Trauma & Stress Disorders Overview

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Questions and Answers

Which statement accurately describes the prevalence of PTSD in different regions?

Asia has the highest prevalence rate at 9.2%.

The Netherlands has a prevalence rate of 9.2%.

Canada has a higher prevalence rate than the Netherlands. (correct)

Asia's prevalence rate is higher than that of the Netherlands.

According to historical data, which is true about the course of PTSD recovery?

Recovery rates increase significantly after two years.

Most individuals fully recover within six months.

50% recover within three months. (correct)

Over 75% recover within the first month.

How does the DSM-5 redefine traumatic events in relation to PTSD?

Traumatic events must involve direct physical harm.

Only physical injuries are considered traumatic.

It includes threats to life, serious injury, and additional events for specific populations. (correct)

Only events involving direct personal experience qualify as trauma.

Which factor related to gender is true regarding the risk of PTSD?

Women report trauma differently due to emotional expression. Signup and view all the answers

What does the concept of nonspecificity in PTSD imply?

Most who experience traumatic events will not develop PTSD. Signup and view all the answers

In terms of second-hand trauma, which situation could be considered traumatic?

Hearing about the death of a close person. Signup and view all the answers

What is a potential consequence of not conducting imaginal exposure professionally?

It could lead to increased fear and distress. Signup and view all the answers

What is one reason why Critical Incident Stress Debriefing might be harmful?

It can lead to premature exposure to trauma. Signup and view all the answers

Which criterion is NOT included in the ICD-11 diagnosis of Complex PTSD?

Intrusive memories Signup and view all the answers

What is a possible consequence of eliminating Criterion A from PTSD diagnosis?

Greater ambiguity in defining trauma. Signup and view all the answers

Which of the following represents a misconception about the treatment of PTSD?

All individuals are expected to recover quickly with therapy. Signup and view all the answers

Which aspect does NOT relate to the historical trauma case study of residential school trauma?

Inherent evil in human nature. Signup and view all the answers

What does cognitive processing therapy primarily address?

Beliefs influenced by traumatic experiences. Signup and view all the answers

Which treatment modality focuses on addressing dysfunctional sensory encoding and negative appraisals before they become entrenched?

Preventive trauma-focused CBT Signup and view all the answers

What defines Complex PTSD in relation to a trauma history?

Childhood exposure to chronic trauma. Signup and view all the answers

What is considered Criterion A for diagnosing PTSD?

Exposure to a catastrophic event Signup and view all the answers

What is significant about the recovery rate of PTSD after two years?

The prognosis becomes guarded, with persistent symptoms. Signup and view all the answers

Which statement regarding the prevalence of PTSD is true?

Prevalence varies greatly depending on the type of trauma experienced Signup and view all the answers

According to the content, what percentage of individuals with military combat experience were formally diagnosed with PTSD over time?

17% Signup and view all the answers

What is one of the key treatment modalities recommended for PTSD?

Trauma-focused therapy Signup and view all the answers

Which pharmacological treatment is commonly used to address PTSD symptoms?

SSRIs like Paroxetine Signup and view all the answers

What percentage of individuals is estimated to recover completely from PTSD?

40% Signup and view all the answers

What is a common misconception about events leading to PTSD?

Natural disasters are the leading cause of PTSD Signup and view all the answers

Which modality allows individuals to relive trauma memories safely to reduce associated fear?

Imaginal exposure Signup and view all the answers

What can be a significant consequence of residential schools on Indigenous populations?

Emotional numbness and suppression Signup and view all the answers

Which feature is NOT typically included in the arousal and reactivity symptoms of PTSD?

Emotional numbing Signup and view all the answers

Which of the following is a symptom of Criterion B for PTSD?

Flashbacks and intrusive memories Signup and view all the answers

What does the term 'Complex PTSD' refer to?

PTSD associated with multiple or prolonged traumatic experiences Signup and view all the answers

What cognitive alteration is associated with PTSD?

