everything first responders need to know about ptsdmed.brown.edu/pedisurg/kiwanis2013/ptsd.pdf ·...
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Everything First Responders Need to Know About PTSD
Nicole R. Nugent, Ph.DStaff Psychologist RIH Bradley/Hasbro Children's Research Center
Assistant Professor (Research) DPHB Alpert Brown Medical School
Disclosures
No financial conflict of interest
What is PTSD? Criterion A: TraumaDeath, threatened death, serious injury, sexual
violence Criterion B: Intrusion (1) Intrusive memoriesNightmaresDissociative reactions (i.e., flashbacks)Distress at remindersPhysiologic reactivity at reminders
Criterion C: Avoidance (1)Thoughts or feelingsReminders
What is PTSD? Criterion D: Negative Cognitions & Mood (2)Dissociative amnesia for eventPersistent negative beliefs about self and worldPersistent blame of self or othersPersistent negative trauma-related emotionsDiminished interest in pre-trauma activitiesFeeling alienated from othersConstricted affect
Criterion E: Altered arousal/reactivity (2) Irritable/aggressive behaviorSelf-destructive / reckless behaviorHypervigilanceExaggerated startlePoor concentrationSleep problems
PTSD Prevalence Overall 13-45% children
Traffic Accidents1-4 months - 12-46% children4-12 months - 13-25% children
PICU Admits5-28% children10-21% parents
Sexual Abuse34-58% children
Acute Predictors of PTSD Predictors you can’t change:Death of a loved onePrior traumaPrior mental health concernsFemale genderFamily SESBiological predictorsAspects of trauma:InterpersonalInjury mechanism rather than “severity”Parental presence
Acute Predictors of PTSD Predictors you can change:Parent presence/supportProvision of resources for parentsActive thought suppressionWillingness to talkHandling early avoidancePain managementIdentification/referral of kids having
difficulty
From: Screening for Risk of Persistent Posttraumatic Stress in Injured Children and Their ParentsJAMA. 2003;290(5):643-649. doi:10.1001/jama.290.5.643
Referral for Intervention Preventing PTSDChild and Family Traumatic Stress Intervention
Treating PTSDTrauma Focused Cognitive Behavioral Therapy
Secondary Traumatic Stress Firefighters: 13-18% PTSD
EMTs and Other Disaster Workers:25% PTSD
Coping with secondary trauma:
Resources Learn more: National Child Traumatic Stress Network
(NCTSN) Resources to share:See NCTSN siteSesame StreetSAMHSA
Local resources:Family Services of Rhode IslandLifespan Child and Adolescent Psychiatry
Contact Info:Nicole R. Nugent, PhD
Assistant Professor (Research)
Bradley/Hasbro Children’s Research CenterRhode Island Hospital
nnugent@lifespan.orgNicole_Nugent@brown.edu
Department of Psychiatry and Human Behavior
Brown Medical School
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