University:
Western Sydney University
Course:
MEDI 2003 | Clinical Sciences 2
Academic year:

2024
Views:

326

Pages:

2
Author:

Mariam A.

Post-traumatic stress disorder         Severe form of anxiety disorder that develops in minority of trauma survivors. Prevalence in Australia is 2.6%. Other populations; refugees up to 30.9 – 80%. Characterised by long lasting anxiety about the memories of a previous severe traumatic event and may experience nightmares, flashbacks, and avoidance of cues that act as reminders of the traumatic event. Criterion A – stressor; person has been exposed to a traumatic event in which both of the following have been present: o The person has experienced, witness, or been confronted with an event or events that involve actual or threatened death or serious injury, or a threat to the physical integrity of oneself or others. o The person’s response involved intense fear, helplessness, or horror. Criterion B – intrusive recollection; at least one of the following ways: o Recurrent and intrusive distressing recollections of the event, including images, thoughts or perceptions. o Recurrent distressing dreams of the event. o Acting or feeling as if the traumatic event were recurring (includes a sense of reliving the experience, illusions, hallucinations, and dissociative flashback episodes, including those that occur upon awakening or when intoxicated). o Intense psychological distress at exposure to internal or external cues that symbolise or resemble an aspect of the traumatic event. o Physiologic reactivity upon exposure to internal or external cues that symbolise or resemble an aspect of the traumatic event. Criterion C – avoidant/numbing; indicated by at least three of the following: o Efforts to avoid thoughts, feelings or conversation associated with the trauma. o Efforts to avoid activities, places, or people that arouse recollections of the trauma. o Inability to recall an important aspect of the trauma. o Markedly diminished interest or participation in significant activities. o Feeling of detachment or estrangement from others. o Restricted range of affect (e.g. unable to have loving feelings). o Sense of foreshortened future (e.g. does not expect to have a career, marriage, children, or normal life-span). Criterion D – hyper-arousal; indicated by at least two of the following:      o Difficulty falling or staying asleep. o Irritability or outbursts of anger. o Difficulty concentrating. o Hyper-vigilance. o Exaggerated startle response. Criterion E: duration (symptoms in B, C and D) need to be >1 month. Criterion F: functional significance, causing clinically significant distress or impairment in social, occupational, or other important areas of functioning. Brain regions implicated: o Hippocampus. o Amygdala. fMRI shows activation in right amygdala is enhanced in PTSD patients compared with trauma-exposed non-PTSD participants during the presentation of emotionally negative pictures. MRI scan of the hippocampus in a PTSD secondary to child abuse shows a 12% reduction in volume when compared to normal control.