1. Etiology of PTSD

2. 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 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

7. 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)

12. – 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=M5UE69o99l o http://www.youtube.com/watch?v=M5UE69o99l o

13. 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

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

16. 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 http://www.youtube.com/watch?v=rYc7Ey- kO-0