What can trigger PTSD
Abuse War Work related exposure Torture Assault Serious accidents
How common is PTSD
6.8% combat being the most common trigger for me and sexual molestation for women
Only 25-30% of people who experience trauma will develop PTSD
When do symptoms develop
Symptoms can develop immediately but can be delayed in less than 15%
Why is there trouble assessing PTSD
People don’t present for months/years despite suffering greatly, they also don’t want to talk about what happened as patients view the condition as untreatable
What are the key symptoms of PTSD
Re-experiencing Avoidance Hyperarousal Negative alteration in mood and thinking Emotional numbing Dissociation Emotional dysregulation Relationship problems Negative self perception
How is trauma re-experienced
Intrusive
Distressing thoughts
Images and flashbacks
Nightmares
Flashbacks feel real
What is hyperarousal
Physiological reactivity (increased heart rate) Sleep disturbance Irritability Anger Hyper vigilant
Brewin and Holmes conclusion about PTSD patients
Feelings of guilt, shame, sadness, betrayal, humiliation and anger
Risk factors for PTSD
Exposure to traumatic event Female sex Younger age Major life stress events Low social support, social disadvantage History of mental health disorder
Concept of intentional harm
Ayers and De Visser concluded intentional harm is more likely to cause PTSD than natural disasters
How deliberate human caused stressors are judged to be also seem to be important
What is resilience
Adult capacity to maintain healthy psychological and physical functioning
What are the characteristics of resilient people
Process a flexible adaption to challenges, sense of continuity in their beliefs about themselves/lives, they retain the ability to regenerate positive experiences
What are the other physiological factors which contribute to PTSD development
Personal impact of the event
Extent of perceived control over future threats
How one is prepared to deal with a stressor
Ones beliefs and assumptions about trauma
What is the consensus on genetic predisposition to PTSD
5-20% within different populations,
Treatment options
Psychological prevention and treatment
Pharmacological treatment
Prevention of PTSD
Psychological debriefing INEFFECTIVE AND INCREASES RISK
secondary traumatisation
Medicalising normal distressing
May prevent potentially protective responses of denial and distancing
Psychological interventions for PTSD
Cognitive processing
CBT
Narrative exposure therapy
Prolonged exposure therapy
EMDR
Eye movement desensitisation and reprocessing (12 sessions offered)
Pharmacological treatment of PTSD in adults
SSRI - Paroxetine and sertraline
Venlafaxine also recommended but off licence
nice recommends CBT and EDMR before medication where possible
