PSYCH 333 1nd Edition Lecture 12 Outline of Last Lecture I Sociocultural Factors II Diathesis Stress Model III Obsession IV Compulsion V Obsessive Compulsive Disorder VI Trichotillomania VII Hoarding Disorder VIII Body Dysmorphic Disorder IX Biological Theories X Biological Treatments XI Behavioral Theories XII Cognitive Theories XIII Cognitive Behavioral Treatment XIV Other Theories Outline of Current Lecture II DSM 5 Definition of Trauma III Post traumatic Stress Disorder PTSD IV Associated Features V Acute Stress Disorder VI Predisposing Factors VII Neurobiological Factors VIII Biological Treatments IX Psychological Factors X Psychological Treatments XI Treatment Efficacy XII Complex PTSD XIII Post traumatic Growth Current Lecture DSM 5 Definition of Trauma o Actual or threatened death serious injury or sexual violence o Exposure to trauma in one of the following ways Personal experience Witnessing the event in person These notes represent a detailed interpretation of the professor s lecture GradeBuddy is best used as a supplement to your own notes not as a substitute Learning of a violent or accidental death of a loved one Repeated or extreme exposure to aversive detail of the events other than through media reports Post traumatic Stress Disorder PTSD o Intrusion symptoms Flashbacks night mares o Avoidance symptoms Avoiding of internal thinking cues and external reminders cues o Alterations in mood and cognitions Depression anxiety dissociative disorders difficulty remembering details of the trauma o Alterations in arousal reactivity Irritability hyperviglance Associated Features o Pseudo psychotic symptoms o Emotional lability Mood shifiting o Difficulty maintaining relationships o Increased risk for suicide o Comorbidities Depression anxiety substance use and dissociative disorders Acute Stress Disorder o Similar symptoms to PTSD o Main difference is length of time since the trauma occurred o PTSD is a longer term diagnosis onset more than one month after the trauma o ASD is a short term diagnosis onset within three days to one month of the trauma Predisposing Factors o Severity of the trauma o Nature of the trauma Natural vs human o History of anxiety disorder o Neuroticism o Childhood adversity o Prior exposure to trauma o Older age Neurobiological Factors o Fear circuitry Increased amygdala activation Decreased activation or prefrontal cortex o Hippocampus Cognitive and memory disturbances Smaller hippocampal volume Premorbid hippocampal size Impact on hippocampal development Biological Treatments o Medications Selective Serotonin Reuptake Inhibitors SSRIs Medication for sleep o Medications are not seen as the first line interventions Psychological Factors o Behavioral learning theories Two factor model Classical conditioning of initial fear Operant conditioning maintain symptoms Ex mugged outside their apartment o Coping strategies Avoidance dissociation Intelligence People of higher intelligence are less likely to develop PTSD Social support Those with more social support are less like to develop PTSD Psychological Treatments o Cognitive behavioral therapies Prolonged exposure Cognitive processing therapy Eye movement desensitization and reprocessing Controversial treatment o Integrative therapies Present centered therapy Not trauma focused More humanistic Seeking safety Treatment for PTSD comorbid with substance use disorder Treatment Efficacy o Trauma focused treatment seem to work best o Medications can help manage symptoms in the short term and help the client engage in therapy o Psychotherapy is the most effective long term treatment o Some treatments may actually be harmful Psychological debriefing o Risks of trauma focused treatments Complex PTSD o Not a DSM 5 diagnosis o PTSD symptoms without an event that meet the DSM 5 criteria for a trauma Ex emotional abuse neglect Attachment traumas o Similar neurobiological response o Should the definition of trauma be extended Post traumatic Growth o Improvement in psychological functioning following a traumatic experience o More common than PTSD o Changes may include Greater appreciation of or satisfaction with life Close more meaningful relationships Pursuit of new goals values Greater spirituality o Role of expression openness to experience and optimism hope