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Questions and Answers
Which of the following characteristics is NOT associated with PTSD as defined in the DSM-III?
What main factor did Breuer and Freud contribute to the understanding of trauma?
Which of the following was a criticism of the evolution of PTSD definitions?
What is considered a risk factor for developing PTSD, based on meta-analysis findings?
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Which of the following models did Freud NOT propose regarding trauma?
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What aspect was removed from the PTSD diagnosis criteria in the DSM-5?
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Which factor is NOT typically identified as influencing the prediction of PTSD outcomes?
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What is indicated by the term 'traumatisation' in the relational view of trauma?
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What does the Ecology of Trauma Model suggest shapes traumatisation?
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Which type of trauma is associated with cumulative victimisation from the caregiving system?
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Which of the following is considered a characteristic of Complex PTSD (cPTSD)?
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What role does social support play in trauma vulnerability?
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What is the primary focus of attachment theory according to John Bowlby?
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Which of the following describes the concept of 'mentalisation' in attachment theory?
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What is one of the common risk factors identified for Borderline Personality Disorder (BPD)?
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In Bowlby's attachment theory, which concept refers to the caregiver's role in mirroring a child's emotions?
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How does cPTSD differ from PTSD in terms of trauma exposure?
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What is dissociation in the context of complex trauma?
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Which of the following is NOT associated with complex trauma?
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Complex trauma is particularly linked to which of the following factors?
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What is a key component of recovery from childhood trauma?
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In understanding mental states, which process is essential for children?
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What is a key criticism of including non-life-threatening events in the PTSD criteria?
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Which statement best captures the essence of 'delayed onset trauma'?
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In addressing the role of community in trauma recovery, which aspect is highlighted?
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How does the ecological model of trauma view the influences on an individual's experience of trauma?
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What is a common environmental factor that can enhance resilience in the face of trauma?
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Which cultural concept of distress influences how individuals interpret traumatic experiences?
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In terms of childhood trauma recovery, which approach is most recognized as effective?
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How do cultural beliefs influence trauma recovery according to recent findings?
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What role do environmental variables play in the context of trauma according to Harvey's model?
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Which factors are included in the ecological view of trauma?
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What aspect of childhood trauma does D’Andrea et al. highlight in their research?
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According to the ecological model, what is the interaction of the person, event, and environment crucial for?
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What is indicated by the DSM-5's mention of 'cultural concepts of distress'?
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Select which are components of cPTSD:
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Which is not a risk factor for BPD?
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When viewing distressing images, what did BPD and PTSD patients experience?
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Study Notes
Trauma
- Trauma is a complex experience, with various types such as betrayal and cumulative trauma.
- Trauma is not predictable and its impact is different for everyone.
- The history of trauma in psychology goes back to the 19th century, where hysteria was studied.
- Diasthesis-stress model: Individuals with psychological vulnerabilities are more susceptible to trauma.
- Hysterics: Lacking integrative capacity and mental energy, they experience splitting of consciousness and subconsciousness, leading to conditions like dissociative identity disorder.
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Breuer and Freud: Studied hysteria, focusing on the connection between traumatic events and repressed memories.
- Breuer: Hypnoid states combined with trauma events led to memory splitting.
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Freud: Two models:
- 'Unbearable situation' model: Overwhelming events lead to repression and splitting of memories.
- Conflict model: Repression of intense desires.
- World War 1: Introduced terms like 'shell shock' and 'traumatic neurosis', characterizing a wide range of symptoms including amnesia, confusion, exhaustion, and physical presentations.
DSM and PTSD
- DSM-III: PTSD was initially classified as an anxiety disorder, requiring a distressing event exceeding normal experiences.
- DSM-IV: Expanded to include developmentally inappropriate experiences without violence or injury.
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DSM-5: Removed the need for an emotional reaction during the traumatic event and acknowledged that fear doesn't predict PTSD.
- Added symptoms like persistent negative alterations in mood and cognition.
- Expanded Criterion A to include first-hand repeated or extreme exposure, such as first responders.
Trauma Research: Challenges and Criticisms
- PTSD onset: Typically occurs within the first three months after trauma, although delayed onset (months or years) is possible.
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Criticisms of Trauma Research:
- Expanding PTSD criteria may devalue its original meaning.
- Concept creep: Pathologizing 'normal' stress responses.
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Difficulties with Trauma Research:
- Correlation vs. Causation: Difficult to establish direct causal links.
- Retrospective studies: Rely on memory and subjective recall.
- Predicting specific outcomes is challenging.
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Trauma as an event: Exposure to trauma is common, yet PTSD is relatively rare.
- Traumatisation is highly subjective.
- Relational View of Traumatisation: Traumatic events are not inherently traumatic but rather depend on their impact on the individual.
Trauma Risk Factors
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PTSD Risk Factors for Adults (meta-analysis):
- Lack of social support
- Life stress
- Severity of trauma
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Harvey's Ecology of Trauma Model:
- Vulnerability: The combination of the individual, the event, and the environment determines the level of trauma.
