Psych PTSD

Question 1

PTSD axis?

Answer 1

Axis 1 disorder

Complex PTSD = Axis 2

Question 2

Complex PTSD

Answer 2

Those with complex PTSD often have problems with self-perception, relationships, attention/consciousness, affect and impulse, and often develop distorted perceptions of the perpetrator

Question 3

Diagnosing PTSD - Stressor Criterion

Answer 3

There has to be an exposure to traumatic event, in which BOTH were present:

Experienced, witnessed, or been confronted with an event/events that involved actual or threatened death or serious injury to oneself or others

AND

Person’s response involved intense feat, helplessness or horror

Question 4

Criterion/Clusters B, C, and D

Answer 4

B = Intrusive recollection –> need at least one of the following: Distressing recollections, Distressing dreams, Acting/feeling like the event is recurring, Psychological distress at cues resembling the event, Physiological reactivity to cues resembling the event

Cluster C –> Avoidance/Numbing symptoms (this will be split in DSM V) –> avoids thoughts, feelings or conversations about trauma, avoids activities or places associated, inability to remember part of the trauma, marked disinterest in significant activities, pervasive negative emotional state

Cluster D –> hyperarousal symptoms –> need two or more of the following –> difficulty sleeping, irritability or outbursts of anger, difficulty concentrating, hyper-vigilance, exaggerated startle response, recklessness and self-destructive behavior

Must also be LONGER THAN ONE MONTH IN DURATION and cause SOCIAL, OCCUPATIONAL or FUNCTIONAL IMPAIRMENTS

Question 5

Epidemiology of PTSD

Answer 5

Lifetime risk for women is anywhere from 8-14% –> rape is the traumatic event that brings about the highest risk of PTSD; COMBAT for men

In Men, overall lifetime prevalence is 4-6%

COMBAT = 31% lifetime prevalence if experienced; 18.5% of returning service members have PTSD or depression!!; 5x more likely to COMMIT SUICIDE than those without PTSD; PTSD rates INCREASE with time AFTER military service

Question 6

Comorbidities of PTSD

Answer 6

Vast majority (80%) of people with PTSD have other diagnoses –> MDD, alcohol abuse/dependence (men); panic, phobic, and generalized anxiety disorders; psychosis and personality disorders

PTSD is OFTEN THE PRIMARY DIAGNOSIS in a lot of these patients (others are unhealthy coping mechanisms)

Question 7

Who is at risk for PTSD?

Answer 7

Those who are subjected to environments with high probability of traumatic events – war, physical or sexual torture, natural disasters

Demographics –> FEMALES, AFRICAN AMERICANS higher, ASIANS lower

Prior history of psychiatric/emotional problems, PTSD from prior trauma, and poor social resources

Question 8

Duration of PTSD

Answer 8

Average duration is FOUR YEARS for women

For men = ONE YEAR

Remission rates are not great –> 26% remit within 6 months, 40% remit within a year, and the median remission time is 25 months

6x more likely to commit suicide; 40% increased chance of failing school; 60% increase in marital problems; 150% increased odds of unemployment