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PS2028 - Mental Health & Clinical Psychology > stress, trauma & PTSD > Flashcards

stress, trauma & PTSD Flashcards

1
Q

what is stress?

A
  • stressor > coping = stres
  • stressor (acute/chronic)
  • distress (stress impedes function)
  • eustress (stress enhances function)
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2
Q

PF,EF,AF,E/D,P

what are some different coping strategies to help with stress?

A
  • problem-focused
  • emotion-focused
  • appraisal focused
  • engagement/disengagement
  • proactive
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3
Q

what makes a stressor stressful?

A
  • external, environmental demands (physical or emotional)
  • impact may depend on severity, duration (acute/chronic), timing, personal impact, predictability, controllability
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4
Q

AR,SoR,E

what is Selye’s general adaption syndrome (1956)?

A
  • phase 1 = alarm reaction (fight or flight)
  • phase 2 = stage of resistance (coping)
  • phase 3 = exhaustion (recovery)
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5
Q

what mediates the stress response?

A
  • HPA axis (hypothalamic-pituritary-adrenal axis)
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6
Q

P,R,H,A

what is PTSD and how to briefly define it in 4 words?

A
  • persitant
  • re-experience
  • avoidance
  • hyper-arousal
  • impaired concentration and memory
  • feelings of depression may take over
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7
Q

S,IS,PA,NAiCM

what are criterions A, B, C and D in the DSM-5 for diagnosing PTSD?

A
  • criteria A = stressor
  • criteria B = intrusion symptoms
  • criteria C = persitant avoidance
  • criteria D = negative alterations in cognitions and mood
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8
Q

R,P,A

what does complex PTSD contains?

A
  • 3 clusters of symptoms of PTSD
  • re-experiencing trauma in present
  • persitant sense of threat
  • avoidance of traumatic reminders
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9
Q

AR,NS-C,DiR

what 3 additional symptom clusters does C-PTSD contain?

A
  • “disturbance of self-organisation”:
  • affective regulation
  • negative self-concept
  • disturbances in relationships
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10
Q

who may get PTSD?

A
  • PTSD may affect the person directly involved/witnessed in traumatic event:
  • armed forces
  • emergency services
  • rape/abuse victims
  • childhood trauma
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11
Q

did the DSM-5 make the disorder more stringent?

A

YES

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12
Q

why may there be an increased risk of trauma in some cases of PTSD?

A
  • if event witnessed involved human intent
  • if trauma is personal in nature
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13
Q

what is the prevalence of PTSD/risk factors?

A
  • US life prevalence = 6-8%
  • greater risk if F
  • F may experience more personal/direct trauma
  • can develop at any age
  • 1/3 of people who experience traumatic event go on to develop PTSD
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14
Q

will everyone who is exposed to traumatic event/set of traumatic experiences develop PTSD?

A

NO

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15
Q

what are some generic risk factors for PTSD?

A
  • occupation
  • gender (M>F)
  • family history of trauma exposure
  • conduct problems in childhood
  • high scores on measures of extraversion and neuroticism
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16
Q

what are some more specific/trauma-related risk factors of PTSD?

A
  • negative cognition of self, following trauma
  • family history of psychiatric illness
  • childhood trauma
  • personality (neuroticism)
  • isolation/low social support
  • negative social environment
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17
Q

what are some protective factors of PTSD?

A
  • high cognitive ability/education
  • social support and high levels of optimism, psychological control and mastery
18
Q

what is the stress response like in PTSD?

A
  • low cortisol or no difference to normal
  • but heightened response to experimental stress induction
  • high cortisol @ baseline for F
  • low cortisol among sexually/physically abused
19
Q

what causes PTSD (diathesis + stress)?

A
  • individual risk factors
  • stress hormones/cortisol
  • sociocultural factors
  • lack of social support
  • early life stress
  • neurochemistry
  • associative learning/cognition
20
Q

is there a genetic risk of PTSD?

A
  • it runs in families
  • it is heritable
21
Q

what are the main biological targets of PTSD?

