Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

PSYCHIATRY > Responses to Traumatic Stress > Flashcards

Responses to Traumatic Stress Flashcards

1
Q

What are the two types of trauma that individuals themselves are exposed to?`

A

Intentional - assault, robbery, rape

Unintentional - motor vehicle accident, industrial accident

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What two types of trauma can communities/populations be exposed to?

A

Human made - technological, train /plane crash

Natural - hurricane, tornado, earthquake, flood

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What is the difference between Type 1 and 2 trauma?

A 
Type 1  = Single incident trauma, unexpected
Type 2 (complex) = prolonged or repetitive 
e.g. ongoing abuse, hostage taking (piracy)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Type 2 trauma has an increased risk of PTSD developing afterwards. TRUE/FALSE?

A

TRUE

e.g. combat is considered expected trauma => Type 2 but many veterans experience PTSD

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What is the difference between shell shock and PTSD?

A

Shell shock = specific to combat (term was generated after WWI)
PTSD = for combat AND more generalised things

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Trauma is equal opportunity, without respect for social class or economic status. TRUE/FALSE?

A

FALSE

Poor and marginalised are much more likely to be victims/die.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What relatively common events can cause PTSD?

A

Fires

Admission to ICU/ITU

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

How should patients with chronic depression be treated if they have an early life history of trauma?

A

psychotherapy as an adjunct to pharmacotherapy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Trauma can affect a patient’s physical health. TRUE/FALSE?

A

TRUE

- infections, pain disorders, hypertension, diabetes, asthma, allergies

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

PTSD is associated with what chronic physical health conditions?

A
  • cardiovascular
  • digestive (including liver disease)
  • musculoskeletal
  • endocrine
  • respiratory
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What is the purpose of our anxiety response to fear?

A

Promote survival

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What are the main types of “fight or flight” response?

A

Freeze (if threat is distant and inescapable)
Flee (if threat is nearby and escapable)
Tonic immobility (if very near stimulus)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What symptoms occur in a tonic immobility response?

A 
Distal tremor
Decreased vocalisation
Intermittent eye contact
Rigidity and paralysis
Loss of pain response (in preparation for attack)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Why is tonic immobility used as a tactic?

A

Evidence that predators are less likely to attack immobile prey

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

WHat is the difference between an attentive and attention freeze response?

A

Attentive - broad field => person is aware of all around them

Attention - narrow field => person is fixated one one thing

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What causes each persons response to vary to a threatening stimulus?

A
  • Nature of the stimulus (familiar or unfamiliar)
  • Internal state of the person (level of consciousness)
  • person’s previous experience (e.g. past traumatic experience)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Why is the core of the brain sometimes considered the “reptilian brain”?

A

parts of the brain which carry out the most basic function

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

How does brain activity in the “reptilian brain” shift when someone is under threat from a predator closing in?

A

ventromedial prefrontal cortex to the periaqueductal grey

periaqueductal grey matter correlates with the dread of “capture”

19
Q

Acute stress increases cortisol levels. TRUE/FALSE?

A

TRUE

20
Q

What parts of the brain are involved in negative feedback of cortisol?

A

pituitary
hypothalamus
hippocampus
amygdala

21
Q

Are cortisol levels high or low in PTSD?

A

cortisol levels are low in PTSD

biological paradox

22
Q

After a major incident or trauma NATO explained that some patients will be resistant, resilient and others will recover. Explain what this means and what groups of patients have been missed out?

A

Resistant - level of distress not majorly altered by incident
Resilient - affected by incident for 1-2 weeks then recover
Recovery - patients are affected for longer than those who are resilient

Some patients NEVER recover and 1/3 get chronic symptoms

23
Q

What are the trauma-related risk factors?

A
  • man-made rather than natural events
  • prolonged exposure
  • perceived threat to life
  • multiple deaths and/or mutilation
  • personally relevant factors (e.g. involvement of a child)
24
Q

What patient related risk factors can cause a reaction to trauma?

A
  • low serum cortisol which increases acutely
  • family or personal history of mental disorder
  • extremes of age
  • past experience of trauma
  • coping style
  • behaviour disorder
25
Q

What environmental risk factors may make the period after a traumatic event difficult for some patients?

