war, car accidents, unexpected death of loved one, seeing someone killed/injuried, abuse (physical, sexual, emotion) | ||
enviornmental/social factors (social support), psychological factors (basic assumptions, pre-existing distress, maladaptive coping styles) | ||
personal invulnerability (bad things won't happen to you), world is meaningful and just | ||
avoidant, denial, rumination, drinking, self-isolation | ||
amygdala hypersensitivity, frontal hyporesponsivity, hippocampal atrophy, HPA-SNS decoupling, genetics | ||
greater bloodflow, metabolism and number of dentritic spines = greater, more prevelant response to stimuli resulting in stress | ||
less activity leads to impaired inhibition over amygdala fear processing networks... leads to overreactions to fear | ||
damage leads to reduce ability to turn off the fear response once activated | ||
SNS is hyperactive inproducing NE/E/5-HT, HPA has increased CRH and decreased CORT leading to inability to signal hypothalamus to shut off process | ||
childhood exposure to trauma may permanently alter biological stress response | ||
vulnerability to PTSD is inherited. | ||
expose clients to what they fear to extinguish it, challenge distorted cognitions contributing to symptoms, help clients manage ongoing life problems | ||
systematic desensitization, identify/challenge maladaptive cognitions (causal attributes, control beliefs, dysfunctional global assumptions) | ||
(treat anxiety, sleep problems, irritability); in 5-HT is low then GABA is low. | ||
increase GABA to shut down stress responses |
anxiety disorders: PTSD - theories, treatments
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