is influenced by our cognition and emotion.

Question 6

What are the different models that consider different factors around how we respond to trauma?
Overview of each?

Answer 6

Model of Physiological response - focuses on personal and situational factors affecting response
Self regulatory model - focus on problem solving to find an appropriate coping stratergy.

Question 7

Explain the model of physiological response to trauma.

Answer 7

When an injury occurs we cognitivly apprais the situation, this appraisal depend on personal factors and situational factors.
This appraisal alters our behavioural and emotional response hence our recovery outcomes.

Question 8

What are some personal factors affecting response to trauma?

Answer 8

Personality
Age
Gender
Previous experiences
Opinions and religious views
Other demographic factors.

Question 9

What are some situational factors affecting trauma response?

Answer 9

PERSONAL
- support network
- economic situation
- employment
- other people involved
HEALTHCARE
- medical provision
-MDT support
- rehabilitation environment
-speed of recovery from physical injury and pain.

Question 10

What are some common behavioural responses to trauma?

Answer 10

Aggression
Agitation
Over or Under Adherence to rehabilitation
Depression
Use of social support.
Malingering.

Question 11

What is malingering?

Answer 11

Dishonest and intentional creation of symptoms e.g increasing severity of pain.

Question 12

What are some emotional responses to trauma?

Answer 12

Numbness
Anger
Shock
Depression

Question 13

How does an increase in negative emotions links to response to trauma?

Answer 13

Negative emotions are linked to an increased reporting of symptoms, pain and distress.

Question 14

What is meant by recovery outcomes?

Answer 14

Physical recovery - healing of injury
Psycho-social recovery - resilience of mind, able to rejoin society as before.
Return to before in mind, body and behaviour

Question 15

What are the different stages and sub-sections within each stage of The self-Regulatory Model?

Answer 15

Stage 1 - perception of injury, cognitive representation, emotional response
Stage 2 - coping with thoughts and emotions
Stage 3 - appraisal of coping

Question 16

What factors might influence how we percieve an injury?

Answer 16

Social messages and stigma
Attention given to injury (of person and others to person)
Environment of injury (being sick at home v in a lecture theatre)
Individual differences - personal factors and situational factors.
Emotions at the time

Question 17

What is meant by cognitive representation of a traumatic event?

Answer 17

How the patients think of…
What the injury is? - life threatening
What caused the injury? - all cars, my fault
How they can control it? - don’t/do
How long the injury will last?
What are the consequences?

Question 18

What are the two different coping styles?

Answer 18

Approach style - wanting to learn more about injury and attend rehabilitation
Avoidant style - denial, wishful thinking, alcohol abuse

Question 19

What is the deal with the appraisal of coping with trauma?

Answer 19

Person thinks about and evaluates how they think they will cope in a situation.
This changes how the person thinks about the event and threat
A negative appraisal will cause the person to cope poorly, creating their own future, will be because they thought so.

Question 20

What are some long term physiological impacts of injury?

Answer 20

Acute Stress Disorder - lasting 2 to 4 weeks
Post-traumatic Stress Disorder - develops within 6 months of the events and lasts for longer than 4 weeks.
Phobia development
Chronic pain and disability.

Question 21

What is acute stress disorder?

Answer 21

Develops as some of the immediate response to a traumatic situation.
Often causes a dazed state, dissocation, and unable to process external stimuli.
May be followed by a period of diminished responsiveness, agitation or over activity.
Amnesia
Symptoms decline rapidly.

Question 22

What is potentially beneficial about acute stress disorder?

Answer 22

Biological defence
Body unable to remember trauma, provides protection from event, more likely to recover psychologically.

Question 23

What is PTSD?

Answer 23

When exposure to an intense/frightening emotional experience leads to changes in behaviour, mood and cognition.
Predisposing factors can prolong that symptoms.
Varies in the case of not every person and not after every event.
Must occur within 6 months of the event and last for 4 weeks or more.
Experienced by 6.8% of the population.

Question 24

What are the effects of PTSD on memory?

Answer 24

Have intrusive and distressing memories of the traumatic event.
Paradoxically also associated with marked impairments in learning and memory of new material.

Question 25

What some symptoms of PTSD?

Answer 25

Repetitive reexperiencing of the event - flashbacks, vivid dreams and hallucinations
Avoidance of stimuli associated with stressor, social withdrawal and emotional numbness
Increased arousal to always be prepared for the threat, insomnia, anger, and exaggerated startle response.

Question 26

What are some long term social impacts of injury?

Answer 26

Breakdown in family behaviour
Affects relationships
Depression or poor mental coping amongst other family members
Inability to return to normal work/activities

Question 27

What are some methods of psychological management of longer-term effects from traumatic injury?

Answer 27

Diagnosis of problem
CBT
EMDR eye movement desensitisation and reprocessing
Exposure based treatments
Victim support groups.

Question 28

What are some implications for the MDT when dealing with a patient recovering from a traumatic experience?

Answer 28

Good communication between team members, spot and discuss possible symptoms of longer-term psychological problems.
Promote activities to improve patients wellbeing not just making a physical recovery.
Reduce the risk of long term pathological consequences.

Question 29

What is meant by the illusion of wellbeing?

Answer 29

A self serving self deception, a person with better wellbeing will underestimate the chances of bad things happening to them in order to protect their wellbeing. and vice versa.
Give themselves larger amounts of credit for small tasks to keep positive attitude.

Question 30

How does a traumatic event influence the illusion of wellbeing?

Answer 30

Can shatter the positive illusion of wellbeing and can reinforce the negative illusion of wellbeing.

Question 31

What does ‘reciprocally related’ mean for emotions, thoughts and behaviour?

Answer 31

All influence each other and can be assumed by monitoring the others.

Question 32

What are the four F of trauma response?

Answer 32

Fight
Flight
Freeze
Fawn - same as appease.