PTSD

Question 1

What is PTSD?

Answer 1

The experience of trauma either by directly experiencing/witnessing or hearing about the event.

Question 2

What are some symptoms of PTSD?

Answer 2

• presence of intrusion symptoms(distressing memories or dreams, flashbacks, intense prolonged psychological distress)
  -Persistent avoidance of stimuli associated with the event
• Negative alterations in cognition and mood(eg. inability to remember details, negative beliefs about self, feelings of detachment)
• Irritability, angry outburst
• Problems with concentration
  -Sleep Disturbances

Question 3

What is the prevalence of PTSD?

Answer 3

-Canada projected lifetime risk= 9.2%
- PTSD is more prevalent in females than males

Question 4

What is the fear circuitry? and what does it do?

Answer 4

It is the neural basis of PTSD. The medial prefrontal cortex(mPFC) appraises threat, if there is a threat it signals to amygdala/HPA. The amygdala signals to hippocampus and hypothalamus which activates brainstem response to fear.

Question 5

What are the symptoms after fear circuitry is signalled with threat?

Answer 5

• Hypervigilance
• Intrusive Symptoms
• Avoidance of stimuli associated with trauma
  Cognitive distortions

Question 6

What does it mean when there is a reduced volume of hippocampus?

Answer 6

Hippocampus is not able to use contextual cues in the environment to signal safety. vmPFC fails to maintain extinction of conditioned emotional responses once traumatic learning is no longer available. It reduces cortisol capacity to inhibit fear and negative emotions.

Question 7

What is a biomarker?

Answer 7

A measure that captures what is happening in a cell or organism at a given moment.

Question 8

What is the biomarker for PTSD?

Answer 8

Dysregulated signaling of noradrenaline.

Question 9

What causes PTSD patients to have enhanced stress in both the SAM & HPA pathways?

Answer 9

-There is altered adrenaline, noradrenaline and cortisol levels.
-Excessively strong adrenergic response to traumatic events may mediate formation fo durable traumatic memories.

Question 10

What is the best treatment for PTSD and how does it work?

Answer 10

-Propranolol(a beta receptor antagonist which prevents binding of noradrenaline)
-Within hours of trauma exposure reduces likelihood of developing PTSD.
-Seems to be most effective even though criticized and data has been all over the place

Question 11

What are the pros and cons of taking cannabis when having PTSD?

Answer 11

-Pro: Smoking cannabis(high levels of CBD) may decreases symptoms of PTSD. It is effective at reducing of fear memory.

• Con: Smoking cannabis(high levels of THC) worsens PTSD
• Suggests dysregulated eCB system post-trauma.