Download Neurology and Trauma Impact and Treatment Implications Damien Dowd & Jocelyn Proulx

Neurology and Trauma
Impact and Treatment
Implications
Damien Dowd & Jocelyn Proulx
HPA - Axis

Hypothalamus


Corticotropin-releasing hormone
Pituitary gland
Beta-endorphins – pain suppression
 Adrenocorticotropic hormone

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Adrenal gland

Cortisol
Effects of Beta Endorphins
Avoiding stimuli reminiscent of the event
 Emotional numbing
 Loss of interest in daily activities
 Detachment from others

Effects of Cortisol



Dysregulation of cortisol
levels
Low levels interfere with
ability to process the
event into long term
memory leading to
flashbacks and intrusive
memories
High levels can lead to
hypersensitivity to
psychologically
threatening stimuli
Hippocampus
Formation of
memories
 Stress regulation

Medial Prefrontal Cortex



Decisions about
appropriate or required
cognitive, emotional or
behavioural responses
Suppresses or
modified emotional
responses generated
by the amygdala
Filtering of information
Genetic Markers
Family mental health
 Cortical dysfunction
 Smaller hippocampus
 Larger cavum septum pellucidum
 Serotonin and dopamine systems

Treatment Approaches

Drug Therapies
Serotonin re-uptake inhibitors
 Drugs reducing corticotropin-releasing
hormone
 Antidepressants

Cognitive Behaviour Therapies

Exposure therapy

Imagery rehearsal
Stress inoculation therapy
 Narrative therapy
 Emotion focused therapy

EMDR

Eye movement desensitization and
reprocessing
MBSR
Mindfulness based stress reduction
 Meditation

Evidence and Recommendations
Eclectic approach
 Therapeutic relationship
 Need for evaluative research
