Trauma Midterm
Explain PTSD in a developmental context
-A delay in cognitive and social development may be understood as symptoms of PTSD in a child who has been severely traumatized -Likewise, PTSD can affect the development of social skills, personality style, self esteem, self concept, and overall impulse control
What are risk factors associated with PTSD?
-Adolescence: juvenile offenders and substance abusing teens are at high risk for exposure -Exposure to previous trauma -previous diagnosis of anxiety disorder or other psychiatric disorders -more severe and more frequent trauma has been linked to more sever psychopathology -ongoing psychological stressor
What are protective factors associated with PTSD?
-An internal locus of control -- the kid is more likely to see themselves as in control of their actions -A sense of self-efficacy and a lack of feelings of helplessness -An optimistic cognitive schema -Social Support -Lack of ongoing psychosocial stressors
Why does childhood maltreatment exert such powerful effects?
-Because it occurs during sensitive developmental periods & experience affects brain development -Childhood is a time for learning (languages, music, motor skills are most easily acquired) -The number of synapse increases dramatically after birth -Environment-stimulated neuronal activity is critical for elaboration of synaptic territories and "proper" connections
What are peri-traumatic (during or immediately after) Risk Factors?
-Durations and severity of the traumatic exposure -Uncertainty that the danger has passed -Presences of peritraumatic dissociative symptoms (depersonalization, derealization)
What are some of the risk factors for trauma after events?
-Exposure to direct life threat -Injury to self -Witnessing of mutilating -injury/death -Being trapped/helpless -Degree of brutality, etc -Have previous traumatic exposures -Family history of psychiatric -disorders -Lower SES -Female sex -Being windowed or divorced
What are some protective factors for trauma effects?
-High IQ -Presence of supportive adults -Ability to create/find safety -Older age
What are other psychiatric illnesses associated with trauma?
-Major depression -Abuse or dependence on alcohol, drugs -anxiety disorders including phobias and ocd -social anxiety disorder -generalized anxiety disorder -panic disorder -Eating disorders (specifically binge eating & purge behaviors, bulimia nervosa) -Suicidality -- increased rates of suicidal gestures and ideations -Dissociation -psychosis
Explain the incidence in Chowchilla, CA and how it impacted the study of trauma
-Masked kidnappers accosted a school bus and abducted the bus driver and 26 children, ages 5-14 -The kids were buried for 16 hours -The driver and older children were able to dig themselves out and escape physically and medically unharmed -Most experts and people thought the kid would be okay because of the age of the child, the limited exposure time, the lack of physical injuries and the quick arrest of the suspects Researchers, like Lenore Terr, studied these kids longitudinally to find short and long term psychological consequences to the kidnapping and found that EVERY SINGLE ONE OF THE KIDS HAD POST TRAUMATIC SYMPTOMS --> Acute findings: fears of further trauma, hallucinations, "omen" formation --> Later findings: posttraumatic play, personality changes, repeated dreams of the event and of dying during the event, ongoing fears of being kidnapped again heightened generalized fears not necessarily related to the trauma
What are Pre-Traumatic Risk Factors?
-Quality of attachment during early development -Neurobiological factors - dysregulation of the Hypothalamic Pituitary Adrenal Axis (low cortisol levels, lack of reactivity, disruption of circadian rhythms) -Genetics and epigenetics
What are Post-Traumatic Risk Factors?
-Sufficient access to needed resources -Real vs perceived social support -Cognitive beliefs (bad coincidence vs. trauma was deserved) -Physical activity, capacity to place attention elsewhere during critical period of memory consolidation -Memory reconsolidation and updating with reinforcement of trigger
How many PTSD look in children?
-They may demonstrate disruptions of their normal behavioral patterns including increased oppositionality, impulsivity, aggression, and inattention -Poor performance in school, social withdrawal, and isolation is common -Regressive behaviors such as bedwetting (enuresis and encopresis) or thumb sucking may emerge -Children and adolescents will often have no goals for their future, no fantasies about marriage or career and demonstrate a sense of a foreshortened future
How may PTSD look in younger children?
-Younger children may not explicitly report their traumas. -They will often demonstrate their experience of trauma and PTSD through their play, drawings, and stories. -Their fears may not reveal actual trauma content -They may be preoccupied by fears of monsters, or separations from their caregiver, or the boogie man
Across various types of trauma, what incidents are associated with the highest rates of PTSD prevalence?
