ADVERSITY How adversity can markedly affect the development of the brain. Describe and evaluate evidence based methods used to overcome these adverse effects. Flashcards
Structure for the section on the effects of adversity on the developing brain? 4 pts
- Intro
- HPA-axis
- Corpus Callosum and other White Matter Tracts
- Functional Brain Differences Associated with Maltreatment
Structure for evidence based methods for overcoming the effects of adversity? 5 pts
- Intro
- Neglect
- Physical abuse
- Sexual Abuse
- Foster care
A substantial evidence base from the animal literature delineates long-term effects on HPA system functioning following disruption to [blank]
adequate maternal care
A substantial evidence base from the animal literature delineates long-term effects on HPA system functioning following disruption to adequate maternal care; these effects …
persist into adulthood and are accompanied by stable behavioural changes
There is accumulating evidence that early trauma, including physical, sexual and emotional abuse, is associated with increased risk of what?
psychopathology in adulthood including depression, PTSD, alcohol and substance abuse, and borderline personality disorder
In view of the persuasive evidence from the human and animal literature of the link between stress and HPA functioning, there is a strong case that early stress may lead to … which in turn predisposes to…
an ongoing dysregulation of the HPA axis
to psychiatric vulnerability in later life
there is a strong case that early stress may lead to an ongoing dysregulation of the HPA axis, which in turn predisposes to psychiatric vulnerability in later life (van Goozen & Fairchild, 2006). While there is consensus aroud this general principle…
the putative mechanisms of how the HPA axis might mediate the link between stress and psychopathology and the precise nature of any interaction remain less clear.
The corpus callosum (CC) is … and controls…
the largest white matter structure in the brain
inter-hemispheric communication of a host of processes, including: arousal, emotion and higher cognitive abilities
With the exception of one study (Mehta et al. 2009), decreases in CC volume have been reported in …
maltreated children and adolescents compared to non-maltreated peers (DeBellis et al. 2002)
With the exception of one study, decreases in CC volume have been reported in maltreated children and adolescents compared to non-maltreated peers (DeBellis et al. 2002) - who conducted the study that was the exception?
(Mehta et al. 2009)
With the exception of one study (Mehta et al. 2009), decreases in CC volumehave been reported in maltreated children and adolescents compared to non-maltreated peers (DeBellis et al. 2002). Furthermore, preliminary evidence suggests that these effects are characterized by what?
sex dependent differences
In a recent DTI study, Eluvathingal and colleagues (2006) found what?
decreased fractional anisotropy values in the left uncinate fasciculus (which connects the OFC to the anterior temporal lobe, including the amygdala) in maltreated children compared to controls
What is fractional anistropy?
(a measure that assesses white matter fibre tract direction and density)
More recently, a DTI study in a non-clinical sample examined the effects of severe parental verbal abuse (e.g. ridicule, humiliation and disdain) on brain connectivity - who conducted it? What did they find?
three white matter tracts were reported to show reduced fractional anisotropy
Choi et al 2009
More recently, a DTI study in a non-clinical sample examined the effects of severe parental verbal abuse (e.g. ridicule, humiliation and disdain) on brain connectivity; three white matter tracts were reported to show reduced fractional anisotropy (Choi et al., 2009). The authors hypothesised that these abnormalities may underlie what
some of the language and emotional difficulties seen in victims of childhood maltreatment.
Only a few studies have investigated the possible functional correlates associated with maltreatment using X techniques
imaging
In an fMRI study, Carrion and colleagues (2008) used a Go/No-Go task assessing what?
sustained attention and response inhibition, and compared the brain activity of young adolescents with post-traumatic stress symptoms (PTSS) secondary to maltreatment to that of age and gender matched healthy controls.
What kind of study did Carrion and colleagues (2008) do?
fMRI
What kind of tast did Carrion and colleagues (2008) use?
Go/No-Go task
In an fMRI study, Carrion and colleagues (2008) used a Go/No-Go task assessing sustained attention and response inhibition, and compared the brain activity of young adolescents with post-traumatic stress symptoms (PTSS) secondary to maltreatment to that of age and gender matched healthy controls. What did they find?
The adolescents with PTSS showed relatively decreased activation of the left dorsolateral PFC, but increased activation in the mPFC and ACC.
What did Chugani and colleagues 2001 do?
used PET in the awake resting state to investigate the brain activation associated with early global deprivation in pre-adolescent children adopted from Romanian orphanages where the children had experienced adverse early rearing environments
Who used PET in the awake resting state to investigate the brain activation associated with early global deprivation in pre-adolescent children adopted from Romanian orphanages where the children had experienced adverse early rearing environments ?
Chugani and colleagues 2001
Chugani and colleagues (2001) used PET in the awake resting state to investigate the brain activation associated with early global deprivation in pre-adolescent children adopted from Romanian orphanages where the children had experienced adverse early rearing environments (Chugani et al, 2001). What did they find?
Compared to adult and child control groups, the adopted children showed decreased metabolism in a network of areas implicated in stress regulation, including the OFC.
In this section, we will briefly identify and discuss selected evidence-based intervention models which show promise within child abuse and neglect. These will be outlined under four classes of services for the following forms of adversity - what are they?
neglect
physical abuse
sexual abuse
foster care
Although neglect comprises the majority of child welfare system cases, there is …
limited study of intervention models
Of these, [blank] is among the more widely studied and the best supported.
Project 12-Ways/SafeCare model
Project 12-Ways/SafeCare model is among the more widely studied and the best supported. The model uses X methods
behavioral
Project 12-Ways/SafeCare model is among the more widely studied and the best supported. The model uses behavioral methods, and focuses on …
various targets in the ecology of multiproblem families entering the system for child neglect
The pattern of evidence supporting the model is complex, and involves over X published studies, although..
60
few randomised controlled trials
The Project 12-Ways model is currently being tested in…
a large-scale field trial
Two models in particular show promise for physically abusive parents. - What are they?
Parent–Child Interaction Therapy (PCIT)
Kolko (1996) structured cognitive–behavioral treatment.
What is PCIT?
a live-coached behavioral parent training intervention
Parent–Child Interaction Therapy (PCIT) is a live-coached behavioral parent training intervention which has already met criteria as… Says who?
a well-supported, empirically validated treatment for early childhood behavior problems (Chambless & Ollendick, 2001).
Recent randomized efficacy trial evidence also suggests that PCIT can significantly reduce r…ates of
future physically abusive behavior among abusive parents (Chaffin et al., 2004),
What did Kolko (1996) do?
conducted a randomized trial, and found benefits for physically abusive parents and abused children using a structured cognitive–behavioral treatment.
Who conducted a randomized trial, and found benefits for physically abusive parents and abused children using a structured cognitive–behavioral treatment.
Kolko 1996
Although sexual abuse is not invariably traumatic, it is commonly associated with
the development of trauma symptoms
Trauma-focused cognitive–behavioral therapy, using the principles of … has been evaluated in a series of randomized trials . Who did the research?
gradual exposure and cognitive restructuring
Cohen and Mannarino 1997
Trauma-focused cognitive–behavioral therapy, using the principles of gradual exposure and cognitive restructuring has been evaluated in a series of randomized trials (Cohen & Mannarino, 1997) and has consistently been found to be what?
superior to competing approaches for treating the effects of sexul abuse
TF-CBT meets criteria as what?
a well-supported treatment for sexually abused children with traumatic stress symptoms
