Childhood Trauma & Health-Ryst Flashcards
T/F Children do not get PTSD.
False. We find out in the 1970s that they do.
what is the definition of a trauma?
a serious threat or assault on bodily integrity -may involve the threat of death
or sexual assault
can be towards a loved one or the person
Is there a link b/w prison or drug rehab & childhood trauma?
YES
14% of men in prison abused as children
36% of women in prison abused as children
60% of people in drug rehab had a hx of abuse
**also there is a link to these victims going on to abuse their own children & victims developing psychological disorders
How can trauma relate to the HPA axis?
early adversity–associated w/ atypical development of the HPA axis stress response
T/F The degree of trauma is related to how the child interprets the trauma.
True.
How are brain structures different in people who have experienced maltreatment?
structural differences in hippocampus (memory & learning) & corpus callosum (helps coordinate messages from prefrontal cortex–>amygdala)
decreased activity of prefrontal cortex
**also basal ganglia, amygdala, cerebellum
Which genotype puts you at risk for anti-social behavioral disorders?
carriers of the low activity allele of MAO-A gene–hyperresponsivity of brain to threats
What is the ACE study?
shows health, social, & economic risks that result from childhood trauma–>long term following of patients at Kaiser
What is the progression shown with the ACE study?
Adverse Childhood Experiences Social, Emotional, & Cognitive Impairment Adoption of Health-risk Behaviors Disease, disability, & social problems early death
What are those w/ ACEs more likely to do, according to a study published in the Journal of Pediatrics?
More likely to initiate drinking alcohol at a younger age.
More likely to use alcohol as a means of coping with stress.
More likely to smoke, use drugs, become obese and engage in promiscuity.
Higher risk of school failure, gang membership, unemployment, homelessness, violent crime, incarceration and becoming single parents.
High risk adults who become parents are unlikely to provide stable, supportive parenting (intergenerational cycle).
Poor health-related quality of life and increased risk for diseases such as COPD and liver disease.
What is resilience? How does it relate to trauma?
resilience: ability to thrive, mature, & increase competence in the face of adverse circumstances or obstacles
* **better adapt to the difficulties of trauma
What are some resilience factors?
easy temperament, secure attachment, basic trust, problem solving abilities, an internal locus of control, an active coping style, enlisting people to help, making friends, acquiring language and reading well, realistic self-esteem, a sense of harmony, a desire to contribute to others, and faith that one's life matters (Davis, 2001).
T/F Majority of foster care children are not receiving mental health treatment of any type.
True.
What are the risk factors that increase the likelihood of trauma?
Intensity of trauma exposure and proximity
High media exposure
History of previous trauma, abandonment or attachment problems
History of anxiety, depression, low resilience,high reactivity
Parents’ level of stress
PTSD is a possible post-trauma diagnosis…what are others?
Depression
Anxiety
Substance abuse
Subsyndromal PTSD
What is the exposure criteria for the diagnosis of PTSD.
Criterion A: Exposure to actual or threatened death, serious injury, or sexual violence in one (or more) of the following ways:
- Directly experiencing the traumatic event
- Witnessing, in person, the event (s) as it occurred to others.
- Learning that the traumatic events(s) occurred to a close family member of close friend. If a death, it must be violent or accidental.
- Experiencing repeated or extreme exposure to aversive details of the traumatic events.
T/F Pt is a 15 yo male who is disturbed by images of war on TV. He is having nightmares and is diagnosed with PTSD.
False. The criteria for the diagnosis of PTSD doesn’t apply to exposure to trauma through the media.
What other criteria must be met for a diagnosis of PTSD.
- Exposure
- Intrusive Symptoms
- Persistent avoidance of stimuli associated w/ the traumatic event.
- Neg. alterations in cognitions
- marked alterations in arousal & reactivity
How have they altered the requirements for a diagnosis of PTSD in children?
children may have a harder time describing their cognitions & internal experiences…may prevent them from receiving treatment for PTSD
How can you observe negative alterations in cognition in children suffering from PTSD?
Increased frequency of negative emotional states
Diminished interests including constriction of play.
Socially withdrawn behavior
Persistent reduction in expression of positive emotions.
In a trauma assessment…looking at regulation of affect & behavior…what might we see?
Deterioration of ability to inhibit aggression
Conversely, fear of agression may promote excessive inhibition and lack of assertion.
Substance abuse to manage painful emotions
How might trauma affect core identity?
Powerlessness damages self-efficacy
Magical thinking and tendency to blame themselves leads to guilt
Can interfere with development of empathy and prosocial behavior.
Re-activation of conflicts from earlier periods: disruption of narcisstic fantasies can lead to perpetual search for merger with more powerful
Efforts to master fear and vulnerability can lead to long-term identifications (eg with rescuer, or the aggressor).
How might trauma affect social skills?
Trauma induced anxiety can cause withdrawal from normal social activities.
In some children, trauma leads to oppositional defiant behavior (seeing benign actions or hostile or seeing aggression as the only possible response); this further leads to association with deviant peer group and involvement in anti-social activities.
How might trauma present at the preschool age?
Attachment, Magical Thinking, Oedipal Complex, Fantasy Play
