PTSD Flashcards
(7 cards)
In which DSM did PTSD appear and in which context?
Recent category→ DSM III
- go back to people trying to understand soldiers stress
- appears around Vietnam War
What are the criteria for a diagnosis of PTSD?
Criteria
- 1st→ Need exposure to a traumatic event (actual or threatened death, injury, sexual violence
- can be direct experience, or witnessing
- re-experiencing of the event
- avoidance→ behavioural or cognitive
- negative alterations of cognitions and mood
- Marked alterations in arousal and reactivity associated with the traumatic event (insomnia, irritability, hypervigilance…)
- duration of disturbance is more than one month
What is the epidemiology of PTSD?
Life prevalence→ 7-8%
Gender-> 2F:1M
- rates of trauma are higher→ 60%men and 51% women report traumas
- higher risk is trauma is associated with assault and violence
- kidnapped/tortured→ 54%
- rape→ 49%
Cross cultural
- Rates of PTSD higher in developing non western countries
- but might be because of periods of turmoil
- Symptoms also different
Following a trauma, how many people will go to develop PTSD?
9%
What are some predictors of PTSD following a trauma?
Nature of the person
- Gender→ women more likely
- Familial psychopathology→ any psychopathology is a factor risk
- Pre-existing psychopathology
- Internalizing symptoms in early childhood
- Childhood traumas
- Lower IQ at higher risk
- Psychological processes occurring during and after trauma (guilt, shame…)
Nature of trauma
- Proximity→ happened to you or someone else
- Duration
- Level of life risk to your life
- Intention→ accidents are less likely to resort in PTSD than assault
- Dissociation→ risk factors
—>Social support after trauma buffers risks
What is the link between PTSD and the hippocampus?
Hippocampal abnormalities→ involved in explicit memory and encoding of context during fear conditioning
- interact with amygdala
- Reduced volumes→ verbal memory deficits, dissociative symptom severity
- Reduced neuronal integrity→ communication is worst
- Reduced functional integrity
—>are those scars of the trauma?
- neurotoxic effects of cortisol→ causes atrophy and cell death
Twin study with Vietnam study–>smaller hippocampi represent a pre-existing vulnerability
- exposed PTSD and unexposed co-twin have smaller hippocampus
What are the effects of a reduced hippocampal volume?
Leads to
- diminished neuroendocrine regulation of HPA axis→ more stress
- stronger conditioned fear
Predispose individuals to
- acquire stronger and/or more persistent conditioned emotional responses
- OR stronger hormonal stress responses
- Or BOTH
