PSYC 3082 Exam 2

what is the first criteria according to the DMS-5 to be diagnosed with PTSD

traumatic exposure

traumatic exposure can be

direct or observed

some clinical aspects of PTSD

trauma exposure

continued re-experiencing

avoidance

emotional numbing

reckless or self destructive behavior

interpersonal problems

these symptoms:

trauma exposure

continued re-experiencing

avoidance

emotional numbing

reckless or self destructive behavior

interpersonal problems

must last how long after the trauma in order to be diagnosed ?

more than 1 month

If the PTSD symptoms last less than 1 month it could be

acute stress disorder (ASD)

If the PTSD symptoms last more than 1 month... it can be

diagnosed as PTSD

DSM-5 PTSD criteria A.

person must have a

traumatic exposure

DSM-5 PTSD criteria B.

person must have at least

1 intrusive symptom

DSM-5 PTSD criteria C.

person must have at least

1 avoidance symptom

DSM-5 PTSD criteria D.

person must have more than 2

negative alterations in cognition and mood

DSM-5 PTSD criteria E.

person must have these set of symptoms for more than

a month

may be diagnosed on to three months post trauma

acute PTSD

experience PTSD symptoms immediately post trauma exposure for 0-1 months

acute stress disorder

diagnosed after 3 months post trauma

chronic PTSD

onset six months or more post traumatic exposure

delayed onset

Core PTSD symptom categories

Re-experiencing, avoidance, numbing, reckless behavior

PTSD requires exposure to

actual or threatened death, injury, or sexual violence

DSM-5 PTSD Criterion A is Exposure to ______________

trauma (death, injury, sexual violence)

What are the ways trauma exposure can occur

Direct

indirect/witnessed

learned

repeated exposure

First responders handling remains is an example of

indirect exposure

____________ symptoms involve the trauma repeatedly entering awareness.

Intrusion

flashbacks, nightmares, distressing memories, and strong reactions to reminders are examples of

intrusive symptoms

Re-experiencing trauma involuntarily

intrusive symptoms

What triggers distress in PTSD?

Internal or external reminders

avoid thoughts, feelings, or reminders of trauma in people with PTSD are experiencing

Avoidance and Numbing

(They may also feel detached, lose interest in activities, or have limited emotional expression.)

Reduces emotional responsiveness

Emotional numbing

Feeling detached from others is an example of

numbing

________ alters thinking and mood, including negative beliefs, self-blame, and inability to feel positive emotions.

PTSD

in PTSD __________ of the trauma may also be impaired

memory

negative cognition in PTSD is defined as

negative beliefs about self/world

persistent negative mood

PTSD emotional symptom

Inability to recall trauma details

PTSD memory issue

what percent of people experience PTSD at some point.

7% of people

most common causes of PTSD

Combat and sexual assault

many people exposed to trauma do not develop PTSD

True

may be diagnosed 1-3 months post trauma exposure

acute PTSD

PTSD immediately post trauma (up to one month)

acute stress disorder

onset 6mo or 6mo+ post trauma exposure

delayed onset of

diagnosed 3 months post trauma exposure

chronic

Strong social support reduces risk does what for PTSD

lowers Rish

PTSD risk depends on

trauma intensity

learned fear responses,

biology

lack of control

social support

Why are PTSD twin correlations not close to 1?

because there is a strong environmental influence (trauma required)

Monozygotic twin PTSD correlations

0.28-0.41

dizygotic twin PTSD correlations

0.11-0.24

PTSD annual prevalence

3.5%

PTSD lifetime prevalence

6.8%

most people exposed to trauma do not develop PTSD

true

the tendency to develop PTSD also has to do with

type of trauma

proximity to the trauma

for PTSD to develop one needs to have

generalized psychological vulnerability OR generalized biological vulnerability

must have

generalized psychological vulnerability OR generalized biological vulnerability

THEN experience of _____________

trauma

okay so once you experience/exposure to trauma.... what alarm is next

true alarm

Intense fear during trauma

true alarm

strong, mixed emotions

learned alarm

focused on reexperienced emotions

anxious apprehension

anxious apprehension can lead to

avoidance or numbing of emotional response

PTSD develops from interaction of

biological + psychological vulnerability + trauma exposure.