-violent death of a loved one -being a victim of physical violence, rape or sexual coercion
_____-______ years of age is a crucial time for brain development. During this time, there is the greatest growth in areas of the brain responsible for language, communication, hearing and vision
0-4 years **basic care and engagement is required to support this phase of development
What two movements were important in the recognition of PTSD? What other important things happened?
1. The Vietnam Veterans Against the War (VVAW) -these were groups were they could talk about their traumas -the political pressure in combo with anti-war movements was enough to result in the initiation of study and treatment of veterans trauma 2. The Feminist Movement -this contributed to the understanding that most common PT disorders are been in women in civilian life, not in men of war. -there were groups women could share there stories and give their abuse & symptoms that followed a name 3. Rape was redefined as a crime of violence rather than a sexual act --> "rape trauma syndrome" noted ptsd-like symptoms associated with women recently raped
What is the cause of PTSD?
Different psychological approaches have different opinions but it is best to look at it as a combination: -Psychodynamic: repetition compulsion -Cognitive: cognitive schemas of trauma -Biological: neurotransmitters, structural changes, endocrine dysfunctions -Behavioral: classical learning and failure of extinction -Developmental: interaction between the trauma and meeting the cognitive, social, and emotional milestones of development
Does the prefrontal cortex play a role when one responds to a traumatic event?
NO, In trauma, the prefrontal cortex takes a back seat to the amygdala because thinking about it (through the prefrontal cortex) would take to long, so in a traumatic event we respond emotionally rather than rationally as a form of survival
Does the brain of a child who endured trauma look the same a normally developing childs?
No, brain scan technology has allowed us to see that when a child is severely neglect and did not have physical touch and nurturing, their brain is under active because it was not be stimulated like a healthy and cared for babys was
Is stress always bad?
No, there are different levels of stress and we need some stress to motivate us to do things, but it is unhealthy when it becomes toxic
The ________________ works to determine the emotional meaning of events
amygdala
In the DSM, PTSD used to be under the category of a _______________ disorder but now it is under its own category called what?
anxiety; "Trauma- and Stressor- Related Disorders"
Between what years is the brain growing and developing the most?
between 0-7 years there is a ton of neural activity in the brain and the growth starts to slow down after age 7, so anything that happens between ages 0-7 is going to have such a powerful impact on the child
If adoption occurs prior to, or as close tom the sensitive period for selective attachment (i.e. around 0-6 months), risk for enduring difficulties is ___________________
decreased
When we have ___________ stress, the hippocampus-amygdala system gets overwhelmed and cannot work effectively together
toxic
With PTSD, children who are _____________ will often display symptoms of avoidance and aggression, while children who are ______________ will demonstrated symptoms of re-experiencing and hyperarousal
younger; older
What were the basic findings of the Romanian Adoption Study?
Studies have found a strong relationship between length of time & quality of care received in an orphanage and the child's long term health & development after adoption (the longer one spends in an orphanage, the more likely to have developmental, behavioral, and emotional issues) THIS study looked at kids who had spent at least 8 months in a Romanian orphanage. These kids were more likely to have insecure attachments, displayed more indiscriminately friendly behavior and the insecurely attached kids were more likely to have behavioral problems, lower score on IQ test and have parents who reported more parenting stress. BUT these kids can so increased secure attachment over time
What are the main limbic structures involved in stress response?
The Hippocampus & Amydgala
What happens to the brain during chronic, toxic stress related to trauma?
The amygdala becomes overactive, and responds as if the event is happening, reminding the traumatized person of the event and the Broca's area has decreased activity which is in charge of expressive language... so they cannot necessarily verbalize their experience in the moment of the trauma happening/being reminded of it --> when the amygdala is overactive, the broca's area is inactive
How do the amygdala, hippocampus, and prefrontal cortex work together?
The amygdala perceives emotions The hippocampus stores emotional memory for reference later The prefrontal cortex dictates the response to the stressor or emotion These areas of the brain work together with other organ systems to create the stress response
What is the amydgala responsible for?
The amygdala's 2 basicc functions: -emotional memory -evaluation of emotional stimuli
Explain the dinosaur versus human parts of our brain.
