PSYC 300 > Trauma > Flashcards

Trauma Flashcards

(44 cards)

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1
Q

Trauma- and stressor-related disorders (5)

(i.e., Trauma/stress is central)

A
  1. Post-Traumatic Stress Disorder
  2. Acute Stress Disorder
  3. Adjustment Disorders
  4. Attachment Disorders
  5. Prolonged Grief Disorder
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2
Q

Dissociative disorders: origins

A
  • Often linked to trauma, involving disruptions in memory, identity, or perception
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3
Q

Dissociative disorders: emotional responses

A
  • fear
  • anxiety
  • rage
  • shame
  • horror
  • guilt
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4
Q

The Thousand-Yard Stare

A
  • British solider Wilfred Owen and WWI
  • “Shell Shock”
  • Symptoms mirror modern PTSD decades before the diagnosis existed
  • His poetry provides powerful insight into trauma’s psychological impact
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5
Q

DSM-5-TR Diagnostic Criteria for PTSD - A:

A

Exposure to actual or threatened death, serious injury, or sexual violence in one (or more) of the following ways:

  1. Direct experience
  2. Witnessing as something occurs to others
  3. Learning that a loved one experienced the event(s) (in cases of actual or threatened death, the event must have been violent or accidental)
  4. Repeated or extreme exposure to aversive details of the event(s) (e.g., First responders handling human remains)
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6
Q

PTSD Symptoms - 4 Clusters

A
  1. Intrusive
  2. Avoidance
  3. Changes in thoughts & feelings
  4. Heightened arousal
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7
Q

PTSD Symptom Cluster 1: Intrusion

A

Repetitive, unwanted memories

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8
Q

PTSD Symptom Cluster 1: Intrusion SYMPTOMS

A
  1. Recurrent, involuntary, and distressing memories
  2. Recurrent distressing dreams related to the trauma
  3. Dissociative reactions (e.g., flashbacks) in which the individual feels or acts as if the trauma were recurring
  4. Intense or prolonged psychological distress at trauma reminders
  5. Marked physiological reactions to trauma reminders
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9
Q

PTSD Symptom Cluster 2: Avoidance

A

Resisting conversations about the event

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10
Q

PTSD Symptom Cluster 2: Avoidance - SYMPTOMS

A

Avoiding distressing memories, thoughts, or feelings, external reminders (people, places, conversations, activities, objects, situations) associated with the trauma

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11
Q

PTSD Symptom Cluster 3: Negative Alterations in Cognitions and Mood

(changes in thoughts and feelings)

A

Loss of interest in once-enjoyed activities

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12
Q

PTSD Symptom Cluster 3: Negative Alterations in Cognitions and Mood - SYMPTOMS (7)

A
  1. Inability to remember an important aspect of the trauma (due to dissociative amnesia and not to factors like head injury, alcohol, drugs)
  2. Persistent exaggerated negative beliefs about the self, others, or world
  3. Distorted blame of self or others for the cause or consequences trauma
  4. Persistent negative emotional state (e.g., fear, horror, anger, guilt, shame)
  5. Reduced interest or participation in activities
  6. Feeling detached from others
  7. Persistent inability to experience positive emotions
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13
Q

PTSD Symptom Cluster 4: Hyperarousal/Alterations in Arousal and Reactivity

A

Trouble falling asleep

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14
Q

PTSD Symptom Cluster 4: Hyperarousal/Alterations in Arousal and Reactivity - SYMPTOMS

A
  1. Irritable behavior and angry outbursts (with little or no provocation)
  2. Reckless or self-destructive behavior
  3. Hypervigilance
  4. Exaggerated startle response/reaction
  5. Problems with concentration
  6. Sleep disturbance (e.g., difficulty falling or staying asleep or restless sleep).
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15
Q

DSM-5-TR Diagnostic Criteria for PTSD - other 2 criterion

A
  • Duration of symptom clusters (B-E) last more than 1 month
  • Distress or impairment in social, occupational, or other areas of functioning
  • Exclusion: Symptoms not due to substance use or another medical condition
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16
Q

PTSD Diagnosis

A

Only after 1+ month of symptoms

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17
Q

PTSD Course - ACUTE PTSD

A

Symptoms last less than 3 months

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18
Q

PTSD Course - CHRONIC PTSD

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A

Symptoms lasts over 3 months

19
Q

PTSD Course - DELAYED ONSET PTSD

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A

Symptoms appear 6+ months post-trauma

20
Q

Symptoms before 1 month diagnosed as…

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A
  • Acute Stress Disorder (ASD)
  • Added to DSM-IV to capture intense early reactions within the first month to allow for insurance coverage and access to treatment
21
Q

Specify whether: With dissociative symptoms…

PTSD Specifiers

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A
  • Depersonalization: Feeling detached from self (e.g., numb or as if in a dream)
  • Derealization: Feeling the world is unreal or distorted
  • Not due to substances or medical conditions
  • May respond differently to treatment
22
Q

