Lecture Trauma and Stressor related disorders

why does stress related disorder happen

happens when someone has an emotionalyl catastrophic life event. what some people find traumatic differs. some may get PTSD from an experience someone else would not (resilient)

PTSD criteria

A: exposure to a traumatic event (emotional trauma: person has threat of death or serious injury, or insult to bodily integrity)

distinguish between events:

• interpersonal (rape physical assault, extreme bullying)

• natural environment (fires, floods, hurricanes)

B: Intrusion symptoms 

dreams, images, memories, or nightmares related to the event

C:

avoidance of trauma related stimuli

cognitive: tries to avoid push away talking about trauma, not go to social gathering and talk about it,

environmental cues: avoidance of cues related to the event

(ex. stays away from the ocean, boardwalks)

memories and images PTSD

memories are unwanted intrude into consciousness involuntary

can be triggered by physical stimuli in the surroundings (lights turned on)

Which trauma events more likely to cause PTSD

PTSD is higher following interpersonal events than natural, hard to accept

D: Negative alterations in cognition and mood

exaggerated beliefs:
this has changed me I’m different, my brain doesn’t work the same way

I’m bad: self blame

detachment, inability to feel pleasure:

persistant detachment wil foen say I know bu t i kove myfamily but I cnat feel it agdonfiana

due to emotion can’t process information. (during the event things didn’t seem real and couldn’t take in info dissociation a reaction in ptsd happens when more severe problems)

The world is a dangerous place and you always ahve to be on guard

i feel emotionally flat

E: Marked alteration in arousal and reactivity

Hypervilgilance: always looking for danger, looking for car

Irritability:

gets annoyed to the pont here you assult somine 

bus driver who drvis over somone

yell and people and swear (in his mind trying to rpotect them from getting run over)

self-destructive actions: risky behaviours dont care if die drives riskily

Clinicl Pciture

Canada dn US: 8-9 % (pampered)

Netherlands less and much less in asia and afraicna ciuntries

Civiliand triggered by physical and sexual and motor vechicle accdients.s ee in ifrat responders paramdicas resopndersw iwitnesses people dying 

even if eveydya expiresure

toroture and genocide and preaiucuarly bad

Onset- course

any age less liekly to happen as someone gets older as youve seenenough. stuff that no longerwuit as shocling

begins wihtin 3 months of trauma

reovrey within 3 months

Prev gender

women fore mlikely to be victims can bo both ways

3 days the nstarts to cut off some devacute distess dis last abt a month

longer than a 1 month PTSD

50% of acute sitress diroder cut offf becasue 1 montth recover

12 months liekly to keep

one of falling of course

Acute Distress Disorder

between 3days-4 weeks (will ahve nightmares be aupset) and go down to bu clinical level

added alloe early. treatment

prev: variable

half go on to have PTSD

Controversies PTSD

introduced in 1980 but WWI called shellshock other names and this became offical

1) what is a traumatic event

2) is it the event or the person

3) Complex PTSD

prolonged expisure to multiture traumas

DSM3

event outside of noram l human experience

DSM 4

boradened def brought to workplace accident service workers,

emotional reaction great emphasis cild with lie threating illness and so don

rate of trauma exposure and PTSD 69-89%

confusing whats ditressing with whats trauaamtic

eliminate trauamatci event criteria

nonspecific, most pople wiho rexperience trama dont get PTSF so why needed?

Legal issues:

quesitonable claims: 

Reliance on self report: in court. oflaw : want more than self report want victim or witness unrelaible actually so ideally you need somth more objective

diagnosis assumes event cuases the symptoms not what latwes want so they say let judge decide others say look at impairement

Diagnossi asuumes symptoms were caused by and event

overlap with other disorders

but victims are aware of adisconinutiy of their life, things changed for thme and didnt function

intrsusive images and avoidance only makes sene in light of the trauma

whne you get rid of Acritiera you ge t overlap withdepression

Are these events traumatic>

second hand

witnessed events: seeing smth can be traumatic ex diaster workers

subsyndromal PTSD:

to meet cirteri a of PTSD needt o ahve a certain number of symptomsuut withen this when has al othe ciritera but doesnt have one like avoidance . dont meet formal

thye diecided

second hand events were acceptable like mergency worksers

peole who citeness things can also PTSD

indirect trans of trauama like information is accpetable

subsyndromal:
moved under adjustment disorder

Event or person

faced with same event only some dev PTSD

7% trauama less than 10% PTSD

vuln factors

like neg affective

prev trama experiences

pre exiwtin emotional and beha rpoblems

lower sociao epxo stauts or intellignece a little

gemal aover male

low wcoreelations in general not causation risk factor

brain truama a factor? depedns

event risk factors

ifrst responder sare selecte to have better but even then its not full proff

severit of trauma

low social support

lck of control

duration freq

compelx PTSD

ICD 11

prolonged neglect or avbuse

domesticvolence

results in disorbrnace in self organiszation

PTSD three symptom clusters

affect dyregulation: difficlt y dtriglling with emotion

neg self concept: bad person must have derved

disrbances and in relationships:

difficulty relating to people cant find people who love, find wrong eople

diverse experiences to cope with life

facotr analytic research

cluster symptosm PTSD jigj ;eve;s fo drepressio nand anxiety

common in general population

6.3%

trauama exposed samles

12

trauma exposed militaru

36%

emergency responsders

7.4

men have greater exposre overall in few studies but epmne eperience more due to se x vuiolence

more work nee

criteria A 1 necesaary but not difficent alone.