Childhood trauma

Question 1

Stress

Answer 1

Actual or implied threat to the psychological and/or physiological integrity of an individual

Question 2

Post-traumatic reasons and responses

Answer 2

• dysregulation of neurophysological, psychological and cognitive functioning
• individual’s subjective experience is more relevant to the response than is the objective facts of the event
• age-dependent
• may require no, little or intensive intervention
• often due to:
  
  • traumatic experience = adverse experience that causes injury
  • accumulation of adverse experiences

Question 4

Post-traumatic disorders

Answer 4

• PTSD
  
  • people with childhood or previous trauma were more likely to develop PTSD to a separate trauma later on
• Substance dependence
• Depression
• Separation anxiety

Question 5

Cortisol: function, production

Answer 5

• essential for dealing with stress
• increases ability of body to use sugar as energy source
• alters immune and reproductive systems
• Stress signal from hypothalamus –> pitutiary gland –> adrenal gland –> release of cortisol
• hippocampus detects cortisol levels then sends signal to hypothalamus to shut down stress circuit

Question 6

Cortisol during high stress situations

Answer 6

• methylation of hippocampal GC receptor genes –> down-regulate receptor expression
• interferes w/ negative feedback loop
• hippocampus can no longer tell they hypothalmus to stop signaling the stress circuit
• leads to persistently high cortisol levels
• High/persistent levels of glucocorticoids can have negative impact on PFC and hippocampus
  • can result in smaller dendrites – fewer connections

Question 7

Telomeres and neglect/abuse

Answer 7

• adults with childhood maltreatment had smaller telomeres than controls
• shorter telomeres linked to physical and emotional neglect

Question 8

Genetic vulnerability

Answer 8

• genetic polymorphisms that make one more sensitive to experiences
• e.g. short repetative regions in the serotonin transporter
• e.g. maltreated children w/ low levels of MAOA (due to polymorphism in gene) had higher rates of antisocial behavior and aggression compared to maltreated children w/ high/normal levels of MAOA (they have a different polymorphisms)

Question 9

Chronic stress/trauma’s impact on brain

Answer 9

• ** in children, since their brains are more immature, this process has a more widespread effect on the whole brain
• decrease in:
  
  • corpus callosum volume
  • rate of myelination
  • medial prefrontal cortex volume
  • total brain volume
  • hippocampus activity (less capable of responding to emotion)
• increase in hemispheric lateralization

Question 10

Common symptoms of traumatic responses in children

Answer 10

• Cognitive:
  
  • memory problems
  • poor concentration
  • ruminative thinking
  • poor executive function (judgement)
• Emotional
  
  • anxiety
  • impulsiveness/aggression
  • irratibility
  • withdrawal/depression
• Physical
  
  • aches and pains, bowel problems, nausea, chest pain, increase heart rate, obesity
• Behavioral
  
  • Sleeping pattern changes, isolating, procrastinating, fighting, sexualized behaviors

Question 11

Resilience – protective factors

Answer 11

• genetics
• relationship with caring, supportive adult
• intellectual ability
• talent
• community involvement

Question 12

Intervention and treatments

Answer 12

• CBT – most effective tx
• Eye movement desensitization reprocessing therapy (EMDR)
• Early post-exposure interventions
• ask about adverse childhood experiences to kids and adults