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8 criteria for PTSD
- stressor
- intrusion symptoms
- avoidance
- negative alteration in cognitions and mood that began or worsened after the traumatic event
- alterations in arousal and reactivity
- duration
- functional significance
- exclusion
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central idea of PTSD
- a traumatic event establishes a memory that gives rise to a characteristic profile of signs and symptoms
- natural selection ensures that people remember potentially life-threatening experiences
- stress hormones released during the trauma render the central features of the trauma highly memorable
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Psychopathology of PTSD
- recalling traumas involuntarily with the full emotional force of the original experience
- failure of stress symptoms to abate despite the absence of danger
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4 symptomatic clusters of PTSD
- intrusion cluster — re-experiencing symptoms like traumatic nightmares, sensory images
- avoidance cluster — efforts to avoid feelings, thoughts, and reminders of the trauma
- negative alterations in cognitions and mood (emotional numbing, distorted blame of self)
- alterations in arousal and reactivity (exaggerated startle, aggression, reckless behavior, hyper vigilance)
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why is exposure to a stressor necessary to qualify for PTSD
- core symptoms of PTSD possess intentionality (the symptoms are not merely caused by a trauma, they are about the trauma)
- many symptoms overlap with other disorders, but its the memory of the trauma that unites them into a coherent syndrome
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7 risk factors for PTSD
- female sex
- neuroticism
- lower social support
- preexisting psychiatric illness (especially anxiety and mood disorders)
- family history of anxiety, mood, or substance abuse disorders
- neurological soft signs
- small hippocampi
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two types of thoughts about the trauma
- ruminative and intrusive thoughts about the trauma (why did this have to happen to me)
- repetitive and intrusive thoughts of the trauma (vivid sensory flashbacks of the event)
- only intrusive sensory memories qualify as re-experiencing symptoms, not ruminative thoughts
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what counts as traumatic stressor in DSM-III? and how did that change?
- only traumatic stressor falling outside the boundary of everyday experience could produce PTSD, ordinary stressors could not cause PTSD
- BUT most people exposed to traumatic stressors don’t develop PTSD and some that don’t experience those stressors still meet criteria for PTSD
- so the criteria for trauma was broadened in DSM-IV
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compared to traumatic memories, memories of positive events..
- fade in terms of vividness and emotional intensity
- decrease in accuracy over time
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what are dissociative disorders?
- a disruption in the normal memory, identity, consciousness
- feelings of unreality, emotional numbing, time slowing down
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Dissociative Amnesia
- inability to recall important autobiographical information, usually of traumatic or stressful nature
- the more often trauma occurs, more emotionally distressing it is, the more likely they will not remember having suffered any trauma
- dissociated memories cannot be retrieved normally
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Dissociative Identity Disorder
- act as if different personalities seize control of the person at various times
- personalities vary in their behavior, have diff names
- victims sense of self dissociates into multiple identities
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what does dissociative identity disorder arise from?
chronic, severe sexual and physical abuse during childhood
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Depersonalization/Derealization Disorder
- during an episode, people feel emotionally numb + disconnected from body, experience the world as an unreal dream
- onset is usually sudden but some can experience the state for months or years
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