PTSD and Depression (abnormal exam 2)

What are the 7 criteria for PTSD

Exposure to traumatic event, reexperiening event, avoidance of stimuli associated to trauma, 2 alternations of cognitions and mood associated to event, increase arousal and reactivity w/ event, symptoms 1+ month, clinically significant distress

What counts as exposure to traumatic event

Direct experience, witness, event happening to close family/friend, repeated exposure

How can an event be reexperienced

Intrusive memories, dreams, flashbacks, prolonged psychological distress w/cues, physiological reactions

What can avoidance of stimuli look like

Avoidance of memories (over-scheduling, no silence), avoidance of external reminders

What can alternation of cognitions look like

Inability to remember aspects of event, negative beliefs/expectations of self, distorted thoughts of cause (blame), persistent negative emotional state, diminished interest in activities, detachment from others, inability to experience positive emotions

What can increased arousal and reactivity to an event look like

Irritable/angry outbursts, reckless/self-destructive behavior, hyper vigilance, exaggerated startle response, decrease concentration, sleep disturbance

How long do you need symptoms for PTSD

1+ month

Who many alternations of cognitions do you need for PTSD

2+

What are the treatments for PTSD

Prolonged exposure, cognitive processing therapy (check, challenge, change), SSRI, prozosin

What medications are not used to treat PTSD

Antipsychotics and benzodiazepines

What % of women who experience a traumatic event develop PTSD

20%

What % of men who experience a traumatic event develop PTSD

8%

What race(s) are most likely to develop PTSD

Hispanic, African American, American Indian

What % of military develop PTSD

20%

What % of people with acute stress disorder develop PTSD

50%

What % of people with PTSD DID NOT HAVE acute stress disorder

52%

What are the 3 categories of risk factors for PTSD

Pre-traumatic, peri-traumatic, post-traumatic

What are the pre-traumatic risk for factors for PTSD

Temperament (prior disorder), environment (stressors), biology (female, young, anxiety)

What are the peri-traumatic risk factors for PTSD

Severity, violence, military

What are the post-traumatic risk factors of PTSD

Temperament (anger/blaming, negative appraisals), environment (repeating reminders, more SLE, lack social support)

What are the 9 criteria of depression

Depressed mood, loss of interest, significant weight change or appetite change, insomnia/hypersomia, psychomotor agitation/retardation, fatigue/loss of energy, feelings of worthlessness/excessive guilt, difficulty concentrating/indecisiveness, recurrent thoughts of death

How many of the criteria do you need for depression

5+

Which two criteria must you have for depression

Depressed mood and loss interest

How long do symptoms have to last for depression

2+ weeks

What are the biological causes of depression

Genetics, low activity of serotonin and norepinephrine, high cortisol, Brodmann Area 25/areas with high serotonin transporters (5-HTT), short alleles (ss/sl), 3+ concussions, deregulation of immune system

What are the cognitive causes of depression

Learned helplessness, attribution-helplessness theory, rumination, cognitive triad, errors in thinking, negative core beliefs

How is learned helplessness learned

Not in control of reinforcements/not see escape opportunities, responsible for helpless state

What is the attribution-helpless theory

Internal global and stable mind processse are more likely to develop depression, external, specific, and unstable less likely

What are two things commonly ruminated with depression

Depressive symptoms and meaning of symptoms

What is the cognitive triad

Negatively interpret experiences, themselves, and future

What are the three errors in thinking for depression

Arbitrary inference, minimize, magnify

What is arbitrary inference

Negative conclusion based on little evidence

What is minimized in depressive thinking

Positive experiences

What is magnified in depressive thinking

Negative experiences

What are the interpersonal risk factors of depression

Rejection sensitivity, excessive reassurance, negative feedback seeking

What are the psychodynamic causes of depression

Relationships lead to feel unsafe/insecure, parents push excessive dependence/excessive self-reliance

What are the biological treatments of depression

MAOI’s, tricyclics, SSRI’s, Ketamine, ECT, TMS

What do MAOI’s do

Increase availability of norepinephrine

What do tricyclics do

Increase reuptake for serotonin and norepinephrine

What are the side effects of tricyclics

Sedating, dehydrating

What do ketamine-based medications do

Increase glutamate activity

What are the side effects to ketamine

Addictive, depersonalize, expensive

How long does it take for TMS to work

2 - 4 weeks

What is the behavioral treatment to depression

Behavioral activation

What is behavior activation

Increase rewarding activities, consistently reward non depressive behaviors, improve social skills

What are the cognitive treatments for depression

Cognitive-behavioral therapy, interpersonal psychotherapy

What is cognitive behavioral therapy

Increase activites that increase mood, challenge automatic thoughts, identify negative thinking, change primary attitude

What are the 4 concepts in interpersonal psychotherapy

Interpersonal loss, role dispute, role transition, deficits

How is interpersonal loss treated

Explore relationship with lost one

How is interpersonal role dispute treated

Identify different expectations within relationship

How is interpersonal role transition treated

Develop social support/skills for new role requires

How are interpersonal deficits treated

Recognize social defiicts & teach social skills

What is the gender ratio for depression

2:1 women

What is the race difference for diagnosis of depression

No difference

What race has the highest reoccurrence rate of depression

White

What % of people with depression have anxiety

59%

What are the specifiers for depression

Severity, psychotic features, melancholic features, atypical features, peripartum, seasonal

What depressive specifier is hardest to treat

Psychotic features

What melancholic features mean

Somatic symptoms

What does atypical features mean

Increase sleep, appetite, energy

What depressive specifier is most dangerous

Atypical features