PTSD

stressor (one required)

Person exposed to death, threatened death, actual or threatened serious injury, or actual or threatened sexual violence in the following ways:direct exposure, witnessing the trauma, learning that a relative/close friends was exposure to the drama, indirect exposure (first responders)

intrusion symptoms (one required)

The traumatic event is persistently re-experienced in the following ways: Unwanted upsetting memories, Nightmares, Flashback, Emotional distress after exposure to traumatic reminders, Physical reactivity after exposure to traumatic reminders

avoidance (one required)

Avoidance of trauma-related stimuli after the trauma, in the following ways, Trauma related thoughts or feelings, Trauma related external reminders

negative alterations in cognition/mood (two required)

Inability to recall key features of trauma, Overly negative thoughts and assumptions about oneself of the world, Exaggerated blame of self or others for causing trauma, Negative affect, Decreased interest in activities, Feeling isolated, Difficulty experiencing positive affect

alterations in arousal and reactivity

Trauma-related arousal and reactivity in the following ways: Irritability or aggression, Risky or destructive behavior, Hypervigilance, Heightened startle reaction, Difficulty concentrating, Difficulty sleeping

duration (required)

Symptoms last for more than 1 month

functional significance (required)

Symptoms create distress or functional impairment (social or occupational)

exclusion (required)

Symptoms are not due to medication, substance use, or other medical illness

dissociative type

 high levels of depersonalization (detached from oneself) or derealization (reality feels distorted)

delayed type

symptoms emerge six months or more—sometimes years—after a traumatic event, often triggered by later life stressors like retirement or grief

triggers

Involuntary reminders of trauma (event), Images, Sounds, Smells, Feelings, Dates

events examples

9/11, Wars and conflicts, Natural disasters, Mass shootings, Violence towards individual, Motor vehicle accidents

risk factors

Occupation, Severity of event , Support following traumatic event , Preexisting mental illness 

children

PTSD in children can have a different presentation due to brain age/formation, may act out trauma in play. can present with reckless or aggressive behavior, withdrawn and labile mood

medications

Can vary greatly but can include SSRIs, mood stabilizers, antipsychotics; propranolol, prazosin

prazosin (minipress)

shows evidence of decreasing nightmares/flashbacks

EDMR

encourages reconnection to traumatizing memories and emotions in a safe and structured environment, also effective in anxiety disorders.

trauma informed care

Safety, Trustworthiness, Choice, Collaboration, Empowerment

nursing interventions

Safety- for self and patient, assess for suicidal ideation, Ground to reality, As needed medications, Psychoeducation of triggers and prevention, individual and family

outcomes

Less triggering events, Increased emotional stability, Less to no suicidal thinking/attempts , iIncrease in functioning (ADLs), Medication adherence