PTSD

Question 1

what is PTSD?

Answer 1

• Recognition in 1980s, initially linked to Vietnam war before becoming PTSD in DSM & initially viewed as an anxiety disorder
• developed in individuals who have experienced or witnessed a traumatic event > can interfere with persons, daily life and functioning
• diagnosed when there’s severe trauma involving life-threatening situations, serious violence, or injury, persisting for more than one month

Question 2

what are they key features/ symptoms of PTSD?

Answer 2

• intrusions > re-occurring and distressing memories of flashbacks of traumatic event, dissociation
• avoidance > isolating from triggers
• negative conditions/ changes > self-blame, low mood, neg thoughts about world, feelings of detachment, inability to remember trauma
• arousal> increased irritability, hyper-vigilance, aggression, recklessness

Question 3

What are the DSM criteria for PTSD?

Answer 3

• exposure to trauma (death, serious injury, sexual violence)
• intrusive symptoms, avoidance, changes in mood, and thought process, arousal
  -symptoms persist for more than 1m < less than 1m = acute distress disorder
  -symptoms cause significant distress or impairment

Question 4

what are the subtypes related to dissociation in PTSD?

Answer 4

• depersonalisation > experiencing sense of detachment or disconnection from own body or thoughts > like observing self from distance
• derealisation > feeling as though external world is unreal, distorted > sense of detachment from environemnt

Question 5

what are key facts about PTSD?

Answer 5

• 80% individuals w/ PTSD have other diagnosis > i.e. depression
• lifetime prevalence > 2.2% - 8.8%
• women more likely to be diagnosed than men 4:1 ratio
• associated with higher use of substance use = avoidance to deal w/ event

Question 6

what are biological risk factors of PTSD?

Answer 6

• Heritability > 30-40%, influenced by multiple genes
• Sensation-seeking, neurotransmitter imbalances (serotonin, dopamine, norepinephrine), dysregulated HPA axis.
• Experiences altering gene expression.
• Hippocampus involvement> Smaller size, reduced activation; may predispose to PTSD.
• Amygdala hyperactivity > Increased fear response
• Frontal regions less active = Impaired cognitive control.

Question 7

what are Environmental risk factors of PTSD?

Answer 7

• Environmental risk factors> include minority group status (least predictive) to younger age, low education, psychiatric history, previous trauma (most predictive)
• Childhood traumatic events strongly predict PTSD < highest likelihood for PTSD

Question 8

how do individuals react to trauma and how does this influence the development of PTSD?

Answer 8

• Peri-traumatic distress > experienced during trauma > Indicators e.g. fear, horror, helplessness, emotions (e.g., sadness, guilt), and physiological reactions (e.g., high heart rate) are crucial
• peri traumatic Dissociation> during trauma > where one splits off from oneself (banking out, autopilot) , is also significant and predicts a higher likelihood of PTSD.

Question 9

what are cognitive theories for PTSD?

Answer 9

• cognitive appraisal: Interpretation of the situation predicts PTSD> if there is catastrophic interference of event = ongoing sense of threat after trauma
• Cognitive style (mental defeat) predicts PTSD > Blaming oneself, feeling helpless, expecting permanent change.

Question 10

how does the learning model explain PTSD?

Answer 10

• Classical conditioning plays a role > Neutral stimulus associated with trauma-related fear response = development of conditioned response, i.e. cues associated with trauma may trigger fear or anxiety response, even in absence of traumatic event
• Operant conditioning involves negative reinforcement and avoidance > behaviours that provide relief or avoidance of distressing stimuli reinforced = individuals, learn to avoid situation associated with trauma to reduce anxiety or distress = contribute to maintenance of PTSD symptoms

Question 11

what is the fear network theory?

Answer 11

• foa et al
• refers to interconnected neural circuits and structures in the brain that become activated during fear and anxiety responses = forming fear network
• trauma memory > associated w/ situational cues

Question 12

what is the dual representation theory?

Answer 12

• Brewin, 2001 > two memory systems
• explains how traumatic memories are stored and processing brain > thought to be stored in two separate memories systems, verbal and sensory perceptual
• verbal memory system> consciously, processed event, memories, contextual > hippocampus
• SAM> snapshots too brief to take in consciously > flashbacks> Amygdala

Question 13

what are treatments for PTSD?

Answer 13

• CBT > cognitive reconstructing, reinterpretation to diminish sense of current threat, change in dysfunctional belief and safe exposure > drop out = 26%
• Exposure therapy > gradually approaching and confronting trauma related memories, thoughts and situations to reduce avoidance and fear > in real life, imaginal (eyes closed, or VR) = drop out = 38%

Question 14

how is the assessment conducted for people wanting to seek treatment for PTSD?

Answer 14

• The assessment involves establishing trust, understanding motivation, and using psychoeducation and self-report tools like questionnaires

Question 15

what is eye movement desensitisation and reprocessing therapy (EMDR)?

Answer 15

• designed to help individuals process, distressing memories & reduce emotional & psychological stress associated with memories
  -developed by Francine Shapiro
  -involves bilateral stimulation e.g. eye movement during memory recall> to help process distressing memories > follow eight phase protocol