Trauma 1 the person experienced witnessed or was confronted with an event or events that involved actual or threatened death or serious injury or a threat to the physical integrity of self or others 2 the person s response involved intense fear helplessness or horror Post Traumatic Stress Disorder PTSD Symptoms last 1 month 1 2 3 Re experiencing flashbacks nightmares intrusive memories etc Avoidance numbing amnesia emotional numbness avoidance dissociation Hyperarousal SNS startle response vigilance insomnia angry outbursts Lifetime Prevalence 7 Immediately post trauma over 90 experience PTSD symptoms but only 10 will develop full blown PTSD Biological Model After trauma normal elevation in 2 stress hormones 1 cortisol interferes with memory retrieval promotes new memory 2 norepinephrine NE promotes new memory formation also SNS In PTSD there s abnormally low cortisol after trauma so no suppression of traumatic memory thus high NE leads to memory imprint of trauma Predictors of PTSD 1 Genetic vulnerability explains about 30 of variance in some studies 2 Neurological vulnerability link with early trauma history Adverse Childhood Experiences Study 3 Lack of social support 4 Perceived severity of trauma 5 Use of physical violence in trauma 6 Axis I co morbidity Treatment of PTSD 1 Medications antidepressant antianxiety 2 Cognitive behavioral therapy graded exposure to traumatic memories 3 Psychodynamic therapy it works 4 CISD Critical Incident Stress Debriefing
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