The brain stem (i.e. 'dinosaur brain") controls our autonomic reactions (breathing, digestion, etc.), this are keeps us physiologically sound The limbic system (human and part animal) is the emotional part of the brain The prefrontal cortex (human brain) is what separates humans from other animals because we have these higher order executive functions
What is the Hypothalamic-Pituitary Adrenal (HPA) Axis and how does it relate to the stress response?
The hypothalamus & pituitary are 2 essential & primitive regions of the brain. They are responsible for the neuro-hormonal stress response system. Upon exposure to stress, the hypothalamus produces corticotropin-releasing factor (CRF) Next, CRF stimulates the release of Adrenocorticotropic Hormone (ACTH) from the pituitary gland Then, ACTH stimulates the release of glucocorticoids (cortisol) from the adrenal glands which leads to many measurable aspects of the stress response
Which system in the brain is the collection of interconnected brain centers that play a key role in the regulation of emotion and memory ?
The limbic system
What were the major findings from the Adverse Childhood Experiences (ACE) study?
This study was a collaborative effort of Kaiser Permanente (private health management) and the CDC There were over 17,000 adult enrolles in this study (from a health insurance plan) that were given the ACE questionnaire which listed different types of abuse or neglect, for each category they said they experiences, that was an additional ACE score (not how many times something happened but the category of abuse) This study showed that a host of adverse childhood events were the most significant predictors of adult ischemic heart disease, cancer, chronic lung disease, skeletal fractures, and liver disease This study showed that trauma is more common in childhood than previously thought This study showed that the number of ACE'S increases the likelihood of adult alcoholism, adult smoking, rate of antidepressant prescriptions as well as poor physical health (Cancer, stroke, diabetes, etc.) THIS STUDY CONCLUDED THAT CHILDHOOD TRAUMA IS THE SINGLE BIGGEST PREDICTOR OF HEALTH PROBLEMS IN ADULTS
According to Lenore Terr, what is Type 1 Trauma and what is Type 2 Trauma?
Type 1: single exposure Type 2: chronic exposure (like domestic abuse, neglect, this is more common in childhood)
What are factors that contribute to PTSD?
Type: single vs chronic Dose: magnitude and severity Physical proximity: in general, the closer you are, the more traumatic Emotional proximity: the closer one is to the loss emotionally, the more traumatic Age: some argue trauma has less effect on younger kids Gender: girls report more symptoms Cognitive appraisal factors: did the child think they were in a safe place? Social factors: family support, SES
What are the effects of adequate nutrition on children?
Under nutrition leads to 1/2 of deaths in children under 5 Nutritional deficiencies lead to: -decreased cognitive, social, and emotional capacities -growth stunting -behavioral dysregulation (impulsivity, stealing, aggression)
How is the amygdala impacted by chronic stress?
With chronic stress/trauma, the amygdala becomes hyperactive and sends fear signals even when there is no more danger
How is the hippocampus impacted by chronic stress?
With chronic stress/trauma, the hippocampus becomes smaller, meaning it has decreased volume & diminished capacity to compare new stimuli to stored memories
What we experience shapes how our brains will look. Explain
With each new experience: -Connections between neurons are formed -These multiple neural connections form circuits -The circuits are strengthened each time an experience occurs again -When experiences occur less frequently, connections between neurons are pruned
Explain the patterns of attachment
Within attachment there are two categories, either organized or disorganized. Within organized attachment there is either -Secure Attachment -Insecure-Avoidant (anxious-avoidant) -Insecure-Ambivalent (anxious-resistant)
Explain Bowlby's Phases of Attachment
Birth --> 3 Months: babies prefer proximity to humans over objects, but who human is not critical. At 6 weeks the social smile emerges which is part of the attachment behavioral system, encouraging the caregiver 3 --> 6 Months: the baby begins to focus on familiar people, the baby's social responses become more selective, the baby appears to develop the strongest attachment to the person who most consistently responds 6 --> 24 Months: attachment to primary caregiver is consolidating over this period. 7-9 months "stranger anxiety develops". 12-24 months separation anxiety emerges. By 24 months the child demonstrates preferential attachment to a primary caregiver 3 yrs --> End of Childhood: internal working models of attachment (can tolerate separation by holding in mind), children continue to form attachments throughout life, later attachments are affected by the early attachment experiences of the child, people continue to seek out their early attachment figures in times of crisis and pain
Chess & Thomas's Temperament
Children are born with various temperaments but environment can influence and alter this temperament Chess & Thomas looked at three different temperaments: Easy, Difficult, and Slow to Warm Up Easy: -biological regularity -positive approach to most new situations -easy adaptability to change -mild or moderately intense mood that is predominantly positive Difficult: -biological irregularity -negative withdrawal from most new situations -slow adaptability to change -intense moods that are predominantly negative Slow to Warm: -negative response to new situations -slow adaptation -may have good biological regularity -mild expressions of mood They looked at this by placing marshmallows in front of children and found that the kids who could delay gratification achieved higher academically, SAT scores, and maintained jobs more so they also looked at these kids longitudinally to find ways to help the kids who did not delay gratification
Explain Multiple Attachments
Children will develop an attachment relationship to any caregiver providing regular care, regardless of the quality of the care provided. Children may have multiple attachment figures (like mom, dad, grand,mother, nanny) and the quality of attachment to each can be different and depend on the certain need. SECURE ATTACHMENT TO AT LEAST ONE SIGNIFICANT CAREGIVER IS CONSIDERED TO BE A BUFFERING AGENT AGAINST STRESS
What is PTSD?
