PTSD

Question 1

What are the most common symptoms of PTSD?

Answer 1

After being exposed to a threat or serious injury.

• Intrusions – event is re-experienced in recollections or dreams after being exposed to cues
• Avoidance – efforts to avoid distressing memories and avoid reminders of the activity
• Avoidance (seperated) – unable to recall details or aspect of the trauma
• Hyperarousal – persistent symptoms of increased arousal and alterations in reactivity to stimuli

Question 2

What are the anatomical areas of dysfunction in the CNS of PTSD?

Answer 2

• Amygdala – over activation to normal nonthreatening stimuli
• Hippocampus – reduced hippocampal volumes
• Prefrontal Cortex – LESS activation

Question 3

How is processing different in amygdala vs cortical?

Answer 3

Amygdala – takes in sensory input and can illicit immediate sympathetic response if it cues a threatening memory

Question 4

What is the hippocampus’ role in PTSD?

Answer 4

– contextualizes fear and puts it in context, which is the dysfunctional part in PTSD

Question 5

How is the prefrontal cortex and amygdala regulated together?

Answer 5

They are inversely related.

• • When the PFC is activated the Amygdala is inactive and when the Amygdala is active the PFC is inactive.
• • PFC is generally used for decision making and executive processing, so when its off, non-contextual fear can be illicited.

Question 6

Why can PTSD patient not typically remember details of their events and experiences?

Answer 6

Traumatic memories must be accessed in a state of similar emotional arousal. Memories are State Dependent.

Question 7

What are methods to elicit behavioral deconditioning?

Answer 7

• Flooding – (Implosive Therapy) when they relive the experience and re-expose talking through it
• Systemic Desensitization - slowly re-exposing the patient to stimuli to help overcome their negative response and anxiety.

Question 8

What pathways do the various types of therapies target for PTSD?

Answer 8

Talk Therapy – Prefrontal Cortex control, indirect Amygdala
Cognitive Behavioral Therapy – PFC and direct amygdala
Drug Therapy – Directly Amygdala + rest of brain

Question 9

What is the most effective therapy for PTSD?

Answer 9

Cognitive Behavioral Therapies

• Stress innoculation training
• Rescripting and Reprocessing the event
• Cognitive Reconstruction
• Prolonged exposure

Question 10

What might be symptoms to notice in a patient after they had a traumatic experience to be concerned for PTSD (even if they don’t mention anything)

Answer 10

• Difficulties with concentration
• Sleep disturbances
• Increased startle response
• Irritability
• Change in mood / appetite

Question 11

What are questions that can be asked as a screening tool for PTSD?

Answer 11

• Experienced any vivid thoughts about the injury?
• Are you able to return to the place of the accident or injury?
• What do you think can be done to prevent the injury?

Question 12

What is the difference between Acute Stress disorder and PTSD?

Answer 12

Acute Stress Disorder – usually only lasts less than 4 weeks
PTSD – Has been present for more than 1 week