Post-Traumatic Stress Disorder Flashcards Preview

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Flashcards in Post-Traumatic Stress Disorder Deck (18)
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Name the 3 main symptom clusters of PTSD

Re-experiencing, hyperarousal, avoidance


State some PTSD symptoms in the hyperarousal cluster

Difficulty falling asleep, irritability, angry outbursts, difficulty concentrating, exaggerated startle response


State some PTSD symptoms in the avoidance cluster

Avoiding thoughts and feelings associated with the trauma; avoiding activities, places, and people which produce recollection of the trauma; feeling detached from others; reduced interest and participation in activities


Describe the difference between type I and type II trauma

Type I is a single traumatic event, whereas type II is prolonged and repeated trauma


What percentage of PTSD susceptibility is heritable? (Goldberg et al, 1990)



State some brain changes associated with PTSD susceptibility

Impaired HPA axis sensitivity and reduced hippocampal volume


What is the lifetime prevalence of PTSD in the general population? (Kessler et al, 1995)



State some differential diagnoses for PTSD

Depression, borderline personality disorder, substance abuse


State the most common comorbidities of PTSD

Alcohol misuse, drug misuse, major depressive disorder, stomach ulcers


What is the first-line treatment for severe PTSD?

Pharmacotherapy - SSRIs, mirtazapine, or antipsychotics (olanzapine)


Name some psychological interventions for PTSD

Trauma-focused CBT, eye movement desensitisation and reprocessing (EMDR)


Describe the evidence for single session debriefing after a traumatic event

There is no evidence of benefit and it may even be harmful


What percentage of patients no longer meet the diagnostic criteria for PTSD after psychotherapy?



Describe the main features of 'enduring personality change after catastrophic experience' (EPCACE) in ICD-10

Permanent hostile and distrustful attitude, social withdrawal, constant feelings of emptiness or hopelessness, feeling on-edge or threatened, permanent feeling of being changed, feeling different to others


According to Munjiza et al's 2017 case-control study, what percentage of patients with personality change meet criteria for EPCACE?



What were the problems with the EPCACE diagnosis? (Munijza et al, 2019)

More than 50% of patients who met the diagnostic criteria described symptoms not included in the ICD-10 criteria, including frequent mood changes, anger control problems, persistent feelings of eccentricity, over-sensitivity to criticism, loss of libido, perfectionsism, and suicidal ideation or self-harm


Define complex PTSD, as introduced in ICD-11

Meeting the criteria for PTSD, with the addition of severe and persistent problems with affect regulation, feelings of worthlessness, shame, and guilt, and difficulties with sustaining relationships


State some problems with the ICD-11 criteria for complex PTSD

Significant overlap with personality disorder (diagnostic confusion), significant overlap with personality disorder risk factors, stigma attached to personality disorder leading to preference for complex PTSD, treatment for personality disorder and PTSD being very different (unclear which would be more efficacious)