Week 8 PTSD Flashcards
according to the cognitive model presented by clark, what are the two processes that lead to sense of current threat/ cause PTSD
(1) Negative appraisal of the trauma or its sequel (aftermath)
(2) Disordered autobiographical memory ( too little elaboration of event and context and strong associative memory)
Appraisal of trauma and/or its sequal (overall how one interprets the trauma, their reaction to it and others reaction to it)
Can be internal or external ( the world is a dangerous place or a threat to ones view of oneself “ i am capebale, loving worthy” able to achieve goals etc)
Ones initial PTSD symptoms, reasons for the trauma happening, peoples reaction and other consequences from the trauma can all be topics of appraisa that when turned negative lead to PTSD
(1) Overgernalze danger: see traumatic events as more likely to happen or see themselves as someone that is likely to land in traumatic events
Overgenalized appraisals of presence of threat or future threat happening cause situational fear but also avoidance behavior
(2) self blame appraisal for cause of trauma
I should have known that person was dangerous
How do negative appraisals maintain PTSD?
- Directly produce negative emotions (anger, anxiety, depression) and encourage individuals to engage in dysfunctional ways of coping
- Appraising that having intrusions/ flashbacks of the event is not normal ( although its a normal response from a traumatic event) means they are going insane, the person will try to suppress thinking about trauma and in return this distorts the memory and doesn’t allow it to be incorporated into their autobiographical memory. Therefore the trauma remains unresolved and trying to suppress such memories results in making the thought more likely to come up in the mind.
- Another ex: is other people don’t know how to properly respond to individuals that have experienced trauma, some might assume the other person doesn’t want to talk about it. The impacted person might appraise lack of asking about trauma as them not being supportive/ rejection and in return experience estrangement from others/ social withdrawal and prevents them from discussing the event which prevents therapeutic relieving as they arent getting feedback about event/ others might bring positive appraisals that individual has made negative appraisals to. Therefore their negative thinking aslo doesnt get corrected.
Why is it important for trauma memory to be elaborated and integrated into the context of individual memory/autobiographical memory?
To reduce intrusive memories
- trauma memories are stored in a distorted way, often out of context of time, place, and memory of the order of events is fragmented. Therefore memory is easily triggered, as the stimuli that occurred during the trauma are not stored within the context of time, therefore when the individual is remembering it, they are remembering the sensations as if they are happing in the present. Elaboration of the trauma allows the stimuli from the memory to be discriminated from the stimuli that are currently being encountered. It is important to discriminate the previous stimuli from the present so the individual can stop perceiving a present threat.
According to the Engelhard 2019 reading, are traumatic memories fragmented?
No, memories of trauma are not especially fragmented, but when they are fragmentation is unrelated to recovery from trauma.
Are trauma memories repressed and recalled later on in life? (Engelhard 2019)
No, according to the false memory perspective recalling memories, especially during recovered memory therapy are likely mistaken.
Instead, victims of child sexual abuse are likely to recall the memory in their adulthood and experience it as traumatic/ suffer from PTSD as they have realized later that they encountered abuse, however, the reason it is recalled is not that it was repressed, more so that at the time the memory was not traumatic in a mean of terror, instead was possibly experienced as confusing, anxiety-provoking, disgusting, etc rather than traumatizing.
How are eye movements in EMDR effective for treating PTSD?
- lateral eye-movements are effective at reducing memory vividness and emotional intensity as they limit working memory resources needed for vivid memory retrieval. Therefore, it attenuates the emotionally evocative power of traumatic memories by making them less vivid. The patient recovers from trauma by enabling patient to recall their memories without the “ reliving” experince of emotional intensity.
What is the criticism of DSM 5 Criteria in Hyland et al 2021 reading?
Fulfilling criteria A of exposure to actual or threatened death, serious injury or sexual abuse is limiting to other psychologically threatening events that also result in PTSD such as bullying, stalking emotional neglect, and abuse. As such experiences are not normally considered traumatic but are associated with both PTSD and CPTSD. Therefore, the DSM 5 criteria might hinder the recognition to people with PTSD that don’t meet the criteria A diagnosis.
What is a big predictor of PTSD? (Hyland et al 2021)
adverse childhood events such as neglect and emotional abuse that are not commonly considered as criteria A traumatic event.
according to the Hyland et al 2021 reading, what did the events all have in common that were leading to a PTSD diagnosis?
all events shared a risk of survival
Conclusion on DSM5 criteria A (hyland 2021) reading?
DSM 5 should adopt less specific criteria that does not account for a formal diagnostic criteria
NOT saying that PTSD should be reconceptualized rather that stressful events that had feelings of severe threat and or horror should be considered sufficient events for PTSD.
what were arguments FOR keeping critera A in DSM 5? (hyland et al 2021)
- Criterion A is needed because the traumatic experience in some sense defines PTSD: It usually marks a major change in the life trajectory of a person affected with PTSD, and it provides a context without which intrusion and avoidance symptoms are incomprehensible
- worry that adopting a less formal approach to defining trauma could lead to an increased number of false positive diagnoses and thus undermine the construct validity of the PTSD diagnosis; however, we believe that this is unlikely to occur
Difference in ICD and DSM 5 definitions of PTSD?
- DSM–5: narrow definition of specific trauma exposure events and broad symptom set
- ICD-11: narrow symptom set with a higher diagnostic threshold but a broad gateway consideration (type of event)
Hyland et al 2021, does the DSM 5 criteria A have predictive validity of PTSD?
No!
Describe the characteristics of re-experiencing memories of traumatic events (Clark 2000)
- Reexperincing mainly consists of sensory impressions rather than thoughts- predominantly visual. > (Ex: man in a car crash kept seeing head lights towards him)
- Sensory impressions are experienced as if they are happening right now (not in the past), physical reactions and motor response also happen are the same as those experienced at the time ( “original emotion”
- Original emotions and sensory impressions are rexperinced even if the individual later found other information that contradicts the original impression/ the person knows originally it was not true. > individual dies by suicide but the boy thought it was because that idv took too many sleeping pills and that the boy was responsible for helping him get an ambulance/ keeping him alive - feelings of panic of needing to save someone can still come up even if you later know there was nothing you could have done
- Physiological sensations and emotions that are associated w traumatic events can be experienced even without recollection of the event
- Involuntary reexperiencing of the traumatic event is often triggered by a wide range of stimuli that are often cues that don’t have a strong semantic relationship to the event rather are temporarily associated with the event (smells, particular phrases said in a certain tone) or similar emotional states ( feeling helpless or trapped)
> Proposed that poor intentional recall and vivid unintentional reexperiencing of the here and now quality happens because of how traumatic memories are encoded and laid down in memory
