Day 21-22 - Childhood Trauma Flashcards
What are the 1y incidence rates of child maltreatment in the US and in Canada?
- US: 12/1000
- CA: 9.7/1000
When responding anonymously, __% of parents report using forms of physical punishment that constitute child abuse
10%
What is the most common form of child maltreatment?
neglect
(younger/older) children are more likely to be neglected
(younger/older) children are more likely to be sexually abused
YOUNGER
OLDER (>12y)
(girls/boys) are more likely to be sexually abused
girls
Label the following as protective factors or risk factors for child maltreatment:
- single-parent families
- poverty
- upward social mobility
- lockdowns during pandemic
- single-parent families: RISK
- poverty: RISK
- upward social mobility: PROTECTIVE
- lockdowns during pandemic: RISK
What did Pollack’s original study on emotion recognition and child maltreatment find? What are the 2 possible reasons for these findings?
Study where kids presented w vignettes and asked to pick emotional face that went with emotion in vignette
- physically abused children show bias for angry faces
- neglected children show bias for sad faces
- maybe kids can’t visually discriminate btw faces
- maybe kids have diff understanding of emotional displays
What did Pollack’s follow-up study on ER and child maltreatment find? Which hypothesis was supported?
- no diffs between groups in emotion discrimination task! (means they CAN see differences between emotions)
- task where they had to rate similarity of two emotional faces using shelves on wall
- neglected kids perceive less diff btw angry, sad, fearful
- physically abused kids and controls perceive more diff btw anger and other emotions
- supports hypothesis that experience of maltreatment changes understanding of emotion!!!
What did the study on ER and child maltreatment that used pixilated pictures of emotional faces find?
- physically abused kids identify anger faster!
- physically abused kids identify sad faces SLOWER
- no diffs for fearful and happy faces
What are 2 examples supporting the diathesis-stress model of maltreatment leading to later psychopathology?
- low MAOA activity + maltreatment predicts antisocial behavior in adulthood
- short allele in serotonin transporter gene 5-HTTLPR ass w increased depression only for those who experience significant life stress OR maltreatment!!
What other factor moderates the relationship between maltreated children w short 5-HTTLPR allele and depression rates
social support! (acts as protective factor, moderates the moderator)
maltreatment as a risk factor for later psychopathology supports (multifinality/equifinality)
multifinality
What is a Criterion A stressor?
- actual/threatened death, serious injury, sexual violation
- can be direct experience, witnessed, experience of close other, or repeated exposure to details of event
- recent scholarship includes racism/discrimination as trauma
What are the 4 core features of PTSD? How many of each and how long do they have to last for diagnosis?
- INTRUSION (need 1 of memories, flashbacks, nightmares, etc)
- AVOIDANCE (need 1 of avoiding thoughts/feelings/stimuli)
- EXTREME AROUSAL (need 2 of diff w sleep, irritable/aggressive, hypervigilence, etc)
- NEGATIVE COGNITIONS/MOOD (need 2 of distorted blame, persistent trauma-related negative emotions, diminished interest in activities, alienation from others, etc)
What symptoms are required for a PTSD diagnosis in kids 6 or younger?
- 1+ sx of intrusion
- 1+ sx of avoidance and/or negative cognitions
- 2+ sx of extreme arousal
How can PTSD manifest differently in young children (under 6)?
- symptoms can be expressed through play
- reenactment
- more behaviorally anchored (eg will withdraw instead of “feeling” detached)
- irritability expanded to include tantrums
What is the lifetime prevalence of PTSD in teens?
5%
__% of youth who experienced a significant trauma reported at least 1 symptom of PTSD
85%
What are the 5 disorders in the new DSM5 category of trauma and stressor related disorders?
- acute stress disorder
- adjustment disorder
- PTSD
- reactive attachment disorder
- disinhibited social engagement disorder
What is Acute Stress Disorder?
- development during/within 1 month after exposure to trauma of at least 9 sx ass w intrusion, negative mood, dissociation, avoidance, arousal
- basically PTSD but w shorter time frame
- will get PTSD diagnosis is sx persist after 1m
What is adjustment disorder?
- unusual/disproportionate reaction to more common and less severe forms of stress
What are the diagnostic criteria for reactive attachment disorder (A-G)?
A. Consistent pattern of inhibited, emotionally withdrawn behavior toward adult caregivers manifested by BOTH rare/minimal comfort seeking when distressed and rare/minimal response to comfort when distressed
B. Persistent social/emotional disturbance including at least 2 of: minimal social/emotional responsiveness, limited positive affect, episodes of unexplained irritability, sadness, or fearfulness
C. Child has experienced pattern of neglect in at least 1 of: social/emotional neglect, repeated changes in primary caregivers, or rearing in unusual settings w limited opportunities to form selective attachments
D. care in Criterion C presumed responsible for Criterion A
E. does not meet criteria for ASD
F. evident BEFORE 5yrs
G. child has developmental age of at least 9mo
What are the 2 specifiers for reactive attachment disorder?
- persistent (>12mo)
- severe (all symptoms met at relatively high levels)
What are the diagnostic criteria for disinhibited social engagement disorder (A-E)?
A. Pattern of behavior in which child actively approaches and interacts w unfamiliar adults and exhibits at lease 2 of: reduced reticence in approaching/interacting w unfamiliar adults, overly familiar verbal/physical behavior, diminished checking back w caregiver in unfamiliar settings, or willingness to go off w unfamiliar adult w minimal hesitation
B. Behaviors in A not limited to impulsivity (as in ADHD)
C. Child has experienced pattern of neglect in at least 1 of: social/emotional neglect, repeated changes in primary caregivers, or rearing in unusual settings w limited opportunities to form selective attachments
D. care in Criterion C presumed responsible for Criterion A
E. child has developmental age of at least 9mo
What are the 2 specifiers of disinhibited social engagement disorder?
- persistent (>12mo)
- severe (all symptoms met at relatively high levels)
What are the 3 components of trauma-focused CBT?
- psychoeducation for parent + child
- skills building to deal w extreme anxiety (parent + child)
- trauma narrative (shared w caregiver so child isn’t alone)
What did the study comparing TF-CBT and child centered therapy find?
- random assignment to tx for 12 weeks
- both groups, parent + child improved on most outcomes
- kids in TF-CBT group demonstrated greater diagnostic recovery (20% still met PTSD criteria vs 46% in CCT)
