Trauma Flashcards
(16 cards)
What is the criteria of a trauma?
DSM5: threatened death, serious injury, or sexual violence in one or more of the following ways:
- direct experience
- witnessing in person the occurrence, esp primary caregivers
- learning that the traumatic event occurred toa parent or caregiving person
How common is trauma and PTSD?
31% of young people have experienced trauma by age 18.
- most reactions subside by 3 months. Anything after is hard to change much without treatment, suggesting it is chronic and durable symptoms once stanciated.
What is the diagnostic criteria of PTSD?
DSM5 - intrusions, avoidance, changes in cog and mood (negative self concept), and arousal and reactivity. Must last for at least a month, with significant impairment.
ICD - re-experiencing, avoidance, persistent perception of heightened threat, must last for several weeks, and significant impairment.
Difference is that DSM5 has negative self concept.
*PTSD is not diagnosed during active threat.
What are some risk factors of developing PTSD?
Direct experience of trauma, exposure to interpersonal trauma, assigned female at birth, more disadvantaged SES, lower IQ, children in foster care
How does trauma create risk?
Those with PTSD are more likely to experience psychotic symptoms, drug dependence, suicide attempts, self-harm, compared to no PTSD individuals AND those with trauma.
So basically there is a risk of other behaviours with PTSD, and NOT trauma itself.
Talk to me about childhood trauma and the brain (hint: memory).
Reward system, memory, and threat systems are all interacting with one another. One adapts to threat violence in ways that do not suit normal conditions. Negative memories become more salient, and everyday memory becomes less detailed. Childhood trauma leads to latent vulnerability to other disorders.
How do we assess PTSD?
Through self-reports (screening measures) and diagnostic interviews
Why does persistent PTSD develop?
Processing the event is central to why it develops. When something traumatic happens, there is usually distorted memory of the event, with no clear beginning, middle, or end. Therefore it is difficult to make sense of what happened despite the maladaptive emotions experienced. Our brain tries to make sense of this fragmented memory meaning it will keep thinking back to it, and the negative memories AND threat response with it. In response the individual engages in strategies such as avoidance and ignores it, but causes this never ending cycle.
How do we treat PTSD?
Medication is not recommended. Evidence-based is important.
Trauma-focused CBT: aged 7-17. adapted to developmental age, psychoeducation, strategy learning and safety planning. elaboration of trauma memories. processing trauma-related emotions.
involving caregivers! favours CBTs-TF without caregivers more.
suggests Eye Movement Desensitisation and reprocessing as alternative therapy for children who do not respond to CBT.
Describe findings of PTSD in children aged 3-8 years old.
It is poorly identified in young children in both the general population and foster care population.
What are the special criteria for children less than six years old?
Only symptom 1 of avoidance is needed because kids have less control of where to go and are less articulate in their own emotional and behavioural observation.
What treatment works for younger children?
CBT-3M. Memory exposure especially works, as their story needs a beginning, middle and end. Kids have short attention span that can affect normal CBT
Re-enactment or play (e.g. legos) also work really well to give their memory a coherent story.
Is CBT-3M an efficient treatment strategy?
Yes, there was a higher percentage of remitted PTSD at post follow up compared to T.A.U group. Symptoms were also less occurring.
Explain complex PTSD.
A component of the ICD 11. In addition to the primary criteria of avoidance, re-experience, and sense of current threat, complex ptsd is diagnosed when an additional 3 is also experienced:
- affect numbing/overreactivity
- negative self concept
difficult interpersonal relationships
Factor analysis suports differentiation of complex ptsd from ptsd, especially in adults but diagnostic reability and validity needs further investigation, especially in kids.
What is an example of affective numbing?
Dissociation: feeling detached from own body, as if you were observing yourself
(world feels unreal, like in a dream)
What is complex trauma?
Experience of trauma which is
* repeated occurrence and/or
* varied trauma types
- relation to complex ptsd is strong.
- for children, CBT-TF is recommended.