A disorder in which a person has difficulty recovering after experiencing or witnessing a terrifying event
What is disinhibited social engagement disorder?
A pattern of behavior in which a child actively approaches and interacts with unfamiliar adults (wanting to attach to anybody)
Explain the stress response factor 2 (i.e. early life experiences)
A traumatic event that occurs from ages 0-3 may be more likely to have lasting consequences on brain development and function than one that happens when a child is older and secure attachments can affect the risk early life events can place on a child
Each person responds to stress differently and this response system is determined by:
1. genetic background 2. early life traumatic experiences 3. amount of chronic stress & subsequent changes in the brain function and structure
What are the 3 types of organized attachment
1. secure 2. insecure-avoidant (anxious-avoidant) 3. insecure-ambivalent (anxious-resistant)
What are some changes in brain structures due to chronic stress?
1. smaller hippocampus and amygdala in adults 2. smaller corpus callosum in children 3. decrease in GABA-ergic neurons in cortical areas (such as the prefrontal cortex)
2 different pathways can activate the HPA Axis. What are they?
1st: limbic structures through psychological stress 2nd: brain stem pathways that sen visceral and sensory stimuli
What are the differences in PTSD in children versus in adults?
Adults may show their symptoms differently (i.e. not in play) and have more flashbacks and memory loss than children. Trauma does not effect the sense of self the same way in adults (although it does really effect it)
What makes an event traumatic? Include individual factors & environmental factors
Anything can be traumatic, but not one event can be traumatic for everyone because of internal and external factors Environmental Factors: -chronic poverty and unstable or violent communities -major armed conflicts or civil disturbances -being in detention centers and jails Internal Factors: -previous medical/psychiatric disturbances -Attachments
Explain Disorganized attachment
This is when there is an irresolvable dilemma: the parent is a source of security and also a source of fear (typically related with parental trauma & maltreatment) The child is distressed upon separation, but sometimes approaches and avoids upon return, is mistimed, incoherent, and freezes
Explain the origins Bowlby's Attachment Theory
Bowlby came up with the idea that our early relationships set the stage for everything else in life -He said that prolonged exposure to deprivation could have lasting effects on the child (deprivation can result from separation of a caregiver or from a cold/inconsistent relationship with primary caregiver)
What is cortisol? What role does it play in the stress response?
Cortisol targets gene networks as well that are involved in acute and late recovery phases of the stress response EX: When MR & GR are activated by cortisol, many genes are affected (some of which are responsible for growth factors, electrical activation of neurons & cell death) Overtime, cortisol can alter the brain's structure and composition, lead to loss of a specific type of neuron, lead to growth of another type of neuron, and have long term effects on brain function
What is the diagnostic criteria for PTSD?
