Intro

Question 1

When was the first documented account of posttraumatic reactions?

Answer 1

4000 years ago from ancient Sumer

Question 2

What did the Lamentation of Ur report

Answer 2

disturbed sleep and anxiety

Question 3

When did the term trauma start being used and what did it refer to?

Answer 3

17th century- damage from external source- life events and their impact

Question 4

When did the term trauma expand to include psych impact

Answer 4

19th century

Question 5

What does Judith Herman say are the three historical eras that helped our understanding of trauma?

Answer 5

hysteria in 19th century, shell shock from WWI, feminist movement in 70s and 80s related to domestic violence

Question 6

How did Freud describe trauma?

Answer 6

stimulation that exceeds the ability to cope

Question 7

What kind of abuse did Freud not think was traumatic initially?

Answer 7

Childhood sexual abuse- changed this opinion later

Question 8

What happens when more raters are added to define a traumatic life event?

Answer 8

Goes from 87% agreement for 2 raters down to 41% for 5 raters

Question 9

What is bracket creep?

Answer 9

Bracket Creep- list of events that are considered traumatic are growning over time

Question 10

What is a misconception about trauma?

Answer 10

That it is infrequent- 70% of people have experienced it

Question 11

What is a universal emotional response?

Answer 11

a stressor that evokes significant distress in everyone

Question 12

What is wrong about a universal emotional response?

Answer 12

most people show resilience after traumatic life events so most people can recover from events and not experience difficulty

Question 13

What is the problem with specific acute (peritraumatic) reaction used to define trauma and PTSD?

Answer 13

not diagnostic- some people who develop LT difficulties do not experience immediate difficulties and most people may have difficulties immediately but get better over time

Question 14

what is peritraumatic reaction

Answer 14

Reaction right around the trauma

Question 15

What is wrong with specific chronic (posttraumnatic) reaction used to define trauma and PTSD?

Answer 15

many different kinds of events can cause PTSD symptoms- equifinality - no one coherent category for traumatic events - also circular reasoning

Question 16

How do we define a traumatic life event today?

Answer 16

threat to life of physical integrity or threat to psych self- threat to physical event is required

Question 17

How has the DSM changed through its editions?

Answer 17

exclude universal emotional reaction, physical threat, removed fear at the time of trauma

Question 18

What are the best practices for ASD and PTSD assessment?

Answer 18

initial considerations like safety and obstacles to disclosure, established event-response timeline, standardized surveys and interviews and psychophysiological tests

Question 19

What is the best practice for PTSD assessment?

Answer 19

interview style- over surveys or questionnaires

Question 19

What are some intitial considerations in assessment?

Answer 19

can the person fully disclose their symptoms, is talking about the trauma too much, is their a risk to safety, etc

Question 20

Need to know details on the different assessments?

Answer 20

????????

Question 21

T/F - PTSD responses develop in a linear fashion

Answer 21

False- they fluctuate - half of people show different status following diagnosis

Question 22

What are some examples of psychophysiological assessment measures?

Answer 22

heart rate, skin conductance, respiration rate, brain imaging

Question 23

What are the four trajectories that have been identified for PTSD?

Answer 23

resilient- 70-75%- low distress over time
recovery- 10% - intitial high distress but gradual remission
delayed- 10%- initial low distress that increases
chronic- 10% - consistently high

Question 24

what are some predictors of what trajectory a person will have with PTSD?

Answer 24

earlier stress, severity of stress, social support, low IQ, high neuroticism

Question 25

Which trajectory is most likely to bbe diagnosed with PTSD?

Answer 25

chronic

Question 26

What is one trajectory of PTSD that is not included in one of the main four?

Answer 26

Relapse- recovery to baseline but relapse later

Question 27

What is a risk factor?

Answer 27

measureable characterization of a subject that exists or occurs prior to a specific outcome and has a clinically and statistically significant relation to that outcome

Question 28

What are protective factors?

Answer 28

opposite of risk factor- negatively associated with unwanted outcomes

Question 29

more detail about risk factors? - time varying, outcome as unwanted state, etc

Answer 29

?????

Question 30

What are the types of risk factors?

Answer 30

objective- bio subjective pre-trauma post-trauma- social support

Question 31

What is conditional probability and slide on prevalence and over estimates- don't understand

Answer 31

??????

Question 32

Why is it difficult to interpret findings between sociodemographic groups

Answer 32

Groups are confounding- ex both low income and a woman versus high income and man

Question 33

What is the prevalence of PTE exposure in adults?

Answer 33

70% (but ranges from 55-90) have experienced at least one traumatic event

Question 34

What is the prevalence of a person experiencing more than one traumatic event?

Answer 34

35% in men and 25% in women

Question 35

What is the conditional probability of lifetime PTSD for people with more than one PTE

Answer 35

8-11%

Question 36

What is the lifetime prevalence of PTSD?

Answer 36

7-10%

Question 37

T/F - The more traumatic events a person has experienced, the more likely they are to have PTSD

Answer 37

True

Question 38

When does PTE exposure peak and what happens after that?