A
  • dopaminergic system: D2 receptor
  • serotonergic system: serotonin transporter gene
  • neuropeptide
22
Q

what is the G x E interaction on PTSD?

A
  • particular form of serotonin transporter gene (5HTTLPR) has been focus of research
  • people with high risk genotype of this have high level of risk of PTSD when exposed to high level hurricane related trauma/low social support
23
Q

what are the effects of chronic stress/PTSD?

A
  • high levels of stress lead to/increase risk of physiological changes
  • risk of suppression of the immune system (link to depression)
  • risk of other psychological disorders: addiction, depression, anxiety
24
Q

what is declarative/semantic memory?

A

memories that can be consciously recalled such as facts and verbal knowledge

25
Q

what is episodic memory?

A

memory of what you had for dinner last week

26
Q

what is procedural knowledge?

A

knowledge of how to hold a knife and fork

27
Q

what is the process of memory formation?

A
  • sensory info and emotional info (amygdala) affect an event (acquisitional learning)
  • event goes to STM where consolidation happens in hippocampus and moves to LTM
  • reconsolidation and retreival happen in LTM which strengthens/modifies memory
  • emotional info also affects reconsodilation of event
28
Q

what does the process of memory formation look like in PTSD?

A
  • effects at acquisition
  • consolidation affected
  • disruption of reconsolidation
  • emotional info still in amygdala
  • more severe in terms of aversive memories
29
Q

where in the brain are there structural and functional abnormalities in PTSD?

A
  • amygdala
  • insula
  • medial prefrontal cortex
  • rotral anterior cingulate
  • hippocampus
  • areas associated with fear conditioning and extinction
30
Q

how to the amygdala and insula behave in PTSD?

A
  • hyperactive in response to trauma script provocation and when fearful vs happy faces
  • positive correlation between activation and PTSD severity
31
Q

DAA

amygdala and insula: successful exposure therapy associated with?

A

decreased amygdala activation

32
Q

what are some PTSD therapies/treatments?

A
  • prevention
  • medication: SSRIs but not very successful
  • psychological therapy
  • trauma-focused CBT
  • eye movement desensitisation and reprocessing
33
Q

what are some ‘common rules’ across therpaies that deal with PTSD?

A
  • safe environment
  • enhance coping mechanisms and social support
  • relaxation and emotion regulation skills
  • psychoeducation
34
Q

why would medications be used in PTSD if they do not work that well?

A
  • to help stabilise symptoms prior to psychotherapy
  • and because waiting lists for therapy are so long
35
Q

what are some common maintaining factors of PTSD?

A
  • nature and duration of trauma
  • role in trauma
  • meaning of trauma
  • isolation
  • guilt
36
Q

what are some other factors that may be create challenges in treatment?

A
  • co-morbidity
  • alcohol and drugs
  • motivation
  • co-operation
  • compliance
37
Q

what is the process of trauma-focused CBT?

A
  • psychoeducation
  • relaxation training
  • stress inoculation
  • exposure
  • behavioural techniques
  • cognitive restructuring
  • problem solving, relapse prevention
38
Q

why is EMDR used to help treat PTSD?

A
  • to reflect cognitive changes that occur during treatment and to identify info processing theory
  • when in distress, brain cannot process info as it would normally so during traumatic event, intense emotions “freeze” and get stuck in info processing system
  • stimulates the person’s own info processing in order to help integrate targeted event as a contextualised memory
39
Q

TR,CR,SMoE

how does EMDR work?

A
  • therapeutic rapport
  • imagery/envisioning of traumatic scenes
  • focus on sensations of anxiety
  • cognitive restructuring
  • saccadic movements of eyes
40
Q

what is EMDR like in practice?

A
  • disparity = although in activated state, now able to tall to therapist in safe evnironment so fear not reinforced
  • central focus on awareness
  • working with traumatic memories
41
Q

what are some new treatments for PTSD?

A
  • virtual reality
  • MDMA assisted therapy

PS2028 - Mental Health & Clinical Psychology (13 decks)

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