Week 6: Post Traumatic Stress Disorder

PTSD key feature

intense psychological and physiological reactions to events or situations that symbolize or resemble a trauma

Symptoms of PTSD

• fear of re-experiencing a traumatic event

• nightmares or flashbacks

• intrusive thoughts

• avoidance of the intense feelings

How do we determine trauma?

• something that represents an actual threat to someones life

• precieved threat of injury

• threat to somebody else 

What is PTSD comorbid with and why? 

substance use disorders because it is related to avoidant coping mechanisms 

What are the specifiers of PTSD?

• dissociative symptoms: detachment from reality

• delayed expression: symptoms weren’t present until 6months after the trauma

Prevalence of PTSD

prevalence numbers are not great or accurate

• not everyone in the world has experienced trauma and some traumas are more likely than others to provoke this disorder (bigger stressors diathesis stress model)

Criteria for PTSD (its a lot)

A. Exposure to actual or threatened death, serious injury, sexual assault 

• direct experience of the trauma

• trauma happened to a close family member or friend

• witnessing the trauma

• experiencing repeated exposure to traumatic events (first responders, detectives, etc)

B. One or more of the following symptoms

• recurring distressing dreams

• dissociative reactions like flashbacks

• distress when exposed to cues or triggers (internal or external)

• physiological reactions

C. Avoidance of stimuli associated with the event

• avoiding distressing memories

• avoiding external reminders (people, places, conversations)

D. Negative changes in mood

• inability to remember the event

• negative beliefs about urself or the world

• distorted thoughts about the cause or consequence (survivors guilt, thinking ur at fault)

• anhedonia

• detachment

E. PHREC

• Physiology: angry outbursts

• Hypervigilance

• Reckless behaviour 

• E: easily startled 

• C: concentration and sleep issues 

F. Symptoms occur for more than 1 month 

G. causes distress and dysfunction 

Dissociative amnesia 

symptom of PTSD

• when our brain doesn’t want us to remember the event so we “black out” 

Explain how PTSD occurs on a spectrum 

• since not eveyone experiences trauma the same, different situations cause more or less trauma

• as well, DSM criteria does not require all symptoms so different peoples symptoms may be more or less severe than others 

Explain the genetic factors to the ethology of PTSD

if a person has the gene, personality they are more vulnerable to being exposed to stressors that will cause the disorder (people with high openness are more likely to take risks and therefore expose themselves to more stressors)

Explain the biological and psychological approach to PTSD

• hereditary or loss of control in life 

• if we have biological vulnerability, that is a risk factor, so a smaller stressor can lead to PTSD than someone who doesn’t have the biological or psychological vulnerability 

How does the intensity of trauma effect PTSD

• when trauma is perpetrated by a human, development is much higher

List the causes of PTSD (ETIOLOGY)

exposure to trauma

bio, psycho, social factors (support systems)

intensity of trauma

Complex PTSD (not in DSM)

• a series of traumatic events over time or one prolonged event 

  • ex. human trafficking, war, childhood experiences

• symptoms are familiar to PTSD but can be more extreme

Acute Stress Disorder

• severe early reactions to trauma that occurs in the first month after the trauma (PTSD is diagnosed after the first month)

• 50% of individuals develop ptsd after acute

Adjustment Disorders

• anxious or depressive reactions to life stress

  • more mild than acute or PTSD

  • stressfull events are not considered traumatic here, but the individual is having a hard time coping

treatment for PTSD disorders

• CBT with exposure therapy 

• Critical Incident Stress Debriefing

• Stress inoculation therapy

• biological therapies

Critical indident stress debriefing

• done as a prevention method 

• group therapy style where they discuss and process the event and are told about the symptoms they may experience 

Stress inoculation therapy 

focuses on developing skills that allow the individual to cope with stress

• type of CBT

Biological therapies for PTSD

mostly SSRI’S and sometimes benzodiazepines

• these drugs treat physical symptoms of PTSD like sleep issues, nightmares, and irritability 

Difference in people with PTSD and those without PTSD

lower levels of cortisol when not exposed to a trauma

• cortisol helps manage stress, so low levels of cortisol means that cannot regulate stress normally