trauma Flashcards
PTSD criteria
experiences witnesses, learns about the event happening or experiences repeated exposure to details of traumatic events
one or more intrusive sx (nightmares, flashbacks)
avoidance behaviors-avoids memories or feelings associated with trauma or avoid external reminders that trigger sx
2 or more negative alterations in cognitions and mood related to traumatic event (inability to remember trauma, negative beliefs about one self or persistent negative emotional state)
2 or more alterations in arousal and activity related to trauma (hypervigilance)
sx present 1 or more months
basis of trauma focused CBT
patient education
cognitive restructuring
exposure
PTSD neuroimaging finding
increased activity of amygdala
hypoactivation or deactivation in medial prefrontal cortex regions
decreased hippocampal activation
demographic with higher rate of PTSD than AA and Euro american counterparts
latino
reactive attachment disorder
repeated changes in caregiver
hx of neglect
avoidance of social interaction
resistance to comforting from others
younger vs older PTSD vets when taking ssri
younger respond better
adjustment DO
within 3 mo of stressor
ceases within 6 mo of stressor ending
change in emotional or behavioral symptoms that are out of proportion to severity of stressor and/or causes impairment
adjustment DO differences in prognosis between teens and adults
teens prognosis and more guarded, more likely to develop psychiatric illness than adults with adjustment DO.
psych illness comborbidity rate
pts w PTSD are 80% more likely to meet criteria for another menal disorder
in kids- ptsd is comorbid with separation anxiety disorder
adult males more likely to have comorbid substance abuse and conduct disorder
PTSD has comorbidity with major neurocognitive DO
persistent complex bereavement time criteria for kids and adults
kids- 6 mo
adults- 1 yr
4 categories of PTSD sx
intrusive thoughts
mood alterations
hypervigilance
avoidance (of sensory and trauma related material)
3 major brain function dysregulation in PTSD
overstimulated amygdala
underactive hippocampus
ineffective variability
stages of grief
DABBA
“death always brings deep acceptance”
denial anger bargaining depression acceptance
dissociative amnesia
aka psychogenic
loss of autobiographical memory
sometimes with preserved ability for new learning
often associated with stressful events
usually either localized or selective
transient global amnesia
impairs recent memory
spares immediate memory and remote memory
inability to learn new info, sustained memories
- secondary syndromes caused by medical or primary cerebral , substance use, medication adverse effects
usually around 6-24hours
linked to ischemia of temporal lobe and diencephalic brain regions
dissociative identity disorder
two or more personality states
gaps in recall of everyday personal information
hx of childhood trauma
1.5% prevalence
genders roughly equal
over 70% have hx of SA or self harm
depersonalization/derealization Disorder
DDD
presence of recurrent expereince of depersonalization, dereal or both
being detached from thoughts, feelings, body, sensations or actions
experiences of unreality or detachment w/ respect to surroundings
highly comorbid with unipolar depression and anxiety DOs and infrequently with PTSD
dissociative fuge
fugue is latin for flight
amnesia for autobiographical info and sudden purposeful travel away from home or other unfamiliar settings.
types of amnesia
selective: can recall some, but not all events during a circumscribed period of time
systemized: loss of memory relating to particular category of information
localized: cant recall any events in circumscribed period of time
generalized: complete loss of memory for one’s life history
continuous: forgets each new event as it occurs