Exaggerated beliefs about self and the world Signup and view all the answers

Which of the following is NOT a criterion for diagnosing PTSD?

Excessive emotional expression Signup and view all the answers

How does historical trauma influence the emotional development of subsequent generations?

It inhibits the ability to show love and support Signup and view all the answers

What does Criterion C of PTSD diagnose?

Avoidance of trauma-related stimuli Signup and view all the answers

Which societal factor is a risk for developing PTSD according to the information provided?

Low social support Signup and view all the answers

Which treatment philosophy is often criticized for not considering cultural differences?

Western therapeutic models Signup and view all the answers

What is a common behavioral consequence related to trauma exposure in Indigenous populations?

Substance abuse as a coping mechanism Signup and view all the answers

Which statement best describes the treatment challenges faced by individuals with C-PTSD?

They may face cultural mismatches in therapeutic settings. Signup and view all the answers

What is a prominent symptom cluster added in the diagnosis of C-PTSD compared to PTSD?

Negative self-concept Signup and view all the answers

Which of the following statements reflects the impact of societal structures on Indigenous communities?

Societal punishment for violence perpetuates intergenerational trauma. Signup and view all the answers

What factor is considered a contributor to higher rates of C-PTSD in survivors of residential schools?

Lack of access to cultural practices Signup and view all the answers

Study Notes

Trauma & Stressor-Related Disorders are caused by catastrophic or aversive life events.
They cause more impairment than expected.
Variability exists in how individuals respond to events.

Post-traumatic Stress Disorder (PTSD)

PTSD is categorized by exposure to a traumatic event involving actual or threatened death or serious injury to self or others.
Most common traumatic events are interpersonal, such as sexual assault, physical assault/abuse, combat, torture, and genocide.
Less common sources of PTSD involve natural environmental events, such as floods and earthquakes.
PTSD is associated with four symptom clusters: Intrusion symptoms, Avoidance of trauma-related stimuli, Negative alterations in cognitions & mood, and Marked alterations in arousal and reactivity.

Criterion A: Exposure to traumatic event

Interpersonal trauma is the most common cause of PTSD.
Individuals struggling with PTSD often have difficulty accepting the fact that others would hurt them.

Criterion B: Intrusion symptoms

Intrusion symptoms include memories, images, dreams, and nightmares related to the event (not always the exact event) that often contain common themes.
Flashbacks are common among combat victims.
Images can involve dissociation.
Intrusive symptoms are often cued by trauma stimuli.
Physiological reactivity and physiological distress to trauma cues also occur.

Avoidance occurs cognitively and environmentally.

Criterion D: Negative alterations in cognitions & mood

Individuals may develop exaggerated beliefs about themselves and the world.
Persistent negative emotions, detachment, and an inability to feel pleasure (emotional numbing) can occur.

Criterion E: Marked alterations in arousal and reactivity

Symptoms include hypervigilance, startle response, concentration problems, sleep disturbance, irritability, and self-destructive actions.
Individuals may try to protect themselves in ways that are not safe, such as driving fast after a car accident under the belief that they are a “less likely to hit a moving target”.

Treatment of PTSD

Avoidance or attempts to avoid trauma-related stimuli is common.
Biological treatments include SSRIs, such as Paroxetine, which may increase neurogenesis.
Trauma-focused therapy is considered the gold standard for PTSD treatment.
Prevalence rates of PTSD vary geographically, with the USA at 8.7% and Asia at 1%.
Common events that lead to PTSD in civilians include rape, assault, emergency work, and motor vehicle accidents (MVA).
Common events related to combat include captivity, torture, and genocide.
PTSD can occur at any age, but is less common in older individuals.
Females are more likely to be at risk for PTSD than males, possibly due to a higher incidence of traumatic events in women.
Some argue that women are more likely to report their distress.
Men may manifest trauma in different ways, such as through anger.
The recovery rate for PTSD is 50% within 3 months, but declines after that time.
The incidence rate of PTSD also falls off at a slow rate.
After 2 years, the prognosis for recovery is guarded and individuals may continue to experience significant symptoms.

