Stress Disorders Flashcards Preview

Neuro > Stress Disorders > Flashcards

Flashcards in Stress Disorders Deck (17):
1

PTSD epi
which group most likely?
comorbid disorders?

8%
50% exposed --> 15% develop PTSD
young adults (highest exposure to trauma)
borderline/antisocial PD
risk proportional to severity/type/proximity of stressor and to vulnerability of individual

2

high risk exposures for PTSD
other RF's

captive, kidnapped, tortured
life-threatening illness
combat
rape
shot/stabbed

female gender
hx of trauma
family hx of PTSD/depression
lack of social supports
use of benzos/alcohol

3

male vets w/combat-related PTSD have high rates of what?

physical/sexual abuse

4

what's the deal w/hippocampi and PTSD?

small hippo predispose
size of hippo is genetically determined

5

PTSD folks have hyperactive what?
e.g. of compounds that enhance/reduce sx?
PTSD folks have low levels of what?

noradrenergic system
yohimbine (agonist)
prazosin (reduces)

cortisol (enhanced neg fdbk on HPA)

6

behavioral model of PTSD development?

classical conditioning --> avoidance of stimuli --> emotional detachment and social isolation

7

4 core sx of PTSD
hyperarousal sx?

exposure to trauma then...
intrusive/dissociative sx
negative mood
avoidance
hyperarousal (insomnia, irritability, hypervigilance)

8

remission of PTSD?

50% remit in 3 months
many have sx 12+ months

9

key difference of acute stress disorder?

TIME FRAME
sx start immediately after event
don't last longer than ONE MONTH
risk factor for dev PTSD

10

the PTSD disturbance and sx must occur for longer than?

one month

11

PTSD requires exposure to what 3 types of events?

actual/threatened death
injury
sexual violence

12

somatic tx of stress disorders
SSRI ineffective for what?
what for nightmares/insomnia?
avoid what medication?

1st line: SSRI (sertraline and paroxetine)
--> can also tx comorbid depressive d/o
no effective for combat PTSD

also prazosin for nightmares/insomnia
atypical antipsychotics
benzos --> might actually increase risk

13

psychotherapy of PTSD: 3 types of therapies

no more debriefing, instead monitored

prolonged exposure: people learn to fear what reminds them of past event --> learn that they don't have to fear them and change how they react to stressful memories

cognitive processing: affects how people think/interpret subsequent events --> WRITTEN exposure and how they think differently as a result; therapist challenges interpretations and helps ID "cognitive distortions" and replace with more accurate interpretations

14

co-morbid conditions in PTSD

mood, anxiety, substance use
75% pts have more than 1 psych dx
50% have 3 others
6x increase in MDD and 4x in panic d/o

15

PTSD ddx

acute stress d/o
GAD
schizophrenia

16

PTSD prognosis
impede?
improve?

impede: lang barrier, isolation, severity of trauma, duration of sx, somatic sx, BZD use

improve: social interaction, family support, prazosin and co-morbid tx

17

PTSD pts have low levels of what hormone?

Cortisol (enhanced neg fbdk)