Week 8: PTSD

Question 1

What is the Ehlers & Clark explanation for PTSD? (2)

Answer 1

1. Negative appraisal of the trauma and the consequences
2. Disordered Autobiographical memory
   -Too little elaboration and context and strong associative memory

• Chronic perception of acute threat

Question 2

What is Foa’s cognitive model explanation for PTSD?

Answer 2

Trauma undermines 2 basic assumptions:

1. The world is safe
2. I am competent 	E.g., Freezing during SA

Chronic perception of acute threat

Question 3

What % of those who are exposed to trauma later develop PTSD?

Answer 3

10%

However, such experiences can still precipitate other mood and anxiety disorders

Question 4

How might EMDR work, according to devaluation?

Answer 4

Taxing working memory with a dual task and reconsolidation

Question 4

How might EMDR work, according to devaluation?

Answer 4

Taxing working memory with a dual task and reconsolidation

Question 5

What is the right way to debrief after a traumatic experience?

Answer 5

Don’t force person to talk about it

 Better to offer support and empathy. Provide info if needed
 Check if social support structure is available to them

Question 6

If symptoms not appraised as normal components of recovery, they may be…

Answer 6

… interpreted as indicators of permanent change or ongoing threat

Question 7

According to Ehlers and Clark, the nature of emotional responses depends on the appraisal. (5)

Answer 7

o Appraisals concerning perceived danger lead to fear
 (e.g. ‘‘Nowhere is safe’’),

o Appraisals concerning others violating personal rules and unfairness lead to anger
 (e.g. ‘‘Others have not treated me fairly’’),

o Appraisals concerning one’s responsibility for the traumatic event or its outcome lead to guilt
 (e.g. ‘‘It was my fault’’),

o Appraisals concerning one’s violation of important internal standards lead to shame
 (e.g. ‘‘I did something despicable’’)

o Appraisals concerning perceived loss lead to sadness
 (e.g. ‘‘My life will never be the same again’’).

Question 8

Reasons for delayed onset of PTSD, according to Ehlers & Clark

Answer 8

Change in Meaning:
o E.g.,
 Removing dead bodies of children did not elicit PTSSs until one’s own children reached the same approximate ages

Potent Reminders:
o E.g.,
 Not acquiring PTSD until returning to site of a car crash

Question 9

According to Ehlers and Clark, a sense of threat arises as a consequence of: (2)

How is it maintained?

Answer 9

(1) excessively negative appraisals of the trauma and/or its sequelae

(2) a disturbance of autobiographical memory characterised by poor elaboration and contextualisation, strong associative memory and strong perceptual priming.

Change in the negative appraisals and the trauma memory are prevented by a series of problematic behavioural and cognitive strategies.

Question 10

What event has been associated with producing PTSD symptoms, but isn’t recognized as a traumatic event in the DSM-5?

Answer 10

Stalking

Question 11

What are the key characterizations of the DSM-5 and ICD-11 for diagnosing PTSD?

Answer 11

DSM–5
o Provides a narrow gateway for the consideration of PTSD by virtue of its specific trauma exposure definition and subsequently provides a broad symptom set,

ICD-11
o Provides a broad gateway for the consideration of PTSD and CPTSD by virtue of its sensitive trauma exposure guidelines and subsequently provides a narrow symptom set with a higher diagnostic threshold.

Question 12

Concerns about EMDR (2)

Answer 12

Lab research using a car-crash video showed that a subsequent eye-movement intervention increased susceptibility to misleading information

It is unclear when and which memory features should be therapeutically targeted