Criterion A: EXPOSURE -exposure to actual or threatened death, serious injury, or sexual violence either by direct exposure, witnessing in person, learning that it occurred to close family or friend, experiencing repeated or extreme exposure to averse details (like first responders) **if there was no exposure, there is no more assessing for trauma Criterion B: INTRUSION SYMPTOMS -recurrent, involuntary, intrusive distressing memories of the traumatic events -recurring dreams related to event -dissociative reactions (Flashbacks) where the individual feels the event is happening -psychological distress -marked physiological reactions to internal/external cues that may resemble an aspect of trauma Criterion C: AVOIDANCE OF STIMULI ASSOCIATED WITH THE TRAUMA -avoidance or efforts to avoid distressing memories, thoughts, feelings about or associated to the event -avoidance or efforts to avoid external reminders associated Criterion D: NEGATIVE ALTERATIONS IN COGNITIONS & MOOD -inability to remember an important aspect of trauma event -persistent and exaggerated negative beliefs or expectations about oneself, others, or the world -persistent cognitions about the cause or consequences of the event that lead the individual to blame themself or others -diminished interest or participation in activities -feelings of detachment or estrangement -inability to experience positive emotions Criterion E: MARKED ALTERATIONS IN AROUSAL & REACTIVITY - irritable behavior or angry outbursts -reckless or self-destructive behavior -problems with concentration -startled easily -Criterion F: DURATION OF DISTURBANCE IS MORE THAN 1 MONTH -Criterion G: THERE IS SIGNIFICANT IMPAIRMENT AS A RESULT -Criterion H: THESE SYMPTOMS ARE NOT ATTRIBUTED TO ANOTHER DIAGNOSIS OR SUBSTANCE ABUSE
What do children need for healthy development?
Health: nutrition, hygiene, environment, healthcare, education, maternal health Simulation & the opportunity to interact with the environment in ways that support cognitive, motor, language, and social-emotional development Stable, supportive interpersonal relationships: attachment to a CONSISTENT primary caregiver
When was PTSD included to the DSM?
IN 1980, in the DSM-III-R in the wake of the Vietnam war, the strong antiwar movement, and the feminist movement
What is the bodies "immediate stress response"?
If the limbic system perceives a threat: 1st: the HPA system is activated through the release of hormones by the amygdala 2nd: the Noradrenergic system is activated (norepinephrine is release from the locus ceruleus in the brain which stimulates the sympathetic response) 3rd: the sympathetic response leads to increase in arousal, heart rate, and blood flow to essential organs 4th: Cortisol is released from the adrenal glans 5th: we go into the "fight or flight" response
What is maltreatment? And what seems to happen to children who are maltreated?
Maltreatment: involves a person who is supposed to protect you from harm and comfort you, who becomes a source of alarm, danger, and/or pain leading to significant difficulties (social and emotional deficits) EX: neglect & abuse Maltreated children tend to have lower social competence Often have less empathy for others Have greater difficulty recognizing others emotions Tend to over-read anger Are less able to recognize their own emotional states Are more likely to be insecurely attached to their parents Are frequently hypervigilant These kids have significant school problems, require special education programs, potentially have decreased IQ, and are more likely to be unemployed
What were the major findings from the Challenger Study?
In 1986, the space shuttle Challenger broke apart 73 seconds after it launched into space, killing the entire crew one of whom was a school teacher Millions of American school children were watching the event, including the school teacher's class & child watching live in person Lenore Terr studied 3 groups of kids (kids who saw it on the East coast live on TV, kids who were on the West coast that did not watch it live, and kids who were in the class that watched it live, in person) RESULTS: -Her research showed that the East coast kids and the kids who viewed it in real life had the same negative effects and kids on the West coast has less negative effects -62% of East coast children had dreams related to Challenger -Younger kids would draw about the explosion versus adolescents who used writing as a coping skill more frequently -21% of East coast kids reported clinging habits, in comparison to 3% of West coast kids -90% of latency age (6-11) kids has some type of fear (i.e. fears of death, dying, explosions, fires, taking risks) -East coast kids were significantly more symptomatic that West Coast kids -Children with a history of personal traumatic events had more symptoms than children who reported no previous exposure to trauma -Kids live in person versus watching it live on TV did not have an effect in terms of symptoms THIS SHOWED THAT KIDS MIGHT BE TRAUMATIZED BY EVENTS THAT DO NOT DIRECTLY AFFECT THEIR PERSONAL SAFETY OR THE SAFETY OF THEIR LOVED ONES THIS SHOWED THAT CLOSENESS TO THE TRAUMATIC EVENT PLAYS A ROLE IN THE SEVERITY OF SYMPTOMS THIS SHOWED THAT ADOLESCENTS MAY HAVE FEWER SYMPTOMS BECAUSE THEY CAN PLACE THE EVEN WITHIN A LARGER CONTEXT AND WRITE ABOUT IT
Attachment is a good predictor of what?
