1. 1. Classified as an anxiety disorder. After trauma exposes the victim to actual or threatened death or serious injury, 3 dimensions of PTSD unfold: (1) reexperiencing the event with distressing recollections, dreams, flashbacks, and/or psychologic and physical distress; (2) persistent avoidance of stimuli that might invite memories or experiences of the trauma; and (3) increased arousal (Vieweg et al, 2006) Post traumatic stress disorder 1
2. 2. Post traumatic stress disorder 2
3. 3. Research into the pathophysiology of PTSD has focussed on areas of the brain associated with fear processing and memory: - Amygdala, Hippocampus, Medial prefrontal cortex There is still uncertainty over the patho- physiology of PTSD. Hypothesised that PTSD represents a failure of the prefrontal-anterior networks to regulate the amygdala resulting in hyper-reactivity to threat. Pathophysiology of PTSD 3
4. 4. Where would you see the physiotherapists role in helping people with PTSD? QUESTION 4
5. 5. 1) genetic factors and gene by environment interactions; 2) developmental/childhood factors; 3) neurobiological risk and resilience factors; 4) psychological risk and resilience factors (e.g., coping style, personality); 5) cognitive/behavioral risk and resilience factors (e.g., processing information and appraisal of information); 6) social factors. Pathophysiology only one part of the picture 5
6. 6. Through this session you have: Considered and practically utilised relevant outcome measures to identify common mental health conditions. Gained a brief overview of the pathophysiology of common mental health conditions. Discussed the practical application of this knowledge to physiotherapy practice. Considered other influences on individuals mental and emotional health. Overview 6
7. 7. Vieweg WV, Julius DA, Fernandez A, Beatty-Brooks M, Hettema JM, Pandurangi AK. (2006) Posttraumatic stress disorder: clinical features, pathophysiology, and treatment, American Journal of Medicine, 119 , 5, 383-390. Hasler, G. (2010) Pathophysiology of depression: do we have any solid evidence of interest to clinicians?. World Psychiatry, 9, 3, 155161. NIMH (2013) Signs and symptoms of depression, accessed 18/02/2013 @ 11.30 am http://www.nimh.nih.gov/health/publications/depression/what-are- the-signs-and-symptoms-of-depression.shtml CNS Forum accessed 18/02/2013 @ 10:00am http://www.cnsforum.com/ References 7