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PTSD (Definition and Diagnosis (Symptoms of a PTSD episode (FLASHBACKS...…

- - - - ...such high levels of anxiety cannot be 'rationalized away' and, unlike fear, anxiety emerges even in the absence of an immediate threat... "stop, look + listen"
      - ...in response to high anxiety individuals may panic - sudden and inappropriate intense fear with physical symptoms
      - now in "Trauma and Stress Related Disorders" section
      - ...but it is inherently linked with anxiety. While low/moderate levels of anxiety may be beneficial, high levels can be detrimental to functioning and can impede performance
    - - 70% ASD -> PTSD
      - NOT synonymous with PTSD... 13% PTSD have NO ASD
    - - high comorbidity with other disorders
      - PTSD can be a delayed response
  - - - agitation linked to suicide
  - - - Cognitive explanation: Encoding is key... tetris study found reduced anxiety when encoding of trauma interrupted
      - retrieval through a non-voluntary, external trigger
      - Warning signal hypothesis: classical conditioning... fb through associations with neutral stimuli
- - - - large scale disasters require unique response... national v local organization and support e.g. Sandy Hook coped fairly well compared to some others since they had a tight knit community and support was available to all in the (small) area after the traumatic event
    - - Re-traumatising victims increases risk of PTSD e.g. rape victims experiencing traumatic events during court proceedings AFTER already having to endure the assault itself
      - Comorbidity needs to be tackled before PTSD, i.e. treat depression/ suicidal thoughts before trying to tackle trauma causing PTSD - need to be mentally stable enough to deal with PTSD treatment e.g. use of SSRIs
  - - - future actions
      - present disturbance
      - past memories
    - - Debate that bilateral processing is irrelevant and unnecessary, but simply acts as a distractor from the distress + interrupt cognitive processes which may normally lead to panic/anxiety?... repetition of mundane task whilst recalling trauma leads to loss of meaning/ loss of power of that trauma
- - - - GENERAL PSYCHOLOGICAL V... learnt uncontrollability and low self esteem stemming from childhood experiences
      - SPECIFIC PSYCHOLOGICAL V... trauma/ stressful event or modelling/ reinforcing a specific threat
      - GENETIC V... tendency to be stressed/ uptight/ irritable
        
        ...this element was overlooked for a long time but recent research has found specific gene involvement
- - - - there is evidence that a single debriefings are harmful as they may expose the trauma without dealing with the distress
- - - - High IQ associated with lower number of traumatic events - buffer? sensibility?
      - higher anxiety increased risk PTSD
  - - - ...to avoid this parents should be responsive to childrens' needs and teach them that they can affect their environment e.g. negotiation with child
    - - RESILIENCE...depends on feeling prepared and in control - this is key to reduce likelihood of PTSD when entering a traumatic experience e.g. Police
      - PREPARATION/ COMMITMENT... Basoglu: torture survivors Turkey: A. innocent falsely accused OR B. guilty and expected/ prepared for event of torture
        
        "psychological preparedness" explained 9% of variance in PTSD between A + B
        
        it is a PF (protective factor)
        
        further evidence... Perrin unaffiliated volunteers most likely to develop PTSD after 9/11 compared to firefighters etc
      - SOCIAL FACTORS
        
        support post-trauma is a PF... it reduces cortisol
        
        Problem solving response v anger/blame key
        
        long exposure to cortisol, caused by stress, exacerbates symptoms
      - Ozer: meta analysis found 7 significant predictors
        
        Perceived threat to life (severity)
        
        Post-trauma support
        
        Family history
        
        Emotional responses
        
        Dissociation... unable to make sense of traumatic experiences or have selective amnesia/ feel that the event 'didn't really happen to me'... these types of cognition predict high likelihood of PTSD
        
        Prior psych adjustment
        
        Prior trauma
        
        TO AVOID PTSD: early/immediate intervention, review trauma and engage with it, positive self-appraisals and understanding of events, working through emotions and being aware of them, social support.