Week 4

Question 1

What is PTSD?

Answer 1

Unwanted, intrusive memories that can develop after a single traumatic event, or from repeated/prolonger experiences

Question 2

Most people who have early symptoms of PTSD do __ go on to develop PTSD

Answer 2

Not

Question 3

What does the history of PTSD say?

Answer 3

It was recognised by the Ancient Greeks, and then in the 1st World War as “shell-shock”

Question 4

What does Criterion A say?

Answer 4

That you have to have had some exposure to a trauma, with actual or threatened death, either experiencing or witnessing

Question 5

What does Criterion B say?

Answer 5

Intrusion symptoms e.g. recurrent memories and flashbacks

Question 6

What does Criterion C say?

Answer 6

Avoidance symptoms and external reminders of the trauma

Question 7

What does Criterion D say?

Answer 7

Negative alterations in cognition and mood e.g. poor memory

Question 8

What does Criterion E say?

Answer 8

Alterations in arousal and reactivity e.g. poor concentration

Question 9

What does Criterion F say?

Answer 9

Persistence of symptoms for more than one month

Question 10

What does Criterion G say?

Answer 10

Functional Significance

Question 11

What does Criterion H say?

Answer 11

Attribution e.g. disturbance is not due to medication

Question 12

Name 3 clinical characteristics of PTSD?

Answer 12

Intrusive thoughts or memories, Sleep problems, Body memories

Question 13

What is a Flashback?

Answer 13

A vivid experience in which you relive some aspects of a traumatic event or feel as if it is happening right now

Question 14

There can be intrusive images _______ a flashback

Answer 14

Without

Question 15

What is Complex PTSD?

Answer 15

When exposure to the trauma has been prolonged, hard to manage emotions, find relationships hard, and it overlaps with Bipolar Disorder

Question 16

What % of people will experience at least one traumatic event in their lifetime?

Answer 16

70

Question 17

Name 3 factors that will increase the risk of developing PTSD?

Answer 17

Female, Lower SES, and Pre-existing mental health problems

Question 18

What do Ehlers and Clark (2000) say that is a “puzzle” about PTSD?

Answer 18

That PTSD is classed as an anxiety disorder, even though anxiety is about future threat and PTSD is to do with memory

Question 19

What do Ehlers and Clark (2000) say that is a “solution” for this puzzle about PTSD?

Answer 19

That individuals are remembering the trauma in a way that poses current threat in the here and now

Question 20

Explain the Amygdala’s role in PTSD

Answer 20

It is part of our threat system, and is there to alert us to danger and keep us safe from it. However, it cannot discriminate between real danger and perceived danger, and will trigger the same response of adrenaline even if the danger is perceived e.g. thinking about a traumatic memory

Question 21

Explain the role of the Hippocampus in PTSD

Answer 21

It helps store and remember information, and processes memories and puts a timestamp on memories so that they are organised, however, with traumatic events, the hippocampus doesn’t work as well and is unable to put a timestamp on the memory, so this is why traumatic memories are often re-experienced, they keep popping up as they haven’t been filed away properly so feel as though they are happening now

Question 22

What are the 4 key features of Trauma Memories?

Answer 22

1) Come to mind uninvited
2) Vivid
3) Can feel like its happening again
4) CBT works with the memory of the trauma

Question 23

Explain the Wardrobe Analogy for working with traumatic memories

Answer 23

The traumatic memory is like a duvet full of stinging nettles, you would have to shove it away quickly and try and close the doors on it, but the door wouldn’t close properly and it would fall out again when your back was turned, stinging you again, similarly avoiding these traumatic memories only works in the short term, and it can intrude back into consciousness. Therefore, need to take the duvet out, which will sting at first, someone to help, but then fold it up, make room, think it through, and then store it like a normal memory

Question 24

According to the Cognitive Model of PTSD, what 4 reasons does the feeling of current threat arise?

Answer 24

Trauma is processed using sensory means rather than conceptually within autobiographical memory, This disturbance prevents elaboration and contextualisation of memories, Avoidance strategies are employed which worsens the PTSD, and Treatment aim is to process the trauma so its seen as a time limited past event

Question 25

Name 3 guidelines from NICE about PTSD

Answer 25

1) Debriefing after trauma events should not be offered
2) Consider EMDR
3) Offer individual trauma focused CBT intervention

Question 26

What is the aim of the Formulation Diagram for CBT for PTSD?

Answer 26

To help clients to reclaim life and live in accordance with their goals

Question 27

Outline the structure of the Formulation diagram?

Answer 27

1) Memory e.g. daughter and grandson died in car accident
2) Feeling of threat e.g. hot and sweaty whilst driving
3) Unhelpful thoughts short term e.g. I cannot keep my family safe
4) Unhelpful behaviours e.g. avoidance
5) Unhelpful thoughts long term e.g. I am responsible for harm

Question 28

What is the main outline of the structure of CBT for PTSD?

Answer 28

Setting goals, Re-living, Reliving and updating, Stimulus discrimination and addressing anger, Therapy blueprint as relapse prevention

Question 29

What is Imaginal?

Answer 29

Asking the person to re-live the event, describing it in present tense in full detail with eyes closed, this identifies hot spots

Question 30

What is In Vivo?

Answer 30

Behavioural experiments with now safe stimuli, helping the person re-remember in the now context, and re-code in a safe environment, also re-visiting the trauma site to replace memories

Question 31

Name 3 maintain factors of PTSD

Answer 31

Rumination, Pre-trauma beliefs, Thought suppression e.g. pushing away different thoughts

Question 32

Name 3 negative effects of trauma work on the therapist

Answer 32

Exposed to bias view of the world, Trigger certain memories for them, Compassion fatigue e.g. not enough resources so draining

Question 33

What is EMDR?

Answer 33

Eye Movement Desensitisation Reprocessing Therapy, moving eyes from left to right by following the movement of the therapists finger, whilst recalling the traumatic event, desensitised and decreased negative emotions associated with upsetting memories

Question 34

Why was it found that Eye Movement wasn’t needed?

Answer 34

Because providing additional cognitive load to tax working memory was just as good, not necessarily eye movement