Flashcards in Stress Disorders Deck (17):
which group most likely?
50% exposed --> 15% develop PTSD
young adults (highest exposure to trauma)
risk proportional to severity/type/proximity of stressor and to vulnerability of individual
high risk exposures for PTSD
captive, kidnapped, tortured
hx of trauma
family hx of PTSD/depression
lack of social supports
use of benzos/alcohol
male vets w/combat-related PTSD have high rates of what?
what's the deal w/hippocampi and PTSD?
small hippo predispose
size of hippo is genetically determined
PTSD folks have hyperactive what?
e.g. of compounds that enhance/reduce sx?
PTSD folks have low levels of what?
cortisol (enhanced neg fdbk on HPA)
behavioral model of PTSD development?
classical conditioning --> avoidance of stimuli --> emotional detachment and social isolation
4 core sx of PTSD
exposure to trauma then...
hyperarousal (insomnia, irritability, hypervigilance)
remission of PTSD?
50% remit in 3 months
many have sx 12+ months
key difference of acute stress disorder?
sx start immediately after event
don't last longer than ONE MONTH
risk factor for dev PTSD
the PTSD disturbance and sx must occur for longer than?
PTSD requires exposure to what 3 types of events?
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
benzos --> might actually increase risk
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
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
acute stress d/o
impede: lang barrier, isolation, severity of trauma, duration of sx, somatic sx, BZD use
improve: social interaction, family support, prazosin and co-morbid tx