Unique necessary diagnostic criteria to PTSD
Etiology is one of the diagnostic criteria: Exposure to a traumatic event
Only one in the DSM 5 with this feature
PTSD vs Acute Stress Disorder
PTSD
Duration = at least 1 month
Acute Stress Disorder
Duration = 3 days to 1 month
The types of events that are traumatic and lead to the symptoms of PTSD
Exposure to actual/threatened death, serious injury, sexual violence
The ways in which people can experience these traumatic events
Direct experiencing it
Witnessing it in person happen to others
Learning it happened to a close family member or close friend
Repeated or extreme exposure to aversive details of traumatic event(s)
In cases of actual or threatened death of a loved one/friend, the death has to be ___
violent or accidental
learning about this news is the traumatic event
How many intrusion symptoms?
One
Intrusion symptoms
Intrusion (1): persistent & distressing memories, nightmares, flashbacks,
intense psychological or physiological responses to trauma cues
Avoidance symtpms and how many are needed for diagnosis
Avoidance (1): effortful avoidance of internal & external cues and
reminders
Negative cognition and mood symptoms and how many
2): numbing, guilt, anger, fear, negative
beliefs about self, others & world
Arousal & reactivity symptoms and how many they need
(2): sleep difficulty, concentration impairment,
exaggerated startle, hypervigilance, irritability/aggressivity, reckless or
self-destructive behaviours
Duration of symptoms for PTSD diagnosis
1 month
prevalence of trauma vs PTSD
Lifetime prevalence of trauma: 51.2% women; 60.7% men
Lifetime prevalence of PTSD: 10.4% women; 6.8% men; up to 42% in trans
and non-binary people
PTSD higher in other traumatized groups (i.e. Indigenous peoples, SA survivors, 9/11 survivors)
Exposure to trauma is a ____ but not a _____ cause of PTSD
necessary, sufficient
Pre trauma
Characteristics of the individual and environment that
preceded trauma exposure
Peri trauma
Characteristics of the trauma and the environmental and
individual response to the trauma
Post trauma
Individual and environmental factors that occur after the trauma
Key idea of Minority Stress Theory
The effect of trauma on adverse mental health outcomes in
individuals identifying as sexual and/or ethnic minorities is
strengthened by:
external and internal stressors
if you have a heightened background stress, you may be more affected/sensitive to a stressor to trigger the onset of PTSD
strongest predictor for developing PTSD
Lack of social support post-trauma
fear related pathologies we commonly see in individuals with pre-trauma sensitivity in response to trauma
Heightened fear conditioning
Fear generalization
Attentional bias to threat
Avoidance
Pre-Trauma
Vulnerability
Impaired extinction learning in relation to PTSD
Maintaining the conditioned of the stimulus to the fear
-memories continue to be associated with fear and factors related to the traumatic event
Post-trauma factors can exacerbate the impairment of extinction learning
Provide examples of some negative appraisals of trauma
“Nowhere is safe”
“The next disaster will strike soon”
“I attract disaster”
“I am a victim”
“I’ll never get over this”
“I deserve the bad things that happen to me”
“Nobody is there for me”
“I’m dead inside”
Describe trauma memory
Fragmented
Unintegrated into autobiographical memory
two gold standard treatments for PTSD
Prolonged Exposure (PE): Exposure to trauma-related memories
(imaginal exposure) and situations (in vivo exposure)
COGNITIVE PROCESSING THERAPY (CPT)
focus of the fear in PTSD
intrusive memories, the memory of the trauma
