Problem 2

Question 1

Post-traumatic stress disorder (PTSD)

Answer 1

Refer to the consequences of experiencing extreme stressors as a result of a traumatic event

ex.: feeling numb, detached, chronically aroused

Question 2

The presence of 3 types of symptoms are required to diagnose PTSD.

Name them.

Answer 2

1. Repeated re-experiencing of the traumatic event
2. Emotional numbing
   - -> persistent avoidance of stimuli associated with the trauma
3. Chronic arousal
   - -> being on guard for the traumatic event to recur

Question 3

Acute stress disorder

Answer 3

Occurs in response to traumas similar to those involved in PTSD, occur within a month

–> BUT: short-term response to trauma, only lasting for appr. 1 month

Question 4

Which symptoms are common in acute stress disorder ?

Answer 4

Dissociative symptoms, which arise within a month of the experience of the stressor

–> numbing, detachment, reduced awareness of surroundings

Question 5

Adjustment disorder

Answer 5

Consists of emotional + behavioral symptoms

–> stressors leading to this disorder can be of any severity

BUT: stressors for acute disorder or PTSD have to be severe

Question 6

Children may manifest different symptoms in PTSD than adults.

How do they show ?

Answer 6

May express their recollections in their play

ex.: child witnessed someone being shot, may repeatedly have one doll kill another

Question 7

What are possible traumas leading to PTSD ?

Answer 7

1. Human made disasters
   ex. : wars, terrorist attacks, torture
2. Natural disasters
   ex. : floods, tsunamis, earthquakes
3. Abuse (sexual), physical violence
   - -> increased risk (46%)
4. Interpersonal disasters
   ex. : accidents

Question 8

What are strong predictors of how people will react to trauma/whether they will develop some form of PTSD ?

(Social + environmental factors)

Answer 8

1. Severity
2. Duration
3. Proximity to it
4. Available social support

Question 9

What are psychological factors that will indicate that a person is more likely to develop PTSD ?

Answer 9

1. Already experiencing increased symptoms of anxiety/depression before the trauma occurs
2. Coping styles, meaning self- destructive or avoidant coping strategies
   ex. : drinking, self isolation
3. Dissociation
   - -> feeling like one is in someone else body, not the self

Question 10

What are the gender differences in developing PTSD ?

Answer 10

Women are more likely to be diagnosed with it, as they may be more likely to experience some of the triggers

ex.: sexual abuse

Question 11

What are the biological responses to PTSD ?

Answer 11

1. Smaller hippocampus
   - -> due to overexposure to neurotransmitters + hormones that were released in the stress response
2. Over-activation of Amygdala+ less activity in the MPFC
   - -> responding more actively to emotional stimuli
3. Low levels of cortisol
   - -> leads to prolonged activity of the SNS, thus more easily developing conditioned fear
4. Increased secretion of epinephrine + norepinephrine
   - -> memories are over consolidated/planted more firmly in memory

Question 12

Is PTSD heritable ?

Answer 12

Yes,

abnormally low cortisol levels may be a heritable risk factor for PTSD

Question 13

What are possible treatment options for PTSD ?

Answer 13

1. Trauma-focused psychotherapies (TFPs)

a) Cognitive behavioral therapy
- -> involves systematic desensitization
b) Eye movement desensitization and reprocessing (EMDR)

2. Selective reuptake inhibitors (SSRI)
3. Stress-incoulation therapy
   - -> when people can’t be exposed to the trauma

Question 14

Systematic desensitization

Answer 14

Patient has to vividly imagine + describe the feared events in the safety of the therapists office

–> allows to habituate to the anxiety + distinguishing memory from present reality

Question 15

Emotion-based reasoning (ER)

Answer 15

Interpreting an anxiety response as evidence that threat is impending

Question 16

Intrusion-based reasoning (IR)

Answer 16

Interpreting the presence of intrusions as evidence that threat is impending

–> intrusions refer to similar trauma experiences that are triggers

Question 17

Are ER and IR involved in chronic PTSD ?

Which role does IR play in PTSD

Answer 17

1. People with PTSD typically engage in both ER + IR
2. IR is strongly related to

a) acute + chronic symptoms
b) onset + maintenance of PTSD symptoms
- -> IR is a cause of PTSD

Question 18

Why is it said that Dissociation will have a negative impact on a possible successful PTSD treatment ?

Answer 18

1. Could hinder fear activation
   - -> key mechanism to a successful PTSD treatment
2. Increased activation of the anterior cingulate cortex + MPFC

–> leads to prevention of emotional engagement of trauma related matters

Question 19

Does Dissociation really have a negative impact on the outcome of a trauma focused treatment program ?

Answer 19

No,

the results suggested differently

Question 20

Eye movement desensitization and reprocessing

EMDR

Answer 20

Involves recalling traumatic memories while simultaneously making horizontal eye movements + accepting ones memories + thoughts

Question 21

How does EMDR work, respectively why ?/

What is the correct hypothesis ?

Answer 21

By taxing WM during recall

–> as the WM is then busy with two tasks, the memory is reconsolidated less vividly, thus any other dual task has the same effect

Question 22

Mindfulness-based cognitive therapy

Answer 22

Works similar to EMDR

–> uses mindfulness breathing instead of eye movements

Question 23

Dissociative symptoms

Answer 23

1. Depersonalization

–> detachment from town mental processes or body

2. Derealization

–> detachment from the outside world

BUT: either one is required to be diagnosed

Question 24

Delayed expression

Answer 24

Full criteria for PTSD have NOT been met before in the past, but for the past 6 months MORE of the symptoms are shown to fully meet the DSM 5 criteria

–> opposite to Partial remission (ADHD)

Question 25

Name the 3 Hypotheses of how the EMDR works.

Answer 25

1. EMDR works by recalling abrasive memories + movements aren’t necessary
2. EMDR works by stimulating “inter-hemispheric communication”, meaning it wouldn’t work with up-down movements
3. EMDR works by taxing WM during recall
   - -> CORRECT

Question 26

Mental defeat

Answer 26

Seeing the self as the victim, blaming the self for the whole trauma occuring

–> occurs in combination with PTSD

Question 27

Name the 5 different kinds of Dissociative disorders.

Answer 27

1. Dissociative amnesia (DA)
   - -> loss of autobiographical memory for certain past experiences
2. Dissociative fugue (DF)
   - -> amnesia that covers whole of the persons life
3. Dissociative identity disorder (DID)
   - -> appearing to have more personalities, changed from MPD
4. Depersonalization disorder
   - -> believing one has changed in some way/no longer real person
5. Dissociative disorder NOS

Question 28

Etiology of Dissociative disorders

Cause ?

Answer 28

1. Used to be classified as hysteria
2. DA + DF were thought to occur due to a trauma

–> BUT: almost no evidence that trauma is the cause of dissociation

Question 29

Trauma memory argument

Answer 29

Suggests that not all traumas lead to dissociation, but there are 2 types:

1. Type 1: Refer to surprising - well defined events
   - -> enhanced memory for the trauma
2. Type 2: Repeated over an extended period of time
   - -> denial for the memory thus dissociation creates amnesia