Week #7: Post-Traumatic Stress Disorder

What is PTSD according to the American Psychiatric Association?

Psychiatric disorder that may occur in people who have experienced or witnessed a traumatic event such as a natural disaster, a serious accident, a terrorist act, war/combat, or rape or who have been threatened with death, sexual violence, or serious injury

What is PTSD according to the American Psychological Association?

Anxiety problem that develops in some people after extremely traumatic events such as combat, crime, an accident, or natural disaster… People with PTSD may relive the event via intrusive memories, flashbacks, nightmares; avoid anything that reminds them of the trauma; and have anxious feelings they didn’t have before that are so intense their lives are disrupted

What traumas are women more likely to experience as children?

Sexual assault & abuse

What traumas are men more likely to experience? (5)

• Accidents

• Physical assault

• Combat

• Disaster

• Witness death or injury

What are the 4 types of PTSD symptoms?

1. Re-experiencing (intrusive memories)

2. Avoidance

3. Cognition & mood

4. Arousal & reactivity

What are symptoms associated with re-experiencing? (4)

1. Flashbacks

2. Reoccurring memories or dreams related to the traumatic event

3. Distressing thoughts

4. Physical signs of stress

What are flashbacks?

Relieving or re-experiencing the traumatic event, including physical symptoms such as a racing heart or sweating

What are symptoms associated with avoidance? (2)

• Avoiding places, events, or objects that are reminders of the traumatic event

• Avoiding thoughts or feelings related to the traumatic event

What are symptoms associated with arousal & reactivity? (6, 5 bullet points)

• Being easily startled

• Feeling tense, on-guard, or on edge

• Difficulty concentrating & falling asleep

• Feeling irritable and having angry or aggressive outbursts

• Engaging in risk, reckless, or destructive behavior

What are symptoms associated with cognition & mood? (7)

• Trouble remembering key features of the traumatic event

• Negative thoughts about oneself or the world

• Distorted thoughts about the event that cause feelings of blame

• Ongoing negative emotions such as fear, anger, guilt, or shame

• Loss of interest in previous activities

• Feelings of social isolation

• Difficulty feeling positive emotions

How many Canadians have reported experiencing a traumatic event?

76%

How many Canadians who experience a traumatic event develop PTSD?

8%

Between men and women, who is more likely to meet the criteria for PTSD?

Women

Between men and women, who is more likely to experience more potentially traumatic events?

Men

How many Americans will experience PTSD at some point in their lives?

6%

How many American women develop PTSD sometime in their lives?

8%

How many American men develop PTSD sometime in their lives?

4%

PTSD will increase your risk of what other mental health problems? (4)

• Depression & anxiety

• Substance use disorders

• Eating disorders

• Suicidal thoughts & actions

What are 7 kinds of treatment for PTSD?

1. Trauma-focused therapy

2. Compassion-focused therapy

3. Pharmacotherapy (Rx)

4. Cognitive Restructuring

5. Exposure techniques

6. Problem-solving

7. Relaxation

What does trauma-focused therapy refer to?

Cognitive behavioral therapy and reprocessing to help reduce the sense of current threat by working on the memory of the event

What does compassion-focused therapy refer to?

Treatments aimed to help individuals self-soothe from shame-based thoughts & images

What is an example of compassion-focused therapy?

Group therapy for vulnerable groups such as war veterans

What kinds of medications are used in pharmacotherapy for PTSD? (3)

1. Benzodiazepines

2. Antidepressants such as MAOIs, TCAs, & SSRIs

3. Azapirones

What idea are cognitive restructuring techniques based on?

That anxiety & other emotional disorders are, at least in part, due to fault, maladaptive, or unhelpful thinking patterns

What are 7 forms of exposure techniques?

1. Systematic desensitization

2. In vivo exposure

3. Worry imagery exposure

4. Flooding or intense exposure

5. Interoceptive exposure

6. Ritual prevention

7. Subtle avoidance

What is systematic desensitization?

Therapeutic technique where patients imagine the lowest feared stimuli and combine this image with a relaxation response (gradually work their way up the fear hierarchy learning to handle increasingly disturbing stimuli)

What is the fear hierarchy?

A list of feared situations or objects that are arranged in descending order according to how much they evoke anxiety

What assumption are problem-solving techniques based on?

By generating & implementing effective solutions to problems, patients will experience less anxiety

What does relaxation refer to?

Mental or physical strategies aimed to reduce anxious arousal directly

What are 3 other treatment techniques for PTSD?

1. Mindfulness-based strategies

2. Virtual reality

3. Eye movement desensitization & reprocessing (EMDR)