biological + psychological vulnerability + trauma exposure can lead to

learned fear, avoidance, and eventually PTSD if not resolved.

imaginal exposure to memories of a traumatic event until extinguished is an example of

CBT

best treatment for PTSD

CBT

what disorders include

prolonged grief

adjustment disorders

or attachment disorders in children

stress-related disorders

prolonged adaptation to the loss of a loved on, grief may even intensify with time

prolonged grief disorder

anxious or depressive reactions to life stress that are generally milder than would be seen in acute stress disorder or PTSD but still impairing

adjustment disorders

disturbed and developmentally inappropriate behaviors in children

attachment disorders

child does not bond to or seek out cargiver

reactive attachment disorder

child shows no inhibitions around adults

disinhibited social engagement disorder

involves obsessions (intrusive thoughts) and compulsions (behaviors to reduce anxiety).

OCD

in OCD the compulsions temporarily relieve distress but

reinforce the cycle

Intrusive, nonsensical thoughts, images, or urges

People are usually aware they are ridiculous

Obsessions

thoughts or actions that provide relief

compulsions

compulsions are an example of

negative reinforcement

Compulsions act as

behaviors that temporarily remove or reduce the intense anxiety, distress, or unwanted thoughts (obsessions)

avoiding the cracks in the ground is an example of a

compulsion

not obsession

reoccurring and persistent thoughts, urges or images experienced

obsession

repetitive BEHAVIORS

counting, repeating words silently

the individual feels driven to perform in response to an obsession

compulsions

the obsession and compulsions are time consuming and must last

more than 1 hour per day OR cause clinically significant distress in important areas of functioning

the disturbance is not due to the direct physiological effects of a substance or other medical condition- AND it is NOT better explained by the symptoms of another mental disorder

OCD

OCD annual prevalence is

1%

OCD lifetime prevalence is

1.6-2.3%

OCD rates in male and female are

the same

onset of OCD

childhood to 30s

OCD develops from vulnerability + stress leading to intrusive thoughts. These thoughts are misinterpreted as dangerous, leading to __________________

compulsions

Trigger of OCD

Intrusive thoughts

Key cognitive error in OCD is that

Thoughts = danger

Best treatment for OCD

type of CBT therapy

ERP (exposure and response prevention).

ERP stands for

Expose without compulsion

in OCD SSRIs can help but

relapse is common when stopped.

what are OCD Related disorders

body dysmorphic disorder hoarding

trichotillomania

skin picking

preoccupation with some imagined defect in appearance

body dysmorphic disorder

excessively collecting and keeping items with minimal value, leading to clutter and disruption of living space

hoarding disorder

the urge to pull out one's hair from anywhere in the body

trichotillomania

repetitive and compulsive picking of the skin leading to tissue damage

excoriation

Characterized by intrusion symptoms, avoidance, negative alterations in cognition and mood, and/or alterations in arousal and reactivity

PTSD

Preoccupation with some imagined defect in appearance

Body dysmorphic disorder

Disturbed and developmentally inappropriate behaviors in children characterized by a lack of restraint around adults

Disinhibited social engagement disorder

Characterized by unwanted thoughts, images, and/or impulses that the individual tries to completely avoid through the use of rituals like checking or counting

Obsessive-compulsive disorder

Cadence witnessed a horrific tornado level her farm 3 weeks ago. Since then, she's had many flashbacks of the incident, trouble sleeping, and a fear of going outside in storms.

Acute stress disorder

Sanjay was involved in a car accident 6 weeks ago in which the driver of the other car was killed. Since then, Sanjay has been unable to get into a car because it brings back the horrible scene he witnessed. Nightmares of the incident haunt him and interfere with his sleep. He is irritable and has lost interest in his work and hobbies.

PTSD

Patricia was raped at the age of 17, 30 years ago. Just recently, she has been having flashbacks of the event, difficulty sleeping, and fear of sexual contact with her husband.

Delayed onset posttraumatic stress disorder

________ are intrusive and nonsensical thoughts, images, or urges an individual tries to eliminate or suppress.

obsessions

The practices of washing, counting, and checking to suppress obsessions and provide relief are called ________.

compulsions