It is a good predictor of social & emotional outcome because it effects: -affect regulation & control -self-perception -self-competence -cognitive functioning
What is the hippocampus responsible for?
It is important in the formation & retrieval of memories -It can serve to inhibit the stress response
What is the role of the prefrontal cortex?
It is in charge of executive functions (mediates conflicting thoughts, makes choices, predicts future events, planning, decision making) It inhibits impulses and is strongly implicated in qualities like human general intelligence and personality
Why does a disorganized attachment occur?
It occurs when the source of comfort & protection becomes the source of threat ... fright without solution!!
What is the history of the diagnosis of PTSD as outlines in Judith Herman's book?
JD argues that the history of trauma and PTSD is greatly influenced by the political climate of the times in which the trauma occurred History has shown us that the systematic study of psychological trauma depends on the support of a political movement Symptoms of PTSD were first described in the 1800's as "Da Casta Syndrome" (described by surgeon in US civil war, Dr. Da Casta recognized symptoms of heart disease without any physical findings (SOB, palpitations, sweating,chest pain) Late 19th century in Paris: hysteria was used to describe certain women (first coined by Jean-Martin Charcot who focused on symptoms of motor paralysis, sensory loss, convlusions, and amnesias Then Freud looked into patients with hysteria and found that it was almost universal that they all experiences childhood sexual traumas but when he announced that, there was political pushback and he then retracted and said those stories were false and instead, repressed desires "Shell Shock", the hysteria of WWI: includes symptoms of screaming & weeping uncontrollably, impulse aggression, memory less, paralysis (40% of british war causalities were due to mental breakdown but this was suppressed by military authorities)
Are disorganized attachments common?
Kind-of, disorganized attachment rates are found to be approximately 15% in low psycho-social rick populations and as high as 82% in maltreated infant samples
Explain Mary Ainsworth's Strange Situation Experiment
She looked at the manner in which infants coped with separation and behaved upon reunion and how that may reflect the quality of the caregiver-infant relationship The "strange situation" consisted of 8 episodes, 3 mins each: 1st separation: mother leaves the child with a stranger 2nd situation: mother leaves the child alone Through this experiment & by observing the 3 different types of mothering, she came up with 3 major types of attachments (Secure, anxious-avoidant, anxious-resistant) and she saw that the babies who had secure attachments would explore and play more with their environment
What makes the diagnosis of PTSD different that diagnoses of other disorders in the DSM?
PTSD is the ONLY diagnosis in the DSM that is not just a collection of symptoms PTSD looks at experience and history, not just at inclusion & exclusion symptoms The first step in diagnosing PTSD is look at "did something happen to you, what were you exposed to"
What is de-personalization?
Persistent feeling detached from, and as if one were an outside observer of one's mental processes or body
What is derealization?
Persistent or recurrent experiences of unreality of surroundings (e.g., the world around the individual is experienced as unreal, dreamlike, distant, or distorted).
What are the developmental changes seen in children who have been abused and neglected?
Physical growth falls behind by approximately 1 month for every 5 months spent in an orphanage Children tend to be smaller in height, weight, head, and chest circumference (this shows lack of nurturing and consistent care-giving and nutrition) They may have lower IQ's and have lack of brain stimulation (from lack of a positive stimulating environment as a kid) You need stimulating experience as a kid for proper brain development (when basic needs are not met, the brain cannot develop normally/on track
What are the 4 main disorders under Trauma- and Stressor- Related Disorders?
Reactive Attachment Disorder Dis-inhibited Social Engagement Disorder PTSD Acute Stress Disorder
What are body signals of the Fight or flight response:
Saliva flow decreases Pupil dilated Blood vessels constrict - chills and sweating Quick, deep breathing Output of digestive enzymes decreases Etc.
Explain insecure-avoidant attachment (i.e. anxious-avoidant)
This is when the parent is unavailable and rejecting The child would not be overtly distressed when separated, and would ignore or turn away caregiver upon their returning, and does not resume prior level of play
Explain the stress response factor 1 (i.e. genetic background)
There are heritable factors and environmental factors that can affect whether genes get turned on or do not get turned on
What is the definition of trauma and what are the challenges with this?
