PTSD Flashcards

(35 cards)

1
Q

what are the 4 groups of symtpoms according to DSM 5

A
  • intrusion symptoms
  • avoidance
  • negative alterations in cognition and mood
  • alterations in arousal and reactivity
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2
Q

how severe must the symtoms be for diagnosis

A

enough to impair function

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3
Q

how common are comorbid conditions in PTSD

A

very common - 80%

eg depression, anxiety, anger and substance misuse

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4
Q

is PTSD related to suicide

A

it has a stronger association than any other anxiety disorder - x6

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5
Q

what is the difference between centrifugal and centripetal disasters

A
  • Centrifugal disasters are where the people are together only at the moment of disaster (e.g. plane crash), centripetal disasters are in an existing community
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6
Q

who is more likely to be exposed to trauma

A
  • Certain groups are more likely to be exposed to trauma, e.g. refugee, military, police, emergency service workers
  • Higher frequency exposure in inner cities and where natural disasters occur
  • The poor and marginalized are more likely to be victims
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7
Q

what is type 1 trauma

A

single incident trauma, unexpected

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8
Q

what is type 2 trauma

A

complex, repetitive trauma eg ongoing abuse, betrayal of trust relationship

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9
Q

does type 1 or 2 trauma have a higher risk for PTSD

A

type 2

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10
Q

in which type of trauma does the victim often ‘freeze’ - tonic immobility

A

sexual assault

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11
Q

what is tonic immobility

A

an involuntary state or profound, reversible motor inhibition

a survival instinct when the threat is decieded to be inescapable

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12
Q

what is peri traumatic dissociation

A

disturbed awareness, impaired memory or altered perceptions during and immediately after a traumatic experience

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13
Q

what does peri traumatic dissociation increase the likelihood of

A

PTSD

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14
Q

which brain areas are responsible for actions during threat and fear

A

the amygdala, hippocampus and midbrain areas (superior colliculi and PAG)

shift away from pre frontal cortex - reasoning and making integrated decisions

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15
Q

what are the 2 types of memory

A
  • conscious memory - hippocampus
  • emotional memory - amygdala
    • can recognise and remember danger
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16
Q

what is wrong with memory of the traumatic event in PTSD

A
  • improper storage of traumatic event in implicit memory
  • cant remember key features about event
  • memories are based on fear and emotional memory (amygdala)
17
Q

what is different about the hippocampus in PTSD

18
Q

which side of the hippocampus is damaged in adult and childhood trauma

A

right in adult and left in childhood

19
Q

when do hippocampal changes occur

A

from 6 months after trauma

20
Q

what does current hippocampal size correlate to

A

current severity of PTSD

  • small hippocampus could be a risk factor for lack of recovery
  • or PTSD effects on hippocampal size could be reversible as PTSD recovers
21
Q

what happens to amygdala activity in PTSD

A

increased - failure of the prefrontal networks to regulate it - hyperreactivity to threat

22
Q

what can the timeless quality of traumatic memory be attributed to

A

right hemispheric lateralization

23
Q

what are cortisol levels like in PTSD

24
Q

what happens to the cortisol feedback system in PTSD

A
  • normally puts a stopper on the stress adrenaline release response
  • however in PTSD, the negative feedback system is oversensitive so low levels of cortisol inhibit the production of ACTH and CRH - failure to contain sympathetic response - consolidation of traumatic memories
25
what changes occur in Brocas area in PTSD
decreased regional CBF when individuals access personal traumatic memories - this means that emotional memories are stronger than higher cortical memories
26
is inidividuals having negative views of themselves pre trauma a risk factor PTSD
yes. conversly strong optimisic beliefs can act as a buffer to developing PTSD
27
is thre a diference inhow males and females cope with trauma
males cope better
28
do different ages cope with trauma better or worse
extremes of age and development are pre traumatic risk factors
29
are behavioural problems pre traumaic risk factors
yes
30
which types of event are more likely to cause PTSD
human made, not natural
31
does event duration affect development of PTSD
prolonged exposure is a risk factor
32
management of someone with mild/moderate symptoms presenting \<3 months after trauma
watchful waiting
33
what psychological treatments are indicated
* trauma focused CBT * eye movement desensitization and reprocessing * non trauma CBT
34
is there an indication for pharamcotherapy
can be used symptomatically for acute phases ADs can be used to reduce the severity of core symptoms
35
what are the first and second line agents
1 - paroxetine and mirtazapine 2 - amitriptyline or phenelzine