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) Re-experiencing (flashbacks, nightmares, intrusive memories, etc.)2) Avoidance/numbing (amnesia, emotional numbness, avoidance, dissociation)3) 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 PTSDBiological Model:After trauma, normal elevation in 2 stress hormones:1. cortisol - interferes with memory retrieval, promotes new memory2. 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 traumaPredictors of PTSD:1) Genetic vulnerability (explains about 30% of variance in some studies)2) Neurological vulnerability (link with early trauma history)- Adverse Childhood Experiences Study3) Lack of social support4) Perceived severity of trauma5) Use of physical violence in trauma6) Axis I co-morbidityTreatment 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
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