There are many definitions of trauma but here are the key elements of trauma defined across studies: -it is usually an uncontrollable event -the nature of the event is usually beyond the scope of ordinary human experience (usually rare or infrequent) -it is usually unpredictable in the sense of a sudden event or sudden change in mood of a violent parents -in an effort to process the event, the person is changed (such as, the person does not see the world as safe, relationships as stable, etc) trauma is both the event and the reaction
Explain the stress factor 3 (i.e. stress induced changes in the brain)
There is reduced brain function in those who are traumatized typically because they did not get the stimulation they needed Toxic stress changes brain architecture (this can damage neurons and thus neural connections)
What is Reactive Attachment Disorder?
This develops in babies who have a hard time forming positive attachments (often because of early neglect or abuse). People with RAD have a hard time managing their emotions and making strong relationships Characteristics of this disorder: -a consistent pattern of inhibited, emotionally withdrawn behavior toward adult caregivers -a persistent social & emotional disturbance characterized by minimal social & emotional responsiveness to others, limited positive affect, and episodes of unexplained irritability/sadness/fear even during nonthreatening interactions with caregivers -child have experiences a pattern of extremes of insufficient care
What is acute stress disorder?
This disorder consists of the same symptoms of PTSD but they last for less than a month
Explain Bowlby's idea of the "caregiver-infant behavioral system"
This idea ensures species survival and it an attachment behavioral system 1st: kids are wired to seek out proximity to others and explore their environment because they have a safe base (parent) to go back to 2nd: Babies do things to seek safety and get their needs met 3rd: Caregivers learn to be watchful and protective and be close to the child which feels the infants sense of trust, protection, and safety 4th: If the caregiver is attuned, and has responsive care that is consistent, then the infant develops a "Good enough" sense of trust, protection, and safety & this internal working system will guide the infant's future expectations and behaviors, especially during times of stress
What is Developmental Trauma Disorder (as per readings)?
This is not a formal diagnosis, but rather, a proposed complex post-traumatic stress disorder syndrome for children It is a conceptual framework/way to think of trauma more specific to children & the impact of trauma on development A: look at the exposure: one or more forms (allows for chronic) developmental adverse interpersonal trauma (one person harming another) B: Dysregulation: dysregulated development in response to trauma cues C: Negative Attributions and expectations: negative beliefs in line with experience of interpersonal trauma D: Functional Impairments: impairments in any or all arenas of life, like school, friends, families and the law
Explain Insecure-Ambivalent attachment (anxious-resistant)
This is when the parent is inconsistent, unreliable, and sometimes intrusive The child is distressed when separated, and seeks the caregiver upon return but then angrily reject contact, is not soothed and does not return readily to play
Explain secure attachment
This is when the parent is responsible & available The child would be distressed when separated, seek contact and be easily soothed when the parent returns, and quickly return to play
______________________ attachment is most predictive of concurrent and later psychopathology
disorganized
The idea that our experience in the world that can trigger cortisol release can literally change our genetics is related to what concept?
epigenetics
Early life ___________________ is the foundation on which our brain is built
experience
In children, _______ often express more symptoms of PTSD than ________
girls;boys
Not only is the __________________ particularly susceptible to stress because it develops slowly, it is also one of the few brain regions that continues to grow new neurons after birth
hippocampus
All living organisms strive towards a dynamic equilibrium known as ____________________. This is threatened by physical & psychological events known as "stressors". The brain then mediates the interaction between how we perceive stressors/threats and our subsequent behavior in an attempt to re-establish equilibrium
homeostasis
With toxic stress/trauma the amygdala becomes ______________ while the hippocampus becomes _______________
overactive; smaller
What is toxic stress?
overwhelming, chronic stress that happens over and over that overwhelms the brain and sets the stress response as always on high-alert
____________ & ____________ pressure have a lot of impact of what psychological theories are accepted in society
political & social
In immediate threat, the limbic system does not communicate with the _______________ ____________ because it would take too long - this could be life or death but in a non-life threatening situation, this just means we do not rationalize or use thinking in this process
prefrontal cortex
" ____________ and ____________" is the basic parent and child interaction that is necessary to lay the brain's foundation in a child
serve & return