Answer 38

peaks in adolescence then decreases with age- exception with unexpected death of a loved one which peaks later

Question 39

What is the trend of lifetime prevalence of PTSD?

Answer 39

increases until middle adulthood

Question 40

T/F - Early trauma in childhood is a risk factor for developing PTSD after a later PTE in adulthood

Answer 40

True

Question 41

T/F- The prevalence of PTSD among females is twice as low and are more liekly to be exposed to PTE

Answer 41

False- prevalence twice as high and men more likely yo be exposed to PTE- women have higher PTSD rate but men have higher traumatic exposure

Question 42

What type of traumatic event has highest conditional probability of lifetime PTSD in men and women?

Answer 42

rape- contributing factor to why women have higher PTSD rate despite being exposed to fewer traumatic events

Question 43

Why are people who are divorced, widowed or separated at a higher risk of PTSD?

Answer 43

less social support, associated woth other SDS factor like economic reasons

Question 44

What are situational and biological vulnerability in relation to gender differences?

Answer 44

different genders lead to different levels of risk for PTSD based on different situations each gender may be in as well as their biological risk factors- each contribute

Question 45

What are the gender differences in coping?

Answer 45

Women more likely to seek social support Men more likely to be irritable and aggressive- less social support but they use more problem-solving and practical strategies

Question 46

Who are most likely to drop out of treatment?

Answer 46

Men - especially with combat related PTSD

Question 47

What is a wrong distinction researchers make in race groups?

Answer 47

white vs everyone else

Question 48

What is the rule about heterogeneity of groups?

Answer 48

more difference within groups than between groups

Question 49

What are some cultural differences in trauma recovery?

Answer 49

somatic vs psychological presentation, emotional expressiveness, types of healing, role of family in support, role for specific practices

Question 50

What are some biological risk factors of PTSD?

Answer 50

heritability of 30%, genetoc variants, small hippocampus

Question 51

What are some psych risk factors of PTSD?

Answer 51

low IQ prior to trauma, cognitive biases, social support before and after

Question 52

What does it mean that PTSD is confounded and compounded

Answer 52

Mixed up with others things and built up over time

Question 53

How has the DSM changed the number of symptoms for PTSD over its editions?

Answer 53

increase in number of defining symptoms of PTSD- 20 in most recent

Question 54

How many ways does Galatzer-Levy and Bryant predict there are to have PTSD?

Answer 54

636 120 ways

Question 55

How does Armour et al group PTSD symptoms?

Answer 55

re-experiencing, avoidance, negative alterations in cognition and mood, emotional numbing (anhedonia), externalizing behaviours, anxious arousal, dysphoric arousal

Question 56

How can we use Item response theory statistics to assess PTSD? relative clinical significance

Answer 56

what is the total level of severity, likelihood that a person has experienced a symptom relative to overall total score?????? don't fully understand ??????

Question 57

What is the difference between PTSD and C-PTSD?

Answer 57

PTSD symptoms (at least 2) plus three added features- emotional regulation, interpersonal relatedness, sense of self or identity

Question 58

How does the prevalence of C-PTSD change in general populations versus clinical samples?

Answer 58

only 1-5% in general pop but much higher (16-45%) in clinical samples

Question 59

What are the three core features of C-PTSD?

Answer 59

AIR = Affect disregulation, Identity alternations, Relational impairment

Question 60

What are features of C-PTSD but not considered core in ICD-11?

Answer 60

pathological dissociation and somatization

Question 61

What features are higher for people with BPD than people with C-PTSD despite them having similarities?

Answer 61

volatile relationships, fear of abandonment, unstable sense of self, impulsivity, self-harm

Question 62

What disorder is frequently comorbid with C-PTSD?

Answer 62

BPD

Question 63

What were some of the early symptoms of C-PTSD or DESNOS?

Answer 63

Problems with: regulation of affective impulses (self-destructive), self-perception (feeling ashamed), relationships (little trust), systems of meaning (distorted beliefs), attention and consciousness (amnesias), somatization (physical symptoms with no medical explanation)

Question 64

What category of symptoms of PTSD are often not included in recent guides that was in the early definitions?

Answer 64

Somatization- physio symptoms not explained otherwise

Question 65

How has the ICD-11 changed in its definition of PTSD symptoms?

Answer 65

Become more simple

Question 66

How does PTSD in one person affect their relationships?

Answer 66

PTSD symptoms in one person cause relationship dissatisfaction in their parnter- twice as high in divorce rates, higher risk of domestic violence (60%), poor sleep, mood and social change

Question 67

What is double trauma?

Answer 67

Partners who both have two different traumas

Question 68

How are children affected by trauma in their parents?

Answer 68

emotional and social problems generations later, attachment issues, maltreatment

Question 69

What are unhealthy family responses to someone with PTSD?

Answer 69

Weak sympathy, disdain, embarassment, avoidance

Question 70

What are some helpful interventions for families with someone with PTSD?

Answer 70

psychoeducation, support groups, couples therapy, individual therapy