CNS Lecture 15: PTSD & OCD Overview and Diagnosis

What are the risk factors that increase risk of PTSD?

Female

Lower education

Prior hx

Childhood abuse

In a normal response to a shock/trauma, how long would the symptoms typically last?

days-weeks

What is the DSM-5 definition of a stressor?

exposure to actual or threatened death, serious injury, or sexual violence by direct exposure, witnessing the trauma, indirect exposure, or learning a friend or relative was exposed

What is the DSM-5 criteria for an acute stress disorder?

acute, shorter lived condition that follows a traumatic event where symptoms last from 3 days to 4 weeks

What are the DSM-5 criteria for PTSD?

Direct exposure to trauma

Re-experiencing the trauma

Avoidance of trauma-related things

Physchological impact

Sympathetic/HPA involvement

Symptoms for more than 1 month

How long must symptoms persist for it to be PTSD?

1 month or more

What is the child specifier for PTSD?

Presence of 1 or more:

- intrusive distressing memories

- Distressing dreams

- Reactions as if the traumatic events are recurring (in play)

- Distress at exposure

- Physiological reactions to reminders

What are the 4 R's of trauma informed care?

Realize

Recognize

Respond

Resist Re-traumatization

What is an ACE score?

Adverse Childhood Experiences and Adverse Community Environments Score

shows the effects of trauma on health

What three systems are involved in PTSD?

Sympathetic NS

HPA axis

Limbic system

How is the sympathetic nervous system involved in PTSD?

abnormalities play a role in symptoms of intrusion and arousal

How is the HPA axis involved in PTSD?

increased glucocorticoid receptor sensitivity

How is the limbic system involved in PTSD?

overactivity of the amygdala and underactivity of the hippocampus

What are the guidelines recommended therapy options for PTSD?

CBT

CPT

Cognitive therapy

Prolonged exposure

Males tend to have more "____________" obsessions.

taboo

Females tend to have more "_____________" obsessions.

contamination

What are common comorbidities wtih OCD?

Anxiety

Mood disorder

What are the risk factors of OCD?

Family hx

Genetics

Environmental influences

How is OCD diagnosed?

the presence of obsessions AND/OR compulsion

Obsession

recurrent and presistent thought, urges, or images that are experiences as INTRUSIVE and UNWANTED

Compulsion

repetitive behaviors or mental acts that an individual feels driven to perform in response to the distress caused by an obsession

Taboos

unwanted sexual or aggressive thoughts/images

How are obsessions defined by the DSM?

recurrent and persistent thoughts, urges, or impulses that are intrusive and unwanted that cause marked anxiety or distress

How are compulsions defined by the DSM?

repetitive behaviors that the person feel sdriven to perform in response to an obsession to reduce anxiety or distress

With good or fair insight OCD specifier

the individual recognizes that OCD beliefs are definitely or probably not true or that they may or may not be true

With poor insight OCD specifier

the individual thinks OCD beliefs are probably true

With absent insight/delusional beliefs OCD specifier

the individual is completely convinced that OCD beliefs are true

OCPD

obsessive-compulsive personality disorder

a persuasive pattern of preocupation with perfectionism at the expense of flexibility or efficiency