Week 4 Flashcards
What is PTSD?
Unwanted, intrusive memories that can develop after a single traumatic event, or from repeated/prolonger experiences
Most people who have early symptoms of PTSD do __ go on to develop PTSD
Not
What does the history of PTSD say?
It was recognised by the Ancient Greeks, and then in the 1st World War as “shell-shock”
What does Criterion A say?
That you have to have had some exposure to a trauma, with actual or threatened death, either experiencing or witnessing
What does Criterion B say?
Intrusion symptoms e.g. recurrent memories and flashbacks
What does Criterion C say?
Avoidance symptoms and external reminders of the trauma
What does Criterion D say?
Negative alterations in cognition and mood e.g. poor memory
What does Criterion E say?
Alterations in arousal and reactivity e.g. poor concentration
What does Criterion F say?
Persistence of symptoms for more than one month
What does Criterion G say?
Functional Significance
What does Criterion H say?
Attribution e.g. disturbance is not due to medication
Name 3 clinical characteristics of PTSD?
Intrusive thoughts or memories, Sleep problems, Body memories
What is a Flashback?
A vivid experience in which you relive some aspects of a traumatic event or feel as if it is happening right now
There can be intrusive images _______ a flashback
Without
What is Complex PTSD?
When exposure to the trauma has been prolonged, hard to manage emotions, find relationships hard, and it overlaps with Bipolar Disorder
What % of people will experience at least one traumatic event in their lifetime?
70
Name 3 factors that will increase the risk of developing PTSD?
Female, Lower SES, and Pre-existing mental health problems
What do Ehlers and Clark (2000) say that is a “puzzle” about PTSD?
That PTSD is classed as an anxiety disorder, even though anxiety is about future threat and PTSD is to do with memory
What do Ehlers and Clark (2000) say that is a “solution” for this puzzle about PTSD?
That individuals are remembering the trauma in a way that poses current threat in the here and now
Explain the Amygdala’s role in PTSD
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
Explain the role of the Hippocampus in PTSD
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
What are the 4 key features of Trauma Memories?
1) Come to mind uninvited
2) Vivid
3) Can feel like its happening again
4) CBT works with the memory of the trauma
Explain the Wardrobe Analogy for working with traumatic memories
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
According to the Cognitive Model of PTSD, what 4 reasons does the feeling of current threat arise?
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
Name 3 guidelines from NICE about PTSD
1) Debriefing after trauma events should not be offered
2) Consider EMDR
3) Offer individual trauma focused CBT intervention
What is the aim of the Formulation Diagram for CBT for PTSD?
To help clients to reclaim life and live in accordance with their goals
Outline the structure of the Formulation diagram?
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
What is the main outline of the structure of CBT for PTSD?
Setting goals, Re-living, Reliving and updating, Stimulus discrimination and addressing anger, Therapy blueprint as relapse prevention
What is Imaginal?
Asking the person to re-live the event, describing it in present tense in full detail with eyes closed, this identifies hot spots
What is In Vivo?
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
Name 3 maintain factors of PTSD
Rumination, Pre-trauma beliefs, Thought suppression e.g. pushing away different thoughts
Name 3 negative effects of trauma work on the therapist
Exposed to bias view of the world, Trigger certain memories for them, Compassion fatigue e.g. not enough resources so draining
What is EMDR?
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
Why was it found that Eye Movement wasn’t needed?
Because providing additional cognitive load to tax working memory was just as good, not necessarily eye movement
