5 2 2014 PSYC 2101 Notes Microsoft OneNote Web App PTSD Monday April 21 2014 7 41 PM What is Trauma Examples Extrapersonal Trauma Natural disasters Fires Car accidents Witnessing all of this Interpersonal Trauma Childhood Abuse Experiences Assault Sexual Physical Mugging What about war What about watching hearing about traut on the TV radio Hurricane Katrina 19 2 of Hurricane Katrina victims are estimated to have developed PTSD following the hurricane Is this a lot 19 2 is 5 times the national rate of PTSD Why Natural disaster also involving interpersonal trauma Common Reactions to Trauma Many people experience trauma not many develop PTSD Lifetime exposure to trauma 70 of the population PTSD nationally 6 8 of the US population Lifetime Prevalence https onedrive live com edit aspx resid 7AF35F2B369F2BE4 1552 cid 7af35f2b369f2be4 app OneNote wdo 2 1 9 5 2 2014 PSYC 2101 Notes Microsoft OneNote Web App Rate 3 5 experienced in the past year Point Prevalence Rape Victims 32 Car accident victims 15 Veterans 20 How do we Diagnose PTSD Criterion A Exposure to actual or threatened death serious injury or sexual violence in one or more of the following ways Directly experiencing the events s Witnessing in person the event s as it occurred to others Learning that the event s occurred to a close family member or close friends Repeated or extreme exposure to averse details of traumatic events Criterion B Intrusive Symptoms Recurrent intrusive distressing memories of the event s Recurrent distressing dreams Flashbacks Psychological distress at exposure to trauma related cues Physiological reactions to trauma related cues Criterion C Persistent Avoidance 1 Avoidance of distressing memories thoughts or feelings about the traumatic event s Avoidance of external reminders of the traumatic event s Ex people places conversations activities objects Criterion D Negative alterations in thoughts mood 2 Inability to recall an important part of the PTSD Criteria https onedrive live com edit aspx resid 7AF35F2B369F2BE4 1552 cid 7af35f2b369f2be4 app OneNote wdo 2 2 9 5 2 2014 PSYC 2101 Notes Microsoft OneNote Web App trauma Persistent and negative beliefs or expectations about the self world and others I m bad no one can be trusted the world is dangerous Persistent distorted thoughts about the cause or consequences of the event s leading to self blame Persistent negative emotional state inability to experience positive emotions Markedly diminished interest or participation in once enjoyed activities Feelings of detachment or estrangement of others Criterion E Marked Alterations in Arousal 2 Increased irritability Reckless or self destructive behavior Hypervigilance Exaggerated startle response Difficulty concentrating Sleep disturbance Criterion F Symptoms persist for at least 1 month following trauma Other Related Difficulties Overestimation of danger in the environment Loss of trust Loss of intimacy relationship difficulties Impatience Over use of alcohol and drugs Depression Feelings of guilt and shame Feelings of incompetence or inadequacy Acute Stress Disorder Same criterion A 9 of the following Avoidance of reminders Avoidance of people places etc Increased negative emotions Reduced interest participation https onedrive live com edit aspx resid 7AF35F2B369F2BE4 1552 cid 7af35f2b369f2be4 app OneNote wdo 2 3 9 5 2 2014 PSYC 2101 Notes Microsoft OneNote Web App Socially withdrawn behavior Reduction in positive emotionality Irritability hyper vigilance Exaggerated startle response Concentration problems Sleep difficulties 63 70 of individuals with ASD go on to develop PTSD Biology within PTSD PTSD changes the ways your brain works it changes your biology PTSD mainly resides within the limbic symptom of the brain Amygdala Hippocampus and the Cerebral Cortex Hippocampus formation of long term memories Signals cortex for fear anxiety negative emotions The Limbic System The Secretary Amygdala Cortex Rational thinking The Smart Part What Changes Cortisol Corticotropin Releasing Hormone CRH Stress hormone your body releases More is released over a constant period of time Reversible changes to normal levels and patterns post treatment Structural changes in the brain over time Limbic system Hippocampus shrinks due to over activation and constant cortisol release Potentially reversible with treatment Known Correlates What in theory puts you at risk for PTSD https onedrive live com edit aspx resid 7AF35F2B369F2BE4 1552 cid 7af35f2b369f2be4 app OneNote wdo 2 4 9 5 2 2014 PSYC 2101 Notes Microsoft OneNote Web App Type of trauma Intrapersonal vs Extrapersonal Proximity to the Trauma Personality Traits Neuroticism Openness Female Sex Low SES Poverty Size of certain brain structures Low intellectual functioning Family Personal History of Anxiety Interpretive Bias Physiological Sensitivity Dissociation Protective Factors What Protects you Male sex Middle to High SES Decent Intellectual Functioning Strong Support System Development of PTSD Peritraumatic Response Response during the traumatic event https onedrive live com edit aspx resid 7AF35F2B369F2BE4 1552 cid 7af35f2b369f2be4 app OneNote wdo 2 5 9 5 2 2014 PSYC 2101 Notes Microsoft OneNote Web App Involves the Fight or Flight response via activation of the HPA Axis Neuroendocrine changes Increased activation during trauma Related to onset of PTSD Increased activation after trauma Related to maintenance of PTSD Dissociation and Memory Formation Dissociation An altered state of consciousness Characterized by complete disruption of the normal integration of consciousness Leads to compartmentalization of experience Dissociation results in Short and incomplete memories Memories that are highly sensory based Ex sights sounds smells tastes Overall poor memory formation Avoidance We know that people who talk about trauma get better those who don t develop PTSD Individuals who experience PTSD engage in two types of avoidance Avoidance of associated thoughts feelings memories Ex thought suppression Avoidance of associated people places things Ex staying away from reminders of the trauma What is the problem with avoidance Avoidance works in the short term But not in the long term Resulting in Never processing the trauma Never challenging the negative beliefs that developed from the trauma Anxiety Curve Anxiety begins leads to peak of anxiety if avoid the anxiety provoking stimuli at the peak do not learn that anxiety will naturally decrease may lead to https onedrive live com