A
  • lack of a support network
  • ongoing life stresses
  • disadvantage (whether social, educational or economic)
26
Q

What time period of symptoms would indicate a response to trauma is abnormal?

A

Symptoms for 3-4 weeks every night which prevents patient from sleeping
=> abnormal

27
Q

Give examples of symptoms in normal reactions to trauma?

A 
numbness, shock, denial
Change in Mood (depression or elation)
guilt
impaired sleep
avoidance of place where it happened
intrusive experiences (e.g., flashbacks)
28
Q

What percentage of PTSD patients will have another comorbid psychiatric condition?

A

80%

e.g. depression, drug and alcohol abuse, and other anxiety disorders

29
Q

What are the DSM criteria for a diagnosis of PTSD?

A 
Traumatic event in past
- intrusive symptoms
- avoidance symptoms
- increased arousal
- negative alterations in cognition and mood  
FOR 1 MONTH
also impaired daily functioning
can be acute / chronic / delayed onset
30
Q

What is meant by intrusive PTSD symptoms?

A

nightmares

flashbacks

31
Q

What is meant by avoidance PTSD symptoms?

A

avoidance of thinking or talking about the event
loss of interest in activities
detachment
emotional numbing

32
Q

What symptoms may indicate a patient with PTSD is hyperaroused?

A

sleep disturbance
irritable
concentration difficulties
exaggerated startle response

33
Q

What is meant by “bottom-up” and “top-down” processing of the brain?

A

The mammalian brain functions “top-down”
whereas the reptilian brain functions “bottom-up”

  • the basic functions of the reptilian brain causing it to function this way are acting on fear and trying to escape
34
Q

WHat part of the brain is seen as diminished in size in patients with PTSD?

A

Hippocampus
- hippocampal size correlated with severity of PTSD
(this is a biological paradox as high cortisol levels can damage the hippocampus, yet cortisol levels are low in PTSD)

35
Q

What other conditions are associated with small hippocampal volume?

A 
Bipolar disorder
dementia
Cushing’s syndrome
alcohol misuse
borderline personality disorder
36
Q

Why do memories of trauma provoke certain strong emotions?

A

The memories are not organised correctly in the brain
Usually:
1st filter = thalamus
2nd filter = amygdala (emotional connections)
ORGANISATION
then Storage as memory

If organisation is missed, the memory fragments are stored strongly related to their emotion from the amygdala

37
Q

Why do patients struggle to discuss the memories they associate with trauma?

A

deactivation of Broca’s area when individual’s access personal traumatic memories in the brain

=> cant formulate speech well

38
Q

Why can patients recall traumatic events as if they were yesterday?

A

The memories lateralise to the Right hemisphere of the brain (which has NO concept of time)

39
Q

Why is treatment of post traumatic stress and anxiety difficult?

A
  • patients expectations are high
  • delayed tx
  • co-morbidity
  • patients feel they are unworthy of help due to guilt
  • Therapists’ fears
40
Q

What psychological therapies are usually used for post-traumatic treatment?

A

CBT (cognitive behavioural therapy
EMDR (Eye Movement Desensitisation and Reprocessing)

pharmacological methods usually added in afterwards if patient is not responding to these

41
Q

What medications are usually given for PTSD if psychological therapies have not worked ?

A

Non-specialists - paroxetine or mirtazapine
Specialists – amitriptyline or phenelzine

Alternatives:

  • prazosin (often used in veterans nightmares)
  • atypical antipsychotics (risperidone if hyperarousal)
  • mood stabilizers (Carbamazepine)
42
Q

What is the aim of CBT in PTSD?

A

To associate the memories with a neutral emotion as opposed to a strong one
=> if it is remembered the emotion with it may not necessarily be negative

43
Q

Is formal thought disorder (i.e. thought interference, withdrawal, block, broadcasting) a feature of PTSD?

A

No
- not common
=> passivity phenomena also not common as this is interlinked with formal thought disorder

44
Q

How soon after an event can PTSD be diagnosed?

A

Symptoms usually present for 6 months before diagnosis is made

Short time after event = Acute stress reaction
=> this usually resolves

PSYCHIATRY (35 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions