Task 2 Flashcards
(30 cards)
What is Acute-stress disorder?
Same thing as PTSD but ilast no longer than 4 weeks
—> these people are at high risk of then experiencing PTSD symptoms
What is adjustment dirorder?
Emotional and behavioral symptoms that arise whitin 3 months of the stressor.
—> can be of any severity
How often does PTSD happen?
About 7% of adults will experience PTSD at some time in their lives
—> woman are more prone to develop it
General DSM-5 criteria
- Needs to last for at least 1 month
- There need to be suffering
- Cannot be explained by other psychotic disorder (e.g. schizophrenia)
A diagnosis of PTSD requires the presence of 5 types of symptoms (DSM-5 criteria)
Name them.
- Involuntary exposure to actual or threatened death, serious injury, or sexual violence in one, or more, ways
- Presence of one (or more) intrusion symptoms associated with the traumatic event, beginning after it
- Persistant avoidance of stimuli associated with the traumatic event, beginning after it
- Negative alterations in cognition and mood, beginning or worsening after the trauma —> need to meet two sub criterions
- Marked alterations in arousal and reactivity associated with the traumatic event, beginning or worsening after the event - being on guard for event to reoccur
- –> might also experience “survivior gult”
What type of trumas can lead to PTSD?
- Natural disasters
- Human-made disasters (more common)
- –> a common precipiator is abuse, physical or sexual
What are some risk factors that may lead to PTSD before a truma?
- Genetic vulnerability –> heritability
- Gender –> female more prone
- Age –> young more prone
- Intelligence –> low more prone
- Socio-economical status –> low
- Psychopathology (axiety, depression..)
What are some risk factors that contribute to develop PTSD after a truma?
- Negative interpretation of symptoms and consequence of truma
- Social support –> low more prone
- New life events
- Anger/guilt/shame feelings
What is the biological factors leading to PTSD?
Neuroimaging findinds
- Neuroimaging findings:
• Amygdala more active to emotional stimuli
• Medial prefrontal cortex (modulates amygdala reactivity) less active in people w/ more severe symptoms
• Shrinkage in the hippocampus
What is the biological factors leading to PTSD?
Biochemical findings
- Biochemical findings:
• Cortisol levels are lower –> may result in prolonged activity of the sympathetic NS following stress
• Elevated heart rate and increased secretion of epineprhine and norepineprhine
–> causes memories of truma to be overconsolidated
• Hypothalamic-pituitary-adrenal HPA unable to shut down response of Sym.NS
What are the treatments for PTSD?
Name them.
- Cognitive-behavioral therapy –> prolonged imaginal exposure using systematic desentization
- Stress-management interventions
- EMDR
- SSRIs
- MBCT
What is SSRIs?
- -> Selective serotonin reuptake inhibitors
- -> to a lesser extent: benzodiazepines can be useful for sleep problems, nightmares and irritability
What is EMDR?
Eye movement desensitation and reprocessing
Patient recalling traumatic memories while making horizontal eye movements to rebalance the nervous system shift of information that is dysfunctionally locked in the nervous system
How does EMDR work?
- Eye movements are importan but do NOt have to be horizontal, vertical is also ok
- EMs occupy part of WM resulting in recall of less vivid and less emotional memories
What are other factors to take into account for EMDR?
- Other tasks like playing tetris work as well, doesn’t have to be EMs.
- Installing positive cognitions does NOT work
- EMDR works on other disorders like anxiety, depression or eating disorders –> less vivid and emotinal “flash-fowards”
- Those with lower WM capacity benefit more from EMDR
Flash-fowards
Images about future social/financia/medical catastrophes
What is MBCT? How does it work?
midfulness-based cognitive therapy
Similar to EMDR. Mindful breathing is a core element
- -> patients focus their atention on breathing and accept thoughts/images and slowly draw atention back to breathing
- -> also taxes WM
PTSD and comorbidity
50% of people with PTSD have comorbid disorders (duh) –> deppresion,anxiety, sleep disorder, substance-related, and personality disorders
What psychologival mechanisms are responsible for the persistance of posttraumatic symptoms and of a sense of threat?
- Emotion-related reasoning (ER) –> if anxiety, then threat
* Intrusion-based reasoning (IR) –> inferring danger from the presence of intrutions (dreams, flashbacks..)
IR
- Interpreting the presence of intrusions (trigger) as evidence that threat is there
- You need to have been exposed to a traumatic event
- Strongly associated to low intelligence
- Related to acute and chronic symptoms
- Related to onset and maintenance of symptoms
ER
- Interpreting anxiety as evidence that threat is there
* Non-specific for PTSD —> Jule
Trauma-memory argument
Forgetting is the “solution” to trauma
- Amnesia appears only after type II traumas –> incest and other childhood sexual abuse
- Memory is enhaced for trumas od single, surprising, well defined events –> type I
Dissociative disorders
Alteration in conciousness that affects memory and identity
What are the five major dissociative disorders?
- D. Amnesia –> loss of autobiographical memory for certain past experiences
- D. Fugue –> loss of personal identity and amnesia for whole or most life time
- D. Identity disorder DID –> patient posseses/manifests two or more distinct identities. Separated by some degree of amnesia.
- Depersonalistation disorder –> patien believes they changed in some way or are no longer real
- Dissociative disorders not specified –> e.g. spirit-possesion states
