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Etiology of PTSD

Etiology of PTSD. Biological Causes. Role of Noradrenalin : increased levels = more open expression of emotion Geracioti (2001): PTSD subjects had higher NorAd levels than non-PTSD subjects; adrenal stimulation = panic attacks (70%) and flashbacks (40%) vs. 0% in both controls

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Etiology of PTSD

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  1. Etiology of PTSD

  2. Biological Causes • Role of Noradrenalin: increased levels = more open expression of emotion • Geracioti (2001): PTSD subjects had higher NorAdlevels than non-PTSD subjects; adrenal stimulation = panic attacks (70%) and flashbacks (40%) vs. 0% in both controls • Bremner (1998): PTSD subjects had increased sensitivity of Norad receptors

  3. As cortisol levels decrease, norepinephrine levels increase resulting in an inability to regulate and recover from fight/flight responses

  4. Brain Areas Affected by PTSD

  5. Genetic Implications • Kolassa (2010): Val158Met polymorphism, gene for encoding the enzyme catechol-O-methyltransferase (COMT) levels affect Norad and Dopamine release during stress • Helps explain how two people can experience the same trauma and not both show symptoms of PTSD

  6. Cognitive causes • Thoughts of “lack of control” suggest external locus of control and survivor guilt • Intrusive/pervasive thoughts come from “cue dependent memory” (Berwin et al 1996) • Rizzo: flooding therapy, “virtual Iraq” aided coping, recovery and “Habituation” (gradual fading of stress reactions)

  7. Internal locus of control reduces PTSD; External LOC increases PTSD • Sutker et al (1995): soldiers with purpose/commitment to military/mission have lower rates of PTSD (Internal) • Can be linked to attributional style and Beck’s “cognitive schema” ideas on depression (Internal) • Suedfeld (2003): Holocaust survivors with external LOC more likely than controls to experience PTSD and also show low trust and a skeptical world view • http://www.youtube.com/watch?v=M5UE69o99lo

  8. Sociocultural causes • Suggests racism/prejudice/oppression are predisposing factors • Roysircar (2000): meta analysis showed ethnic differences in PTSD rates for Vietnam vets; black 20.6%, Hispanic 27.6%, white 13% • Dyregov: Rwandan kids: threatened with death #1 cause of intrusive thoughts and withdrawal behavior • Bosnian research 1998: 73% of girls (higher due to additional threat of rape, Kaminer et al 2000), 35% of boys from Sarajevo showed PTSD

  9. Somatic symptoms of PTSD commonly treated across all cultures • Body Memory Symptoms: non-western, physical ailments solely from psychological causes (see Somatoform disorders)

  10. Gender Considerations • Horowitz et al (1995): risk is 5x greater for women than men • Breslau et al (1991): 1007 kids exposed to violence PTSD rates: 11.3% in girls, 6% in boys • Different symptoms: Men show irritability, impulsiveness and aggression, substance abuse (external symptoms); women show numbing, withdrawal and avoidance/anxiety (internal symptoms) • http://www.youtube.com/watch?v=rYc7Ey-kO-0

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