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Psychotherapy: 125b/126b - Trauma and PTSD + Patient

Psychology10 CardsCreated about 2 months ago

This flashcard set reviews how PTSD is associated with heightened regulation of the HPA axis, resulting in low cortisol levels and increased cortisol suppression on dexamethasone testing. It also defines acute stress disorder as occurring within the first month after trauma, often predicting later PTSD, and requiring symptoms such as distressing memories, dreams, and reactions.

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How does regulation of the hypothalamic-pituitary-adrenal axis change in PTSD?

There is excess regulation

  • PTSD patients have abnormally low plasma cortisol levels

    • Increased cortisol suppression during a dexamethasone suppression test

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Key Terms

Term
Definition

How does regulation of the hypothalamic-pituitary-adrenal axis change in PTSD?

There is excess regulation

  • PTSD patients have abnormally low p...

What defines acute stress disorder?

  • Onset in the first month following trauma

  • Predicts later development o...

How is PTSD treated?

  • Psychotherapy

    • Cognitive processing

    • What is the treatment for acute stress disorder?

      Cognitive behavioral therapy

      • Decrease symptom severity

      • What is the role of benzodiazepines in the treatment of PTSD?

        There is none!

        Don’t give them!!

      What is psychogenic amnesia?

      • Retrograde amnesia

        • Cannot recall own identity - “fugue state”

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Psychotherapy: 125b/126b - Trauma and PTSD + Patient
TermDefinition

How does regulation of the hypothalamic-pituitary-adrenal axis change in PTSD?

There is excess regulation

  • PTSD patients have abnormally low plasma cortisol levels

    • Increased cortisol suppression during a dexamethasone suppression test

What defines acute stress disorder?

  • Onset in the first month following trauma

  • Predicts later development of PTSD

  • Diagnosis requires symptoms of

    • Distressing memories, dreams, reactions, phsyiological response

    • Efforts to avoid ^

    • Inability to experience positive emotions

    • Altered sense of reality

    • Sleep disturbance, hypervigilence, problems concentrating

(Many listed to define diagnosis, these are general patterns - not diagnostic)

How is PTSD treated?

  • Psychotherapy

    • Cognitive processing

    • Prolonged exposure

  • Medications

    • SSRI, SNRI, or TCA

    • Prazosin

      • Can help with nightmares

    • Do not give benzos

What is the treatment for acute stress disorder?

Cognitive behavioral therapy

  • Decrease symptom severity

  • Decrease rates of conversion to PTSD

What is the role of benzodiazepines in the treatment of PTSD?

There is none!

Don’t give them!!

What is psychogenic amnesia?

  • Retrograde amnesia

    • Cannot recall own identity - “fugue state”

  • Prognosis is good

    • If the individual manages to avoid being framed for crimes he did’t commit

List 3 neurobiologic changes of PTSD

  • Excess regulation of the HPA axis -> low plasma cortisol

  • Decreased activity in anterior cingulate, ventromedial prefontal cortex -> Dysregulation of amygdala (goes into overdrive)

  • Decreased hippocampal volume

    • ​An effect of PTSD and a factor that predisposes people to PTSD

What syptom differentates acute stress disorder from PTSD?

People with ASD may experience an altered sense of reality of ones surroundings or self

How can PTSD be prevented?

By preventing trauma

(Unfortuantely, after the traumatic event no evidence-based treatment to prevent onset of PTSD)

But if a person has acute stress disorder after trauma, CBT can reduce rates of conversion to PTSD

Describe the natural course of PTSD

  • Onset may be delayed by deckads

  • Prognossis is good for may patients

    • Only 10% experience no change or worsening