PTSD

_______ and _________ related disorders are a new category in the DSM-5

trauma / stressor

all trauma and stressor related disorders have exposure to…

traumatic or stressful event as a diagnostic criteria

list diagnoses in “trauma and stressor-related disorders” category

• Reactive Attachment Disorder – abuse/neglect results in inhibited social behavior and difficulties with emotional regulation

• Disinhibited Social Engagement Disorder – abuse/neglect leads to disinhibited social behavior

• Post-traumatic Stress Disorder

• Acute Stress Disorder – similar symptoms to PTSD, <1 month

• Adjustment Disorder – stressor leads to emotional/behavioral symptoms

• Prolonged Grief Disorder – intense grief symptoms, >12 months

difference between stress and trauma

trauma is life-threatening

symptoms of PTSD

• Exposure to traumatic event

• Intrusion Symptoms

• Avoidance Symptoms

• Changes in Cognition and Mood

• Changes in Arousal/Reactivity

• Lasts for > 1 month

• Significant impairment

Reactive attachment disorder and disinhibited social engagement disorder are diagnosed in ________ (age group)

children

biological causal/risk factors of PTSD

• Negative Emotionality in Temperament

• Serotonin transporter gene – short allele

• Highly reactive HPA axis

• Smaller hippocampus

• Highly reactive amygdala + Less activity in prefrontal cortex

list characteristics of PTSD

• Severity

• Trauma by human intent

• Direct exposure

• Torture exposure

psychological causal/risk factors of PTSD

• Personality Characteristics - neuroticism

• Pre-existing depression/anxiety

• Cognitive appraisals of trauma

• Fatalistic/Self-blaming Coping Strategies

social-cultural causal/risk factors

• Low social support

• Societal norms about trauma experience

• Systemic influences (esp. for members of minoritized groups)

• Family instability

• Subsequent neg. life events

list treatments of PTSD

• Cognitive Behavioral Therapy

  • Prolonged Exposure

  • Cognitive Restructuring

• Medications

  • antidepressants

  • medication to disrupt formation of traumatic memory as prevention

• experimental treatments

  • combining hallucinogens (ex MDMA with talk therapy)

Reactive Attachment Disorder

abuse/neglect results in inhibited social behavior and difficulties with emotional regulation

• diagnosed in children

Disinhibited Social Engagement Disorder

abuse/neglect leads to disinhibited social behavior

• diagnosed in children

acute stress disorder

similar symptoms to PTSD, < 1 month

adjustment disorder

stressor leads to emotional/behavioral symptoms

prolonged grief disorder

intense grief symptoms, > 12 months

how common is PTSD?

moderately common (less than anxiety)

are men or women more likely to develop PTSD?

women - 2x more likely

do twin studies reveal that brain differences precede or result from PTSD?

brain differences preexist PTSD symptoms