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abnormal exam 1
| Question | Answer |
|---|---|
| for how long has PTSD been formally recognized as a disorder | since 1980 about 40 years 1980 is when lots of research started; around vietnam |
| lots of PTSDs hisotry comes from combat | |
| what did PTSD as a diagnosis emerge from | converging social and political movements rather than academic, clinical, or scientific initiatives makes it unique from other disorders as a result of this root, it was received with some controversy and had a contentious reception |
| PTSD used to be misattributed as | cowardice |
| when’s the earliest mention of PTSD | has been with us as long as wars have been fought, for as long as we’ve existed |
| symptoms of nostalgia | melancholy incessant thinking of home (desire to leave war) disturbed sleep or insomnia loss of appetite anxiety cardiac palpitations (also saw deaths, suicide or self neglect, tied to this) |
| who coined the term nostalgia and why | in 1678, swiss physician Johannes Hofer to describe symptoms seen in swiss troops he used it to describe people deployed far from home |
| why did people have nostalgia | because they wanted to leave and return home |
| what was hofers solution to nostalgia | send em home |
| soldiers heart | chest thumping (tachycardia), anxiety, breathlessness (hyper arousal) that appeared in soldiers also known as da costas syndrome |
| who coined soldiers heart and when | Jacob Mendes Da costa in 1871 |
| when were ptsd like symptoms actually addressed and looked into | civil war |
| goal of diagnostic terms | to encompass experiences of everyone |
| how were people with ptsd like symptoms viewed | as weak, or cowards needed to toughen them up |
| symptoms of shell shock | staring eyes (thousand yard stare) violent tremors (rigid limbs) blue, cold extremities unexplained deafness, blindness, or paralysis |
| why was it called shell shock | bc war weapons changed, artilerry was now the pain one used, so they thought it was tied to that maybe a reaction (brain damage) to the blasts |
| how and when did we start treating shell shock | 1917 the US Army surgeon generals office created a comprehensive treatment program where they placed psychiatrists in combat units (forward psychiatry) |
| forward psychiatry | attempt to treat soldiers on the front lines the belief was that if you removed them from the front lines, they couldnt’wouldnt return so if you took them away they wouldn’t recover as well |
| ww1 shell shock treatment was centered on | proximity (treating close to battle ) immediacy (treating soon as possible) simplicity (providing simple treatment such as rest, a warm shower, and food)(dont wanna make em too comfy) expectancy (expect they’ll return to fight after treatment) |
| faradization | treatment for shell shock in ww1 basically etc shock therapy they also used hypnosis and whatnot |
| what was ptsd called in ww1 | shell shock |
| what was ptsd called in ww2 | combat fatigue |
| what portion of medical discharges did combat fatigue account for | 40% pretty sizeable the military was concerned about it because it meant losing soldiers |
| what came about during ww2 | growing recognition that. it was a rxn to extreme stress that could affect anyone (not a moral weakness) unit cohesion was recognized as a factor in resilience understanding that duration and intention of combat exposure increased risk more on slides |
| when did PTSD first appear in the DSM/when was it first recognized as a diagnosis | 1952 in the DSM 1 |
| what was ptsd called in the dsm1 | gross stress reaction it was seen as a response to extremely stressful situations not super specific |
| transient situational disorders | trauma related disorders were lumped together into this category in the dsm 2 includes adjustment disorders trauma disorders no longer had their own thing |
| what happened when the dsm 2 was released | gross stress reaction was removed from the dsm so there was now no recognized diagnosis for long term trauma right as activity in vietnam was ramping up |
| why was gross stress reaction removed from dsm | its not clear |
| did the belief of a need for toughness end when ptsd entered the dsm | no in recruitment for vietnam they still promoted it (about 1970) |
| treatment in vietnam | 1968 veterans were treated for “Post Vietnam Syndrome”, which is like ptsd today informed if their symptoms lasted more than 6 months after return, they had a preexisting condition and problem was not service connected |
| how did the way vietnam veterans were handled affect things | the whole thing about it being a preexisting syndrome was hella invalidating it led to a decade of struggle for formal recognition of the psychological impact of war and the needs of veterans |
| when was PTSD first recognized as a diagnosis | in the dsm 3 in 1980 |
| how was ptsd defined in the dsm 3 | an event that is “outside the range of usual human experience that would be markedly distressing to almost anyone |
| how was ptsd initially categorized | as an anxiety disorder |
| why was ptsd first officially introduced | after certain movements Holocaust victims, vietnam veterans, mandated reporting of abuse, feminist movements to shed light on domestic violence… they needed something to encapsulate all of this, it wasn’t just war veterans now |
| ptsd changes in dsm 3 r | there was clearer organization of symptoms around three dimensions of stress response there were inclusions of symptoms specific to children and specification of onset and duration of the disorder added duration criteria, had to last @ least a month |
| what were the 3 dimensions of stress response in dsm 3 r | reexperiencing avoidance and numbing physiological arousal |
| ptsd criteria in the dsm 4 | 1994 mostly consistent with the dsm iii r added specifier: symptoms must cause significant distress or impairment we still retain this, the idea that it has to be distressing to be a disorder expanding, were getting more specific/precise |
| dsm 5 | 2013 ptsd moved out of anxiety disorders and into “Trauma and Stressor Related Disorders” category additional symptoms were added, like relating to self blame shift from 3 to 4 clusters of symptoms (there were about 20 symptoms now, pretty expansive |
| why were people upset about the movies of ptsd out of anxiety disorders | treatment was aimed at the anxiety |
| dsm 5 tr | 2022 ptsd kept the same but prolonged grief disorder was added into the category this was recognition of how trauma can impact grief |
| criticisms of the ptsd construct | it needlessly pathologizes normal reactions it is not a legit diagnosis its a euro american culture bound syndrome it primarily serves a litigious rather than clinical purpose traumatic memories are not valid or reliable |
| why does it matter how we define trauma | it has important practical applications for compensation and disability how we define trauma determines if you can be classified as having ptsd could not be qualified for service compensation |
| one thing that makes ptsd unique | its one of the few mental health diagnoses that identifies an external event as a prerequisite for the disorder expanding one of the few times we can say your mental health issue was tied to this |
| no trauma exposure= | no ptsd |
| criterion A | the gatekeeping criteria the trauma exposure criteria a necessary BUT NOT SUFFICIENT condition |
| neccessary but not sufficient meaning | you need it to qualify but having it doesnt automatically mean you have it just because you have the trauma doesnt mean you have ptsd |
| criterion A in the dsm 3 | 1980 “existence of a recognizable stressor that would evoke significant symptoms of distress in almost everyone” the stressor is outside the range of normal experiences excludes bereavement, chronic illness, marital conflict, business losses |
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