def: PTSD
exposure to stressul event or situation of exceptionally threatening or catastrophic nature, which is likely to cause pervasive distress in almopst anyone
PLUS persistent remembering or reliving stressor by intrusive flashbacks, vivid memories, recurring dreams or experiencing stress when exposed to circumstances resembling or associated with stressor
PLUS avoidance of circumstances
PLUS either impaired recolelction of event OR persistent hyperarousal
hyperarousal symptoms
- difficulty falling or staying asleep
- irritability/outbursts of anger
- difficulty concentrating
- hyper-vigilence
- exaggerated startle response
diagnosis: PTSD
TRAUMA
Traumatic event - violent or lifethreatening (fear/helplessness/terror felt by person experiencing it)
Re-experiencing (flashbacks/nightmares)
Arousal (increased awareness and anxiety of surroundings - hypervigilence)
Unable to function (concentration at work or relationships with those who cannot relate)
Month or more
Avoidance
epidemiology: PTSD
F>M
3% lifetime prevalence
chronic course
remission rate >90% and median time is 14 years
criteria: PTSD
- exposure to stressful event or situation of exceptionally threatening or catastopic natre (likely to cause distress in almost everyone)
- persistent reliving with flashbacks, vivid memories, nightmares or distress when exposed to circumstances remeblong/associated with stressor
- actual or preferred avoidance of circumstances
- either inabililty to recall (partially or fully) some aspects of the period of exposure to the stressor
- OR persistent symptoms of increased psychological sensitivity and hyperarousal any 2 of 1. difficulty in falling or staying asleep 2. irratibility or outbursts of anger 3. difficulty in concentrating 3. hypervigilence 5. exaggerated startle response
signs: PTSD
- difficult falling or staying asleep
- irratibility or outbursts of anger
- difficulty concentrating
- hypervigilence
- exaggerated startle response
- drug/alcohol misuse
- depression
- flashbacks
- re-enacting experience in children, repeptitive play or frightening dreams
neurotransmitters: PTSD
dysregulation of hypothalamic pituitary axis
hypocortisolaemia - upregulates response to stress
increased noradrenlaine
decreased serotonin
tx: PTSD
- trauma CBT
- eye movement desensitisation reprocessing
- SSRI 1st line
- treatment resistant - augment with prazocin (improves sleep) or antipsychotics
def: acute stress disorder
- response to exceptional physical and/or psychological stress
- usually subsides within days
- usually initial state of feeling dazed or numb and unable to comprehend situation
- reassurance and support
- may have benzodiazepines for short course
- may continue to PTSD if lasting over 1 month
def: PTSD
exposure to stressul event or situation of exceptionally threatening or catastrophic nature, which is likely to cause pervasive distress in almopst anyone
PLUS persistent remembering or reliving stressor by intrusive flashbacks, vivid memories, recurring dreams or experiencing stress when exposed to circumstances resembling or associated with stressor
PLUS avoidance of circumstances
PLUS either impaired recolelction of event OR persistent hyperarousal