Specify whether: With delayed expression:

PTSD Specifiers

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A
  • Full PTSD criteria not met until at least 6 months after trauma
  • Onset and expression of some symptoms may be sooner
23
Q

Acute PTSD - EXAMPLE

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A
  • First responders during Opioid Crisis
  • Repeatedly encounter traumatic scenes: overdose deaths, medical emergencies, and distressed families
  • Often involve high-stress, acute exposures, involving direct threats to the responder’s safety (e.g., needlestick injuries, violence)
24
Q

Chronic PTSD - EXAMPLE

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A
  • Nurses during COVID
  • High prevalence
  • Risk increases with more direct patient care, quarantine, or personal loss
  • Contributors: staff shortages, inadequate protective equipment, long and irregular shifts, moral injury, witnessing preventable suffering, lack of leadership support and resources, and rapidly changing protocols
25
Children may lack verbal expression, but show **behavioural signs**:
* Repetitive **play with trauma themes, may re-enact trauma in play** * **Frightening dreams** without clear trauma content * Exhibit **separation anxiety, fearfulness, or clinginess** * Show **developmental or behavioural changes** like bedwetting or behavioural regression * **Memories can become distorted or embellished** over time
26
PTSD in Children - EXAMPLE
* **2016 Fort McMurray Wildfire, AB** * Experienced evacuation, loss, and witnessed destruction * 1 in 3 (37%) likely met PTSD 18 months after event * Symptoms may include nightmares, bedwetting, clinginess…may persist for years
27
Integrative Model of PTSD Development - 4 major interactions
1. Trauma type and severity 2. Biological predisposition 3. Psychological vulnerability 4. Social support environment
28
Integrative Model of PTSD Development - 4 major interactions: **trauma type & severity**
* Type: rape > MVA > veterans... * Proximity, severity, duration
29
Integrative Model of PTSD Development - 4 major interactions: **biological predisposition**
Genes, traits, memory, HPA axis (**regulates the body's response to stress through a feedback loop involving the hypothalamus, pituitary gland, and adrenal glands**)
30
Integrative Model of PTSD Development - 4 major interactions: **Psychological Vulnerability**
* Education/intelligence, childhood adversity, anxiety sensitivity * Conditioning, externalizing behaviours, exisiting coping mechanisms
31
PTSD Treatment - Trauma-Focused: which method is best?
* "Trauma-focused": psychotherapy is the first-line and more effective * Facing the trauma in a safe, structured way is key for recovery
32
3 Types of Trauma-Focused Treatment for PTSD
1. **Prolonged exposure:** **confronts trauma-related memories and reminders** in a structured way to reduce emotional distress 2. **Cognitive processing therapy (CPT):** **helps identify and challenge unhelpful beliefs** about trauma, themselves, and the world 3. **Eye movement desensitization and reprocessing:** **revisits traumatic memories** while engaging in bilateral stimulation
33
Are anti-depressants or anxiety medications (SSRIs or SNRIs) good for the treatment of PTSD?
No
34
Enhancements & Additional Approaches - **within psychotherapy**
* Establishing safety and trust * Gradual exposure (imagined and/or real) * Teach coping and emotional regulation skills
35
Enhancements & Additional Approaches: **2 Non-Specific Approaches**
* **Constructivist-Narrative CBT:** reframes story (limited evidence) * **Stress Inoculation Training (SIT):** teaches coping skills, cognitive restructuring, and gradual exposure (some evidence)
36
Early Intervention & Prevention - pros + things to avoid
* Early structured therapy can reduce PTSD symptom development * However, debriefing alone can be harmful! Single-session, forced (group) emotional expression not recommended
37
Other Stressor-Related Disorders - **OVERVIEW (2)**
1. Prolonged Grief Disorder 2. Adjustment Disorders
38
Prolonged Grief Disorder
* **Grief that is persistent and intense, lasting much longer than expected** * At least **12 months** in adults, **6+ months** for children * **Preoccupied with the deceased, intense longing, difficulty accepting the loss**
39
Adjustment Disorders
* An **emotional and behavioural reaction to identifiable *life stressor* BUT not a traumatic event** (e.g., job loss, divorce) * Occurs **within 3 months of the event** * Distress and impairment **beyond what is typical or expected**
40
Attachment Disorders - onset
Before age 5
41
Attachment Disorders - cause
Pathogenic care (ignorant parental care) * Situations where **a child’s ability to form secure, selective attachments is severely compromised due to significant caregiving deficiencies** * **Failure to meet basic emotional and/or physical needs**
41
Reactive Attachment Disorder
Withdrawn, rarely seeks or responds to comfort, limited emotional response to caregivers
42
Disinhibited Social Engagement Disorder
Indiscriminate friendliness, overly familiar with strangers, lack of normal caution
43
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