PTSD Flashcards
What section is PTSD classified under in DSM-V. And what other conditions are included in this section?
Trauma - and stressor - related disorders
ASD, PTSD, adjustment disorders, reactive attachment disorders
Four sets of symptoms that characterize acute stress disorder
Dissociative features
Persistent re-experiencing
Avoidance
Hyper arousal
Three cornerstones of PTSD
Re-experiencing
Avoidance/numbing
Arousal (poor sleep, irritable, hyper vigilance)
Aetiology of PTSD (biopsychosocial)
Bio - genetics, neurochemical [5HT,NE,opiate], neuroendocrine, brain structure
Psycho - psychoanalytic [defense mechanisms], learning theory [fear based memories]
Social - support, violence, media, natural vs human violence, ‘meaning making’ of trauma
Pre-trauma risk factors for developing PTSD
Previous trauma
Education
Childhood adversity
Fam Hx of PTSD or depression
Predictive factors for developing PTSD during and after trauma
Trauma severity
Additional stressors
Lack of support
Emotional reaction to event (panic, dissociative, pronounced distress)
What is the best way to deal with someone in the acute aftermath of a traumatic event?
ERASE
Reduce exposure to stress
Restore physiological needs
Provide access to information/orientation
Locate sources of support
Emphasize expectation of returning to normal
What not to do in the auto aftermath of trauma
The 3 Ps
Do not pathologise
Do not psychologise (don’t debrief/ council)
Do not pharmacologise
ASD treatment
‘Watchful waiting’ in first 4 weeks
No meds
Educate victim about when to seek medical help
Normalize and reassure only minority develop PTSD
What is the treatment of PTSD
Biopsychosocial
Trauma focused CBT
Eye movement and desensitizing reprocessing
SSRIs, SNRIs (venlafaxine) continue for at least 12 months
What does trauma focussed CBT entail?
Revisit traumatic cognitions Challenge misinterpretations that overestimate and generalize threat Achieve mastery over dispair Dismantle avoidance behaviors Develop skills to cope with stressors
What does EMDR stand for and what does it entail?
Eye movement and desensitizing reprocessing.
Pt recalls image of NB aspect of traumatic event
Follows repetitive side to side eye movements/sounds/taps as image is focused on.
What is the general course of PTSD?
Half recover in 3 months
Symptoms come and go (symptom reactivation)
Comorbidity is a rule rather than an exception! (Eg, depression, anxiety, substance abuse, personality, bulimia)
How are clinicians impacted in PTSD?
"Contagiousness" of trauma Trauma fatigue/burnout Need introspection/reflection Must get support Ethical/ legal matters Advocacy role
7 Question Screening Tool
FAALLIN: no point planning for the Future Avoid being reminded of the experience difficulty falling or staying Asleep Lose interest in important or enjoyable activities difficulty feeling Love and affection Isolation startled by ordinary Noises
