Ch. 19: Trauma and stressor-related disorders

Question 1

PTSD is more common in _____ than in _____

Answer 1

Women than in Men

Question 2

Individuals who have difficulties with stress reactions to more “normal” events may be diagnosed with:

Answer 2

adjustment disorder. Quite common and can occur at any age.

Question 3

PTSD

Answer 3

A reaction to an extreme trauma, which is likely to cause pervasive distress to almost anyone

Question 4

Symptoms of PTSD

Answer 4

• Re-experiencing traumatic event
• Sustained high level of anxiety or arousal
• General numbing of responsiveness
• Intrusive recollections or nightmares
• Amnesia to certain aspects of the trauma
• Depression; survivors guilt
• Substance abuse
• Anger and aggression
• Relationship problems

Question 5

DX PTSD

Answer 5

Symptoms must be present for more than 1 month and cause significant interference with functioning. Symptoms may begin within the first 3 months after the trauma, or there may be a delay of several months or even years.

Question 6

Acute stress disorder (ASD)

Answer 6

Similar to PTSD. Symptoms are limited up to 1 month following the trauma. If symptoms last longer than 1 month, the diagnosis is PTSD.

Question 7

Learning theory of PTSD

Answer 7

Negative reinforcement leads to the reduction in an aversive experience, thereby reinforcing and resulting in repetition of the behavior. (Avoidance behaviors, Psychic numbing)

Question 8

Cognitive theory of PTSD

Answer 8

A person is vulnerable to PTSD when fundamental beliefs are invalidated by experiencing trauma that cannot be comprehended.

Question 9

Biological aspects of PTSD

Answer 9

It is suggested that symptoms related to the trauma are maintained by the production of endogenous opioid peptides that are produced in the face of arousal, and which result in increased feelings of comfort and control. Stressor terminating may cause symptoms of withdrawal.

Question 10

More bio aspects of PTSD

Answer 10

Dysregulation of opioid, glutamatergic, noradrenergic, serotonergic, and neuroendorcrine pathways may also be involved in the pathophysiology of PTSD.

Question 11

Adjustment disorder dx criteria

Answer 11

Symptoms occur within 3 months of the stressor and last no longer than 6 months. Except the “related to bereavement” subtype.

Question 12

EMDR

Answer 12

eye movement and desensitization and reprocessing (EMDR). Treatment for PTSD. As well as cognitive therapy, prolonged exposure therapy, and Group/family therapy.

Question 13

Pharm TX for trauma-related disorder

Answer 13

• SSRIs: Paroxetine and Sertraline approved by FDA for TX of PTSD
• TCAs: Amitriptyline and Imipramine
• MAOIs
• Trazadone
• Alprazolam to help with panic
• Buspirone
• Beta blockers
• Prazosin for nightmares