PTSD and Related Stress Dissorders

What are the four disorders that develop after a stressful or traumatic event

• Post-Traumatic Stress Disorder (PTSD)

• Acute Stress Disorder

• Adjustment Disorder

• Complex PTSD (Newly added in ICD-11)

What is PTSD and when does it occur

• PTSD is an emotional disorder that occurs at least one month after a traumatic event.

List some common causes of PTSD.

• War

• Physical/Sexual assault (e.g., rape)

• Car accidents

• Natural disasters

What is "Criterion A" for PTSD diagnosis?

Exposure to actual or threatened death, serious injury, or sexual violence through:

• Direct exposure

• Witnessing the trauma

• Learning that the trauma happened to a close friend or relative

• Indirect exposure (e.g., first responders, therapists)

What are the four main symptom categories of PTSD?

• Re-experiencing: Nightmares, intrusive memories, flashbacks

• Avoidance: Emotional numbing, avoiding reminders of trauma

• Negative mood/cognition: Distorted beliefs about self, others, and the world

• Reactivity: Hypervigilance, disturbed sleep, increased startle response

What does the PTSD specifier "with delayed expression" mean?

• PTSD symptoms do not fully appear until at least 6 months after the trauma.

What does the PTSD specifier "with dissociative symptoms" mean?

The individual experiences significant dissociation in response to trauma.

What is dissociation?

A disconnection between thoughts, memories, identity, emotions, and perception of reality.

Differentiate between depersonalization and derealization.

• Depersonalization: Feeling detached from oneself.

• Derealization: Feeling like the world isn't real.

Why do trauma survivors experience dissociation?

It is a coping mechanism to manage extreme distress or overwhelming emotions.

What brain structures are affected by PTSD, and how?

• Amygdala: Overactive, leading to excessive fear response and hypervigilance.

• Hippocampus: Shrinks, causing flashbacks, memory gaps, and difficulty separating past from present

How does neuroplasticity contribute to PTSD maintenance?

The brain reinforces fear pathways in the amygdala while weakening memory regulation in the hippocampus, making it harder to reprocess trauma.

How do avoidance behaviors maintain PTSD?

They prevent individuals from processing traumatic memories, reinforcing fear and distress.

What is imaginal exposure therapy, and how does it help PTSD patients

A treatment where patients mentally revisit the traumatic event in a safe setting while practicing relaxation techniques, helping to reduce avoidance and reprocess trauma.

How does Eye-Movement Desensitization and Reprocessing (EMDR) work?

• Clients recall traumatic memories while following bilateral stimulation (e.g., eye movements, tapping).

• Helps by:

  • Reducing amygdala hyperactivity (fear response)

  • Strengthening hippocampus function (memory processing)

  • Moving trauma memories from survival mode (amygdala) to rational processing (prefrontal cortex)

  • Allowing adaptive beliefs to replace fear-based thinking

What are two biological treatments for PTSD?

• SSRIs: Help regulate the brain's overactive fear response and mood.

• rTMS (Repetitive Transcranial Magnetic Stimulation): Uses magnetic pulses to stimulate underactive brain regions, improving emotional regulation.

What is Acute Stress Disorder, and how does it differ from PTSD?

• Occurs within one month of a traumatic event.

• May resolve without becoming PTSD, but it is a risk factor for developing PTSD (40%-80%).

What is Adjustment Disorder?

• Emotional/behavioral reactions to life stress (e.g., divorce, job loss) that are disproportionate to the situation.

• May include depression, anxiety, and conduct problems (aggression, rule-breaking).

How does Complex PTSD differ from regular PTSD?

• Caused by prolonged traumatic events (e.g., long-term abuse).

• Includes PTSD symptoms plus:

  • Emotional dysregulation

  • Interpersonal problems

  • Distorted self-concept

What are the relational impacts of Complex PTSD?

Issues with trust, intimacy, and a tendency to either avoid relationships or seek unhealthy ones.

How is Complex PTSD treated?

Long-term psychotherapy focusing on:

• Coping with traumatic memories

• Improving emotional regulation

• Building self-concept and relationship skills