MEDI7301 Study Guide - Final Guide: Relaxation Technique, Sertraline, Paroxetine
PTSD and Acute Stress disorder
Introduction
Overview Trauma and stressor related disorders involve exposure to traumatic or stressful
event that usually elicits a characteristic phenotype involving anhedonic and dysphoric symptoms,
externalizing angry and aggressive symptoms or dissociative symptoms (distinguished from anxiety
and fear related disorders that usually exhibit fear or anxiety based symptoms)
PTSD = it lasts longer than 4 weeks/1 month
Acute stress disorder = it lasts less than 4 weeks/ 1 month
Adjustment disorder = it does not meet traumatic event criteria unless ASD/PTSD; any
type of event or situation (+ve or -ve) that may elicit an 'overreaction'
Post-traumatic stress disorder
Overview Severe psychological disturbance following a traumatic event characterised by
involuntary re-experiencing of elements of event + symptoms of hyperarousal, avoidance,
emotional numbing
PTSD is more likely to be caused by trauma perceived as potentially life-threatening
or likely to cause physical harm and injury
Male trauma usually related to combat experience/ physical assault
Female trauma usually related to physical/ sexual assault
It is a combination of the make-up of the individual, both in terms of past
psychiatric problems & past experience of and response to trauma
Legal issues like compensation can perturb PTSD symptoms, but may resolve once
compensation is settled (compensation neurosis)
Risk factors Vulnerability
factors
Low education
Lower SES
Afro-Carribean/ Hispanic
Female gender
Low self-esteem/ neurotic traits
Previous self or family hx of psychiatric problems (especially
mood/ anxiety disorders)
Previous traumatic events (eg adverse childhood experiences
and abuse)
Peri-traumatic
factors
Trauma severity
Perceived life threat
Peri-traumatic emotions
Peri-traumatic dissociation
Protective
factors
High IQ
Higher social class
Caucasian
Male gender
Psychopathic traits
Chance to view body of dead person
DSM-5 criteria
(patient above
6yo)
Exposure to actual or threatened dead, serious injury or sexual violence in at least
one of following ways
Directly experiencing traumatic event(s)
Witnessing the event(s) occur to others
Learning the traumatic event(s) occurred to a close family member or
friend; in cases of actual or threatened death of family member or friend, the event(s)
must have been violent or accidental
Repeated or extreme exposure to aversive details of the traumatic event(s)
- eg first responder to collect human remains, police officers repeatedly exposed to child
abuse details (it does not include exposure through electronic media, TV, movies or
pictures unless exposure is work related)
Symptom clusters associated with the traumatic event(s), beginning after the
find more resources at oneclass.com
find more resources at oneclass.com
traumatic event(s) occurred
Intrusion sx (at
least 1)
Recurrent, involuntary and intrusive distressing
memories of the traumatic event(s)
oChildren may express repetitive play in the
themes/ aspects of the traumatic event(s)
Recurrent, distressing dreams in which the content
and/or affect of the dream are related to the traumatic event(s) - child
may have frightening dreams without recognisable content
Dissociative reactions (eg flashbacks) where the
individual feels or acts as if the traumatic event(s) were recurring - it may
occur on continuum with most extreme expression being complete loss of
awareness to surroundings
Intense or prolonged psychological distress at
exposure to internal or external cues that symbolise or resemble an aspect
of traumatic event(s)
Marked physiological reactions to internal or
external cues that symbolise or resemble an aspect of the traumatic
event(s)
Avoidance sx (1
or both)
Avoidance of or efforts to avoid distressing
memories, thoughts, or feelings about or closely associated with the
traumatic event(s)
Avoidance of or efforts to avoid external reminders
(people, places, conversations, activities, objects, situations) that arouse
distressing memories, thoughts, or feelings about or closely associated
with the traumatic event(s)
Negative mood
or cognition sx/
dissociative sx
(at least 2)
Inability to remember an important aspect of the
traumatic event(s), typically due to dissociative amnesia and not other
factors like head injury/ alcohol/ drugs
Persistent and exaggerated negative beliefs or
expectations about oneself, others, or the world (eg “I am bad,” “No one
can be trusted,” ‘The world is completely dangerous,” “My whole nervous
system is permanently ruined”)
Persistent, distorted cognitions about the cause or
consequences of the traumatic event(s) that lead the individual to blame
himself/herself or others
Persistent negative emotional state (eg fear, horror,
anger, guilt, or shame)
Markedly diminished interest or participation in
significant activities
Feelings of detachment or estrangement from others
Persistent inability to experience positive emotions
(eg inability to experience happiness, satisfaction, or loving feelings).
Arousal sx (at
least 2)
Irritable behavior and angry outbursts (with little or
no provocation) typically ex pressed as verbal or physical aggression
toward people or objects
Reckless or self-destructive behavior
Hypervigilance
Exaggerated startle response
Problems with concentration
Sleep disturbance (eg difficulty falling or staying
asleep or restless sleep)
This whole disturbance appears within 6mth of traumatic event + persists for
more than 1 month
It causes clinically significant distress or impairment in social, occupational or other
important areas of functioning
This disturbance is not attributable to the physiological effects of a substance
(medication, alcohol) or medical condition
find more resources at oneclass.com
find more resources at oneclass.com
Document Summary
Ptsd = it lasts longer than 4 weeks/1 month. Acute stress disorder = it lasts less than 4 weeks/ 1 month. Adjustment disorder = it does not meet traumatic event criteria unless asd/ptsd; any type of event or situation (+ve or -ve) that may elicit an "overreaction" Severe psychological disturbance following a traumatic event characterised by involuntary re-experiencing of elements of event + symptoms of hyperarousal, avoidance, emotional numbing. Ptsd is more likely to be caused by trauma perceived as potentially life-threatening or likely to cause physical harm and injury. Male trauma usually related to combat experience/ physical assault. Female trauma usually related to physical/ sexual assault. It is a combination of the make-up of the individual, both in terms of past psychiatric problems & past experience of and response to trauma. Legal issues like compensation can perturb ptsd symptoms, but may resolve once compensation is settled (compensation neurosis)