Controversies of PTSD

The definition of a traumatic event has evolved over time, leading to a broad vs narrow definition debate.
The broad definition of trauma exposure increased from 68% to 89%.
The DSM-5 introduced a requirement for a threat to life or serious injury for events to qualify as trauma, with additional criteria for specific populations.
The nonspecificity of PTSD symptoms creates an overlap with other disorders, such as depression.
Legal issues related to PTSD include questionable/unsubstantiated claims, reliance on self-report, and the assumption that symptoms are caused by the event.
The debate about whether "traumatic events" should be eliminated from the PTSD criteria is ongoing.
Second-hand events, such as hearing about the death or severe injury of a close person, could constitute trauma.

Complex PTSD (C-PTSD)

C-PTSD is not included in the DSM-5, but is listed in the ICD-11.
C-PTSD involves prolonged or chronic exposure to trauma that shapes an individual’s sense of self and disrupts self-organization.
Childhood abuse is the most common cause of C-PTSD.
It has the highest levels of comorbidity with depression and anxiety.
Individuals with C-PTSD demonstrate the lowest levels of psychological well-being.

Diagnosis Criteria of the ICD-11 for C-PTSD

The criteria for C-PTSD include the PTSD criteria + 3 other symptom clusters:
Affect dysregulation- Individuals often have difficulty expressing emotions due to limited exposure to emotional regulation strategies in childhood.
Negative self-concept- Individuals may experience shame and self-hatred.
Disturbances in relationships - Individuals may struggle with relationships due to their experiences with abuse.
The intergenerational transmission of C-PTSD can occur when individuals who have experienced trauma are unable to provide love and support to their children.

Case Study: Residential School Trauma

The cultural clash between Indigenous and Western cultures led to the harmful policies and practices of residential schools.
Differences in cultural perspectives on human nature, relationship to the environment, and cultural practices contributed to the negative impact of residential schools on Indigenous communities.
The impact of residential schools on Indigenous survivors include emotional suppression, numbness, lack of emotional awareness, difficulty expressing emotions verbally, difficulty modulating thoughts, emotions, and behaviors, impulsive violence, socio-cultural shame, and attraction to alcohol and drug use to numb pain.

PTSD vs C-PTSD

While both PTSD and C-PTSD involve exposure to a traumatic event, C-PTSD presents with additional symptom clusters:
- Affect dysregulation
- Negative self-concept
- Disturbances in relationships
The intergenerational transmission of trauma is highly relevant when examining the impact of C-PTSD on Indigenous communities:
- Individuals who are traumatized may be less able to care for their children, resulting in intergenerational cycles of trauma.
- The normalization of abuse through generations can perpetuate harmful behaviors.
Western approaches to trauma do not always consider cultural differences and differences in cultural practices and beliefs.
Legal approaches to violence and abuse in Western society often focus on punishment and isolation, which can perpetuate trauma by creating a disconnect between individuals and their communities.
The treatment philosophy for C-PTSD requires a nuanced understanding of cultural perspectives and the impact of trauma on individuals and communities.

Criterion F: Impairment or Distress

Impairment is a significant factor in the diagnosis of PTSD.
Initially, 50-60% of men who served in combat experienced PTSD, but only 17% are now substantially impaired by it.

Clinical Picture

Prevalence rates of PTSD in the USA are 8.7%, with a point prevalence determined by questionnaires, while 3.5% meet the diagnostic criteria.
The text does not mention prevalence rates for gender.
The impact of trauma is complex and varies depending on individual susceptibility and the toxicity of the event.
While a Criterion A1 event is necessary for a PTSD diagnosis, it is not a sufficient condition.

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Description

Explore the concepts of Trauma and Stressor-Related Disorders, focusing on their causes and effects on individuals. This quiz covers PTSD, including its symptoms, common causes, and the importance of understanding individual responses to traumatic events.