PTSD

Question 1

The following are pretraumatic, peritraumatic or posttraumatic risk factors?

1. •Severity of the trauma
2. •Perceived life threat
3. •Personal injury
4. •Interpersonal violence

Answer 1

Peritraumatic (during the event)

Question 2

The following are pretraumatic, peritraumatic or posttraumatic risk factors?

1. •Lower socioeconomic status
2. •Lower education
3. •Exposure to prior trauma → especially childhood
4. •Childhood adversity
5. •Female gender

Answer 2

Pretraumatic (before the event)

Question 3

The following are pretraumatic, peritraumatic or posttraumatic risk factors?

1. •Poor coping strategies
2. •Subsequent exposure to repeated reminders
3. •Subsequent adverse life events
4. •Financial or other trauma related losses

Answer 3

Posttraumatic (after the event)

Question 4

Strong social support is a ______ factor for PTSD

Answer 4

Protective factor

Question 5

Definition of what:

The complex somatic, cognitive, affective, and behavioral effects of psychological trauma

Answer 5

PTSD

Question 6

What type of medical conditions can lead to PTSD?

Answer 6

Sudden onset type of medical condition (ex: MI, waking up during sx, anaphylactic shock, etc)

Question 7

The following influences ____ of PTSD?

1. Characteristics of the individual experiencing the event (Coping mechanisms, Resilience)
2. Nature of the inciting event
   
   • Intentional trauma found to have a greater association with PTSD than unintentional/nonassaultive

Answer 7

1. frequency

Question 8

Does intentional or unintentional/nonassultive trauma have a greater associateion with PTSD?

Answer 8

Intentional

Question 9

Are women or men more likely to develop PTSD and generally exprience a longer duration?

Answer 9

Women (4x more)

Greater likelihood of exposure to traumatic events (sexual assault)

Question 10

Exposure to _____ or ______ death, serious injury or sexual violence is part of DSM V dx criteria for PTSD

Answer 10

Actual or Threatened

Question 11

What are 4 ways a person can be exposed to actual or threatened death, serious injury or sexual violence

Answer 11

1. Direct experience
2. Witnessing event in person
3. Hearing about a traumatic event that happened to friend/family
4. Experiencing repeated/extreme exposre to aversive details of the traumatic event (ex: first responders)

Question 12

T/F: Presence of 1+ of the following intrusions sxs is associated with dx criteria of PTSD

1. Recurrent, involuntary, and intrusive distressing memories of the traumatic event(s)
2. Recurrent distressing dreams related to event
3. Dissociative reactions (e.g. flashbacks)
4. Intense or prolonged psychological distress at exposure to internal or external cues that symbolize or resemble an aspect of the traumatic event(s).
5. Marked physiological reactions to internal or external cues that symbolize or resemble an aspect of the traumatic event(s).

Answer 12

1. Recurrent, involuntary, and intrusive distressing memories of the traumatic event(s)
2. Recurrent distressing dreams related to event
3. Dissociative reactions (e.g. flashbacks)
4. Intense or prolonged psychological distress at exposure to internal or external cues that symbolize or resemble an aspect of the traumatic event(s).
5. Marked physiological reactions to internal or external cues that symbolize or resemble an aspect of the traumatic event(s).

Question 13

The following are ways PTSD presents in which population?

1. Repetitive play may occur in which themes or aspects of the traumatic event(s) are expressed.
2. Frightening dreams without recognizable content.
3. trauma-specific reenactment may occur in play.

Answer 13

Children

Question 14

What are the 5 main diagnostic criteria of PTSD?

