7. trauma Flashcards
(19 cards)
trauma criterion a
(1ST RESPONDERS) exposed to ACTUAL or THREATENED death, injury, sexual violence:
- directly
- witness
- occur to close family member
EG: police officer, journalists
does not apply if trauma is exposed through MEDIA
trauma criterion b
intrusions:
- recurrent
- distressing dream
- flashbacks
- high arousal to trigger cues
trauma criterion c
persistent EFFORTFUL avoidance
- avoid distressing memories
- avoid external reminders
trauma criterion d
negative alterations in cognition
- memory: unable to remember
- exaggerated negative beliefs “the world is a dangerous place”
- blame oneself. guilt
- diminished interest
- detachment
- unable to experience positive emotions
trauma criterion e
alterations in arousal and reactivity
- irritable
- hyper-vigilance (i must proteck myself/loved ones)
- self destructive behaviour
dsm 5 PTSD
- more than 1mo duration of critera B,C,D,E
- dysfunction
2 specifiers of PTSD
- dissociative symptoms: being outside of one’s body. can’t engage in life, looking at life through a glass
- delayed expression: full criteria not met after 6mo post event
PTSD and variation in presentation
highly variety of posittypes of presentation of PTSD
+ ve: encapsulate experiences of alot of people
-ve: a lot of variety and heterogeneity amongst people diagnosed with PTSD (qn is: are they actually experiencing the same thing?) hence impact on treatment. eg: person 1 has sleep disturbances, but person 626120th doesnt.
acute stress disorder (ASD)
- exposure to criterion a
- criterion b for 3days - 1mo
issue: trajectories following trauma suggests that ASD is just a pathway to development of full PTSD. so no point of single-ing out ASD.
traumatic experiences epidemiology
- male experience more traumatic experience than female
- BUT more female develop PTSD
- most common traumatic event: witnessing
- male: most common –> physical attack, kidnapping
- female: most common –> rape, sexual abuse
– YOU’RE MORE LIKELY TO DEVELOP PTSD IF THE TRAUMATIC EXPERIENCE INVOLVES OTHER PEOPLE (as compared to natural disaster)
PTSD risk factors (pre trauma)
f > m personality: high neuroticism age: young lower IQ unstable family (childhood) --> modifiable
(MOST PRETRAUMA FACTORS ARE NOT MODIFIABLE)
PTSD risk factors (trauma related)
- trauma is interpersonal (involves people)
- perceived degree of life threat (how much one thinks their life is at risk)
- predictability and controllability of event (higher unpredictability then higher risk of PTSD)
- duration and frequency (multiple & repeated then higher risk)
PTSD risk factors (peri trauma)
(trauma at the time of event)
dissociation –> “observing from a glass”
PTSD Psychological processes: memory
- vivid recall BUT vague fragmented flashbacks
- highly disturbing
- working memory being impacted, lower levels of working memory capacity –> explains why lower IQ is a risk factor
PTSD Psychological processes
- memory
- dissociation
- cognitive affective: fear
- cognitive appraisal (personal interpretation of situations - perceived as stressful) and emotion: shame, safety, guilt
- beliefs: negative beliefs about self, world, loss of trust, loss of believe in good of others
cognitive behavioural model
pretrauma factors –> trauma –> negative appraisals (belief systems) + trauma memory (fear conditioning) –>
threat, arousal, intrusions –> dysfunctional (avoidance, dissociation, substance use)
complex PTSD
PTSD but has ADDITIONAL FEATURES.
normally not just 1 trauma event, but MULTIPLE
impairments:
- emotion dysregulation (i react intensely)
- interpersonal dysfunction (extreme ups and downs in rs)
- difficulties in self identity (i feel hollow inside)
how to differentiate people with BPD and complex PTSD
complex ptsd people show LOW symptoms of BPD while BPD might show symptoms of PTSD and BPD
adjustment disorder
caused by stressful event but the stressful event does not have to follow characteristics of ptsd stressful event
very common but unclear (might be waste basket)
