final exam (ch. 8,9 and 10)

Question 1

what are the 6 levels on the ACE etiological pathway

Answer 1

1. adverse childhood experience
2. disrupted neurodevelopment
3. social, emotional and cognitive impairment
4. adoption of health risk behaviours
5. disease, disability and social problems
6. early death

Question 2

what happens if a child is under chronic stress?

Answer 2

Allostatic load: (textbook glossary) progressive “wear and tear” on biological systems due to chronic stress
Essential brain-body functions are suppressed by high cortisol – leading to system break downs
Basically, the sympathetic stress response system at first becomes overactive (repeated neuroendocrine activation), which is very hard on bodily organs and our immune system as it does not turn back off, then eventually becomes ‘depleted’ and no longer works to reduce stress – quite the opposite as cortisol levels decrease. This is known as Toxic stress.

Question 3

as of Jan 4, what is the law on spanking?

Answer 3

Teachers or parents are allowed as ling as they are sober and have a reason and will teach the child something

Question 4

types of child maltreatment and their percentages

Answer 4

physical abuse - 17%
sexual abuse - 8.3%
psychological maltreatment - 6%
medical neglect - 2.2%
Neglect - 75%
other - 6.8%

Question 5

how common is ACE in clinical child samples?

Answer 5

90% of clinic referred children/teens reported at least one ACE before the age of 18

Question 6

what is job burnout?

Answer 6

job burnout occurs when we are in job roles that support others

Question 7

what are 3 signs of job burnout?

Answer 7

1. emotional exhaustion
2. depersonalization (cynical distancing from others)
3. ineffectiveness ( a reduced sense of personal accomplishment)

Question 8

what is emotional Labour

Answer 8

Definition - The management of the expression of feelings to create a public face and meet job expectations

Question 9

what is the National Child Traumatic Stress Network?

Answer 9

The Network’s mission is to raise the standard of care for traumatized youth and families. As part of the National Child Traumatic Stress Network Center, the Learning Center for Child and Adolescent Trauma offers Free Online Education. This includes a newsletter and free power point decks with

Question 10

can trauma in childhood change the way brain pathways develop and change behaviour later on?

Answer 10

Yes, in many ways

Question 11

what is trauma?

Answer 11

trauma is a psychological response to highly stressful negative life events
(experience fear, helplessness or horror

Question 12

what is our bodys response to fear?

Answer 12

a classic sympathetic nervous system response is
1. dilated pupils
2. tight muscles
3. rapid heart beat
4. seeking protection from others

Question 13

what part of our body preps us for sudden acute stress?

Answer 13

our neuroendocrine system and our amygdala, hippocampus and prefrontal cortex - increases adrenaline and cortisol

Question 14

what are the HPA system changes under toxic stress?

Answer 14

Initially when under frequent acute stress, we become hyperreactive. Now if acute stressors become chronic, the HPA axis will move to a hypo-responsive maladaptive response.
As well, when chronic child abuse exists, “fight or flight” may not be feasible. Our biological protective system of releasing glucocorticoids to energize the CNS is no longer adaptive.

Question 15

what is autonomic self regulation?

Answer 15

• rapid muscles impulse- directed
• fight or flight response
• important for urgent situations

Question 16

what is intentional self - regulation

Answer 16

• conscious, planful, proactive
• inhibits automatic responses
• important for achieving goals

Question 17

how does excessive stress effect early childhood?

Answer 17

redirects child brain development away from planning and impulse control toward building the capacity for rapid threat response

Question 18

how does excessive stress effect adulthood?

Answer 18

effects adults ability to use executive functioning and intentional self regulation skills, leaving them to heavily rely on their automatic responses.

Question 19

what are the 4 types of attachment?

Answer 19

1. secure
2. anxious-avoidant
3. anxious resistant
4. disorganized dioriented

Question 20

PTSD in children 0-6

Answer 20

directly experiencing a traumatic event
witnessing an event (especially caregiver) *does not count if seen on tv, media etc
- reoccurring memory of event
- distressing dreams related to incident

Question 21

who does get PTSD?

Answer 21

Predisposing factors including extent of exposure to previous ACE; vulnerable biology
Peri-traumatic factors – the manner in which the trauma was perceived (level of horror, shame, guilt, dissociation)
Post-trauma factors such as social support

Question 22

Trauma focused CBT - what does PRACTICE stand for?

Answer 22

P -psychoeducation and parenting skills
R- relaxation skills
A- affective regulation skills
C- cognitive coping skills
T- trauma narrative & processing
I - in vivo mastery of trauma reminders
C - conjoint parent/child sessions
E - Enhancing safety and future development

Question 23

what is DBT?

Answer 23

Dialectical behaviour therapy

Question 24

what are the 4 core principles of DBT?

Answer 24

1. the primacy of the therapeutic relationship
2. a non judgmental approach
3. differentiating between effective and ineffective behaviours
4. dialectical thinking (holding two different opinions or thoughts at the same time)