Answer 14

1. Exposure to actual or threatened death, serious injury, or sexual violence
2. Intrusion symptoms associated with the traumatic event, after the event occurred
3. Persistent avoidance of stimuli associated with the traumatic event (avoidance of memories, thoughts, external reminders)
4. Negative alterations in cognitions and mood associated with traumatic event
5. Marked alterations in arousal and reactivity associated with event
6. Duration: 2-5 must last >1 month
7. Impairment in social, occupational, or other important areas of functioning.
8. The disturbance not due to effects of substance (ex: meds, alcohol)

Question 15

_________ amnesia can occur in patients with PTSD

Answer 15

Dissociative amnesia (inability to remember an important aspect of the traumatic event)

-Not due to other factors (head injury, alcohol, drugs)

Question 16

Associated with dx criteria of what disorder:

Persistent and exaggerated negative beliefs or expectations about oneself, others, or the world

(e.g., “I am bad,” “No one can be trusted,” “The world is completely dangerous,”)

Question 17

T/F: the following is associated with OCD:

blaming self or others

Answer 17

False. this is associated with PTSD

Question 18

Which disorder?

1. Diminished interest/participation in significant activities
2. Feelings of detachment/estrangement from others.
3. Persistent inability to experience positive emotions (e.g. inability to experience happiness, satisfaction, or loving feelings).

Answer 18

PTSD

Question 19

How long should sxs of PTSD last in order to dx PTSD

Answer 19

>1 month

(>3days- 1 month= acute stress disorder)

Question 20

The following are signs of _______ :

1. Irritable behavior and angry outbursts (with little or no provocation)
2. Reckless/self-destructive behavior.
3. Hypervigilance.
4. Exaggerated startle response.
5. Problems with concentration.
6. Sleep disturbance

Answer 20

PTSD

Part of DSM V dx criteria- Labeled as marked alterations in arousal and reacity

Question 21

Elaborate on the following PTSD DSM V specifiers:

With dissociative symptoms: The pt’s sxs meet the criteria for PTSD and in addition, in response to the stressor, the individual experiences persistent or recurrent symptoms of either of the following:

• Depersonalization
• Derealization

Answer 21

•Depersonalization: recurrent experiences of feeling detached from one’s mental processes or body

• e.g., feeling as though one were in a dream; feeling a sense of unreality of self or body or of time moving slowly

•Derealization: Recurrent experiences of unreality of surroundings

• e.g., the world around the individual is experienced as unreal or distorted

Question 22

__________ regression is often seen in children with PTSD

Answer 22

Developmental regression (often loss of language)

Question 23

T/F: pt’s with PTSD never eveperience social, occupation or phsycial disability

Answer 23

FALSE
PTSD is associated with high levels of social, occupational and physical disability

Question 24

PTSD is ____% more likely to meet diagnostic criteria for at least one other mental disorder

WHich mental disorders?

Answer 24

80%

Depression, Bipolar, Substance abuse

Question 25

What is the first line of therapy in PTSD

Answer 25

Trauma Focused psychotherapy: 1. Prolonged exposure therapy 2. Eye movement desensitization and reprocessing (EMDR)

Question 26

The following describes what therapy? Prolonged exposure teaches individuals to gradually approach their trauma-related memories, feelings and situations. They presumably learn that trauma-related memories and cues are not dangerous and do not need to be avoided

Answer 26

Prolonged exposure therapy (one of the 1st line treatments for PTSD)

Question 28

The following describes which first line treatment for PTSD: ## Footnote A structured therapy that encourages the patient to briefly focus on the trauma memory while simultaneously experiencing bilateral stimulation (typically eye movements), which is associated with a reduction in the vividness and emotion associated with the trauma memories.

Answer 28

EMDR

Question 29

What is pharmacotherapy for PTSD treatment?

Answer 29

1. SSRIs reasonable alternative to psychotherapy 2. Prazosin (Minipress) 30 to 60 minutes before bedtime

Question 30

The following describes which PTSD therapy? ## Footnote * Alpha 1 Blocker * Significant sleep disturbances (nightmares) → reduction in 50% of patients * Off label use

Answer 30

Prazosin (Minipress)

Question 31

Approach to treating PTSD in adults- graph