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PTSD (Acute Stress Disorder (Who progresses to PTSD? (Post-traumatic…
PTSD
Acute Stress Disorder
A. Exposure to actual/threatened death, serious injury or sexual violence in at least 1 way:
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- witnessing it occurring to others
- learning about it happening
- repeated exposure to details
B. Presence of 9+:
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- Negative mood/cognition: unable to experience + emotion
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effort to avoid distressing memories, thoughts, feelings
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Who progresses to PTSD?
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Low SES, low education, childhood exposure to trauma, childhood adversity, lower IQ, family psych hx
Female gender, younger age
dose of trauma, perceived life threat, personal injury, interpersonal violence, dissociation
military: being a perpetrator, witnessing atrocities, killing the enemy
Post-traumatic factors
temperament - negative appraisal, inappropriate coping, development of acute stress disorder
environment - subsequent exposure to repeated upsetting reminders, subsequent adverse life events, financial or other losses from trauma
PTSD
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need 1 intrusion, 1 avoidance, 2 negative cognition, 2 arousal s/s (6, covering all clusters instead of 9)
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Treatment
CBT
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memory structuring - listen and clarify narrative - repetition can be healing - loses emotional impact as you tell the story again
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Pharm
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paroxetine, sertraline, fluoxetine
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benzos may help sleep, but possible worsening of s/s after discontinuation
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Epidemiology
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highest rates: rape survivors, military combat, genocide
50-90% of population may be exposed to traumatic events during their lifetime --> most do NOT develop PTSD