Lec 77 PTSD Flashcards
What is diagnostic criteria for trauma?
exposure to actual or threatened death, serious injury, or sexual violence in 1 or more of the ways:
- direct experiencing traumatic event
- witnessing event as it occurred to others
- learning traumatic event occurred to close family or friend
- experiencing repeated or extreme exposure to aversive details of event
What are intrusion symptoms of PTSD?
presence of 1 or more of the following
- recurrent + intrusive distressing memories of the event
- recurrent distressing dreams
- dissociative rxns [flashbacks] in which feel as if event recurring
- intense psych distress at exposure to cues that symbolize aspects of the event
- psych reactivity on exposure to cues related to the event
What are avoidance systems of PTSD?
persistent avoidance of stimuli associated with trauma such as:
- avoiding distressing memories/thoughts or feelings associated with trauma
- avoiding external reminders [activities/people/places] that arouse distressing memories thoughts or feelings about the trauma
What negative alterations in cognition or mood associated with PTSD?
2 or more of the following
- can’t recall important aspect trauma
- negative beliefs about oneself or others
- distorted cognition about the cause or consequences of the trauma leading to blame self or others
- persistent negative emotional state
- decreased interest in activities
- feel detached from others
- can’t experience positive emotions
What alterations in arousal or reactivity associated with PTSD?
2 or more of the following
- irritability or outbursts of anger
- reckless or self destructive behavior
- hyper-vigilance
- exaggerated startle response
- difficulty concentrating
- difficulty falling or staying asleep
What are diagnostic criteria of PTSD?
- exposure to trauma
- intrusion symptoms
- avoidance of stimuli associated w/ trauma
- negative alterations in cognition or mood
- alterations in arousal or activity
- symptoms last > 1 month
- causes clinically significant distress or impairment in social, occupational functioning
What is acute stress disorder?
- exposure to traumatic event
- presence of 9 or more symptoms from any of the following categoreies: intrusion, negative mood, dissociation [altered sense of reality], avoidance, arousal, impaired function, significant distress
- develops within 4 wks of exposure and lasts < 1 month
- considered a precursor to PTSD
How do you distinguish acute stress disorder from PTSD?
acute stress disorder [ASD] = dissociative symptoms [altered sense of reality, can’t recall important aspect of trauma]
symptoms last less than 1 month
What is course of ASD?
if continues is precursor to PTSD
if psychotherapy may prevent progression
What is epidemiology of PTSD?
- ~25% of those exposed to trauma develop PTSD
- 6.8% of US adults have PTSD , women 2x more likely than men
- co-morbid with psych conditions MDD, anxiety disorders, substance use disorders, unexplained somatic complaints, borderline personality disorder
Which traumas are most likely to result in PTSD?
- rape - 50%
- combat - 38%
- severephysical assault
What is course of PTSD?
- 80% longer than 3 mo
- 75% longer than 6 mo
- 50% at least 2 yrs
- small minority can remain symptomatic for yrs or decades
What are predictors of worse outcomes for PTSD?
- more PTSD sx
- comorbid med conditions
- childhood + additional traumas
- psych [mood, anxiety]
- female
- alc abuse
What are risk factors for PTSD?
- character of individual more than type of trauma
- trauma type, amount, severity
- young age, women more than men, minority, low SES
- preparedness
- level of social support
- perceived control
What is neuro model of PTSD?
- stress-induced changes or inadequate adaptation of neuro systems to exposure to severe stressors
- increase ANS responsiveness [ more NE]
- disinhibition HPA [low cortisol –> hyperactive]
- 5HT modulates synpathetics + HPA
- decreased hippocampal volume, increased amygdala responsiveness, impaired mPFC
net effect –> enhanced encoding of traumatic memories, failures of habituation –> state of perpetual fear