- Social support and cultural beliefs play a significant role in resilience.
- Examples: Aboriginal kinship can be protective against disadvantage and intergenerational trauma.
Interpersonal Trauma and Childhood
- Interpersonal trauma: Events involving close relationships may be more traumatising than impersonal events like natural disasters.
- Childhood victimisation: Diverse forms of abuse and neglect can have lasting effects.
Trauma and Attachment Theory
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John Bowlby:
- Psychoanalytic background, studying war-orphans and maternal deprivation.
- Attachment is a universal and innate need.
- Ethological approach: Attachment is a crucial mechanism that enhances the likelihood of survival by ensuring close bonds between caregivers and offspring.
- Secure attachment: Common in most infants.
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Cross-cultural evidence: Attachment theory is well-supported in Western cultures.
- Allo-parenting: Multiple caregivers common in other societies.
- Attachment is still present in diverse cultures.
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Attachment: Risk and Protective Factors:
- Internal working models: Beliefs about self and others formed through early experiences.
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Attachment and Personality Development:
- Mentalization: Understanding self and others through mental states.
- Mirroring: Caregiver reflecting the child's emotions, helping them understand their own and others' minds.
- Containment: Caregiver showing understanding of the child's emotions while remaining calm, demonstrating that emotions are bearable.
Complex Trauma
- Also known as attachment trauma, type II trauma, early relational trauma, and developmental trauma.
- Involves cumulative victimisation: Perpetrated by the caregiving system.
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Commonly associated with:
- Violence in relationships where safety should be provided.
- Child maltreatment.
- Betrayal of trust by caregivers.
- Intentional violation of bodily boundaries.
- Intentional and inescapable acts creating a fundamental insecurity.
Complex PTSD (cPTSD)
- A proposed condition (not in the DSM).
- Characterized by affect dysregulation, identity alterations, and relational impairment (A-I-R).
- Results from chronic exposure to interpersonal stressors.
- Distinct from PTSD: PTSD arises from acute, impersonal or interpersonal traumatic stressors and can occur at any time in life.
Complex Trauma and Dissociation
- Dissociation: A disconnection between bodily states and emotional experiences.
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Commonly associated with cPTSD:
- Examples: Identity confusion, dissociative amnesia.
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Meta-analyses: High dissociation levels found in borderline personality disorder (BPD) and PTSD.
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BPD as a trauma-related disorder?:
- BPD individuals are more likely to report childhood adversity compared to non-clinical controls and other psychiatric groups.
- Brain activation similarities between BPD and PTSD during exposure to distressing images.
- Risk factors for BPD:
- Social: Low socioeconomic status, stressful life events, family adversity.
- Maternal psychopathology.
- Family: Affective parenting (low warmth, hostility, harsh punishment).
- Maltreatment.
- Individual differences: Low IQ, high negative affectivity, and impulsivity, internalising and externalising psychopathology can influence trauma outcomes.
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BPD as a trauma-related disorder?:
Understanding Mental States
- Children learn to understand their own minds and the minds of others through interactions.
- This process involves recognizing and interpreting mental states, which helps children develop self-regulation.
Complex Trauma
- Complex trauma is a significant consequence of cumulative trauma experienced within the caregiving system during childhood.
- This type of trauma involves repeated, polyvictimization experiences, often by those expected to provide safety and stability.
- Key examples of events leading to complex trauma include child maltreatment, betrayal of trust by caregivers, intentional violation of bodily boundaries, and violence in relational contexts.
Ecology of Trauma Model
- The environment plays a crucial role in shaping and influencing the impact of trauma.
- The "Ecology of Trauma Model" considers person, event, and environment variables that interact with each other in the context of trauma.
- It emphasizes the importance of culture, social, and political factors in shaping trauma vulnerability and resilience.
Interpersonal Trauma and Childhood
- The definition of trauma in childhood has evolved from a focus on objectively threatening events to include subjectively experienced trauma.
- Trauma now encompasses experiences that may not be life-threatening but still cause a significant impact on development and well-being.
- The DSM-IV expanded the definition of trauma to include developmentally inappropriate experiences that do not necessarily involve violence or physical injury.
PTSD Onset
- PTSD can occur at any age, including the first year of life.
- The timeframe for PTSD onset is typically within the first three months following the traumatic event, but delayed onset is possible.
- "Delayed expression" refers to a delayed fulfillment of the diagnostic criteria for PTSD, even after a significant amount of time.
Criticisms of Trauma Research
- There are concerns about the expansion of the trauma definition, which may lead to trivializing the experience of genuine trauma.
- "Concept creep" refers to the tendency to medicalize normal stress responses, potentially pathologizing everyday experiences.
- Some argue that the broadening of the trauma definition has resulted in an over-diagnosis of PTSD.
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Description
This quiz explores the complex nature of trauma, its historical context, and psychological models. You'll learn about the different types of trauma and key figures like Breuer and Freud who contributed to the understanding of traumatic experiences. Test your knowledge on how trauma impacts individuals differently.
