Child and adolescent psychiatry

Question 1

List some causes of trauma

Answer 1

physical abuse
sexual abuse
emotional abuse
neglect
witnessing violence
medical trauma
natural disasters or accidents

Question 2

How does trauma affect the brain?

Answer 2

HPA axis dysfunction - can become overactive or underactive, can cause difficulties regulating emotions and responding to stress

amygdala - associated with fear and emotional processing, can become hyperactive, increased anxiety

hippocampus - responsible for learning + memory - difficulties with memory formation and retrieval

prefrontal cortex - involved in decision-making, impulse control + planning - may be underdeveloped leading to challenges in executive functioning

Question 3

Describe secure attachment

Answer 3

caregivers are consistently responsive and attuned
children feel safe, loved and confident
as adults, they are comfortable with intimacy and independence, forming healthy and balanced relationships

Question 4

Describe anxious-preoccupied attachment

Answer 4

caregivers are inconsistent or unpredictable in their responsiveness
children may feel anxious and clingy, fearing abandonment
as adults, they crave intimacy but are often insecure and worry about their partner’s love and commitment

Question 5

Describe dismissive-avoidant attachment

Answer 5

caregivers are emotionally distant or rejecting
children learn to suppress their emotions and needs
as adults, they value independence and may avoid intimacy, appearing emotionally unavailable

Question 6

Describe fearful-avoidant attachment (disorganised)

Answer 6

caregivers are frightening or abusive
children experience a conflict between seeking comfort and fearing their caregiver
as adults, they desire connection but fear intimacy, often exhibiting unpredictable or chaotic behaviour in relationships

Question 7

Describe reactive attachment disorder (psychiatric diagnosis)

Answer 7

grossly abnormal attachment behaviours in early childhood
in context or grossly inadequate child care (eg. severe neglect)
even if adequate primary caregiver newly available, child does not turn to them for comfort
can only be diagnosed in children and features develop in first 5 years of life
disorder cannot be diagnosed before 1 or in context of ASD

Question 8

What are offspring of depressed mothers more likely to develop?

Answer 8

sleep problems
temper tantrums
separation issues
worse peer relationships