5.2 - PTSD

1 month

The diagnosis of PTSD requires that symptoms must last for at least ________.

PTSD

What this means is that, in the study just described, the women who had symptoms within 2 weeks of the assault would not be diagnosed with ____.

Acute Stress Disorder

a diagnostic category that can be used when symptoms develop shortly after experiencing a traumatic event and last anywhere between 3 days to one month

receive treatment

The existence of this diagnosis means that people with symptoms do not have to wait a whole month to be diagnosed with PTSD.

• Instead they can _____ treatment as soon as they experience symptoms

• Stressor

• Intrusion Symptoms

• Avoidance

• Negative Alterations in Cognitions and Mood

• Arousal and Reactivity

Other Reqd:

• Duration

• Functional Significance

• Exclusion

Criterion of PTSD: (8)

Stressor-Exposure to Trauma (A)

The person was exposed to actual or threatened death, injury, or sexual violence

(directly, by witnessing, learning it happened to someone close, or repeated exposure like first responders).

Intrusion Symptoms (B)

The trauma keeps coming back in the mind through:

• Flashbacks

• Nightmares

• Intrusive thoughts

• Distress when reminded of it

Avoidance (C)

The person avoids:

• Thoughts, feelings, or conversations about the event

• Places, people, or activities that remind them of it

Negative Alterations in Cognitions and Mood (D)

Negative changes in thoughts or emotions, such as:

• Guilt, fear, shame

• Feeling detached or numb

• Blaming self or others

• Loss of interest in activities

Arousal and Reactivity (E)

• Irritable behavior and angry outbursts.

• Reckless or self-destructive behavior.

• Hypervigilance.

• Exaggerated startle response

• Problems with concentration

• Sleep disturbance

Duration (F) = 1 month

The duration of the disturbance is more than _____

Functional Significanc(G)

The disturbance causes clinically significant distress or impairment in important areas of life, such as:

• Social life (trouble connecting with others)

• Work or school (difficulty concentrating or attending)

substance

* Criterion H (Exclusion):

The disturbance is not attributable to the physiological effects of a ______ (e.g., medication, alcohol) or another medical condition.

• Intrusion

• Avoidance

• Negative alterations in cognition & mood

• Arousal and reactivity

Clinical Symptoms of PTSD (20 symptoms in total)

• These are grouped into 4 main areas:

Intrusion

Recurrent reexperiencing of the traumatic event through nightmares, intrusive images, and physiological reactivity to reminders of the trauma.

Avoidance

Efforts to avoid thoughts, feelings, or reminders of the trauma.

Negative alterations in cognitions and mood

This includes such symptoms as feelings of detachment as well as negative emotional states such as shame or anger, or distorted blame of oneself or others.

Arousal and reactivity

Hypervigilance, excessive response when startled, aggression, and reckless behavior.

• Military combat

• Prisoner of war, concentration camp, and torture experience

• Traumas caused by human intent

• Accidents or natural disasters

Rates of PTSD After Traumatic Experiences:

• Nature of Trauma

• Individual risk factors

• Sociocultural risk factors

Causal Factors in PTSD:

• lower

• Biological

Individual Risk Factors:

• High congitive ability may _____ risk of PTSD

• _________ differences may play a role in likelihood of developing PTSD

In combat-related trauma:

• Justification for combat

• Identification with combat unit

• Esprit de corps

• Quality of leadership

Sociocultural Factors:

• Psychological debriefing

• Challenges in studying crisis victims

• Trauma and physical health

Prevention and Treatment of Stress Disorders: (3)

• Military service

• Medical procedures

• Relationship termination

Prevention (Advanced preparation of stressor):

• Telephone hotlines

• Psychological first aid

• Crisis intervention

Treatment for Stress Disorders (Approaches to treatment include):

• Critical Incident Stress Debriefing

• Medications

• Cognitive-behavioral treatments

Psychological Debriefing

(Strategies for relief of PTSD symptoms):

• Traumatic events cannot be predicted or controlled by researchers

• Variables of interest are difficult to assess

• Funding can be difficult to obtain

Challenges in Studying Crisis Victims:

trauma

Studies indicate that ______ is bad for body as well as mind

• Depersonalization

• Derealization

The DSM-5-TR also includes a Dissociative Specification for individuals who meet the full criteria for PTSD and, in addition, experience persistent or recurrent symptoms of either __________ or _________

Depersonalization

feeling detached from oneself

Derealization

experiencing the world as unreal

• Intrusion Symptoms (1)

• Avoidance or Negative Alterations (1)

• Alterations in Arousal and Reactivity (2 reqd.)

There is also a separate set of criteria for PTSD in Preschool Children (ages 6 years and younger):

Intrusion Symptoms (At least one required)

These are ways the trauma is re-experienced. Unlike older children who may have verbal memories, preschoolers' symptoms are often behavioral:

• Recurrent, distressing, intrusive memories or dreams related to the event (content or feelings). For dreams, the content may not be recognizable.

• Trauma-specific reenactment in play (e.g., repeating aspects of the trauma during play).

• Dissociative reactions (e.g., flashbacks) where the child acts or feels as if the event is recurring.

• Intense psychological or marked physiological distress/reactions at exposure to internal or external reminders.

Avoidance or Negative Alterations (At least one required)

This cluster combines avoidance symptoms and negative changes in mood/cognitions, as many of these are difficult to detect or manifest in young children.

• Persistent avoidance of activities, places, or physical reminders of the event.

• Avoidance of people, conversations, or interpersonal situations that are reminders.

• Markedly diminished interest or participation in significant activities, including constricted play

• Socially withdrawn behavior.

• Persistent reduction in the expression of positive emotions.

• Substantially increased frequency of negative emotional states (e.g., fear, guilt, sadness, shame, confusion).

Alterations in Arousal and Reactivity (At least two required)

These symptoms represent heightened emotional and physical reactions.

• Irritable behavior and angry outbursts (including extreme temper tantrums)

• Hypervigilance (constantly on the lookout for danger).

• Exaggerated startle response.

• Problems with concentration.

• Difficulty falling or staying asleep, or restless sleep.

Negative Affectivity (NA)

refers to the tendency to experience negative emotions across time and situations and to feel emotionally distressed.

• It's a general, pervasive disposition to be gloomy, tense, and irritable.

Social Inhibition (SI)

refers to the tendency to inhibit the expression of emotions, thoughts, and behaviors in social interactions to avoid disapproval or rejection.

• It represents a fear of social situations and a reluctance to seek out support.

Social Inhibition (SI)