Life adversities and Trauma Flashcards
What are the 2 ways to define trauma?
1) A distressing reaction
2) Exposure to events and circumstances
Trauma is a distressing reaction. What does this mean?
A distressing reaction resulting from adverse life experiences that exceed the person’s ability to cope in the short and long term
e.g. symptoms of ‘post-traumatic stress and related forms of psychological distress
Trauma is exposure to events and circumstances. What does this mean?
Exposure to events and circumstances that are experienced as harmful or life-threatening and that have lasting impacts on mental, physical, emotional and/or social well-being (and development in children/adolescence)
What are the 6 main types of trauma?
1) Big T traumas
2) Small t traumas
3) Childhood trauma (type 1 and type 2)
4) Complex childhood and developmental traumas
5) Social trauma
6) Historical trauma
What are Big T traumas?
Traumas involving major distressing life events, experiences of interpersonal violence
e.g. trauma from rape or domestic violence
What are small t traumas?
Traumas involving more common events that still have the potential to negatively impact individuals’ mental health and wellbeing
What is childhood trauma type 1?
Trauma involving witnessing or experiencing a single event such as a serious accident or rape
What is childhood trauma type 2?
Trauma resulting from repeated exposure to extreme external events, such as ongoing sexual abuse
What are childhood and developmental trauma?
Trauma resulting from bullying, gang culture, sexual assault, homicide, war, abuse, neglect, abandonment and family separation
What is social trauma?
Trauma involving inequality, marginalisation, racism and poverty
What is historical trauma?
Trauma resulting from violence committed against entire groups, including slavery, genocide and the Holocaust
True or False?
Trauma can only be a single event
False
Trauma can be a single event or multiple events occurring over time
Traumas involving major distressing life events, experiences of interpersonal violence
e.g. trauma from rape or domestic violence
This is known as…?
Big T traumas
Traumas involving more common events that still have the potential to negatively impact individuals’ mental health and wellbeing
This is known as…?
Small t traumas
Trauma in childhood involving witnessing or experiencing a single event such as a serious accident or rape
This is known as…?
Type 1 childhood trauma
Trauma resulting from repeated exposure to extreme external events, such as ongoing sexual abuse
This is known as…?
Type 2 childhood trauma
Trauma resulting from bullying, gang culture, sexual assault, homicide, war, abuse, neglect, abandonment and family separation
This is known as…?
Complex childhood and developmental traumas
Trauma involving inequality, marginalisation, racism and poverty
This is known as…?
Social trauma
Trauma involving violence committed against entire groups, including slavery, genocide and the Holocaust
This is known as…?
Historical trauma
What are the 4 factors that could contribute to the development of mental health difficulties?
1) Traumatic experiences are repeated or prolonged
2) When traumatic experiences are difficult or impossible to escape
3) When traumatic experiences are interpersonal (they involve people close to the person or meaningful others)
4) When one experiences multiple traumatic experiences (different adverse life experiences) or when traumatic experiences occur at critical stages of development (e.g. childhood, adolescence and ‘life transitions’)
What happened in the study on Romania’s abandoned children?
1) Under Ceausescu’s rule, contraception and abortion for women under the age of 45 were banned
2) Ceausescu demanded a minimum of five children per family to boost Romania’s population and fuel the economy
3) This led to huge numbers of abandoned children
4) In January 1990, reporters covering the collapse of the communist regime in Romania stumbled across a long-hidden story: 600 state-run orphanages, filled with abandoned children (around 100.000 children)
5) In the hope of joining the EU, in 2006/2007 Romania began closing orphanages or turning them into smaller foster homes
Who investigated the lasting impact of neglect?
Fox et al.
What did Fox et al. do in their study of investigating the lasting impact of neglect?
1) Project assessed 136 children (age from 6 months to 3 years) who had been living in Bucharest’s institutions from birth
2) Then they randomly assigned half of the children to Romanian foster families, and the other half remained in care as usual
3) They also evaluated a control group of local children who had never lived in an institution
What did Fox et al. discover about the lasting impact of neglect?
1) Institutionalized children had delays in cognitive function, motor development and language. They showed deficits in socio-emotional behaviours and experienced more psychiatric disorders. They also showed changes in the patterns of electrical activity in their brains (as measured by EEG)
2) While children in foster homes achieved notable improvements, they still lagged behind the control group of children who had never been institutionalized.
3) Those removed from the institutions before age 2 made the biggest gains; highest chance of improving their cognitive abilities (brain plasticity)
4) When children were moved into foster care before their second birthdays, by age 8 their brains’ electrical activity looked no different from that of community controls
Who investigated the neurodevelopmental impact of neglect in childhood?
Perry
What is the difference between a 3-year-old with severe sensory deprivation neglect’s brain and a healthy 3-year-old’s brain?
The child with severe sensory deprivation has a brain that is significantly smaller (3rd percentile) than average (50th percentile) and has enlarged ventricles and cortical atrophy.
Sensory neglect in early childhood is associated with…?
Abnormal brain development
Children were placed in foster care at different ages (ages 8 months to 5.7 years) and one year later re-evaluated.
Their frontal-occipital circumference was measured and compared to same-aged norms
What happened to their improvement after a year of foster placement?
It started to decrease such that children removed after four years in the neglectful setting had no statistically-significant improvement one year later
The degree of recovery over a year period was proportional to the age at which the child was removed from the neglecting caregivers
True or False?
False
The degree of recovery over a year period was inversely proportional to the age at which the child was removed from the neglecting caregivers
The earlier in life and the less time in the sensory-depriving environment, the (………) the recovery
More robust
A set of 10 traumatic events or circumstances occurring before the age of 18 is known as?
Adverse Childhood Experiences (ACE)
What is Adverse Childhood Experiences (ACE)?
A set of 10 traumatic events or circumstances occurring before the age of 18
Experiencing Adverse Childhood Experiences (ACE) results in…?
Increasing the risk of adult mental health problems and debilitating diseases
There are 10 total ACE categories.
5 are known as …? and the other 5 are known as…?
5 ACE categories are forms of child abuse and neglect (known to harm children and are punishable by law)
The other 5 represent forms of family dysfunction that increase children’s exposure to trauma
What are the 10 categories of ACEs?
- physical abuse
- sexual abuse
- psychological abuse
- physical neglect
- psychological neglect
- witnessing domestic abuse
- having a close family member who misused drugs or alcohol
- having a close family member with mental health problems
- having a close family member who served time in prison
- parental separation or divorce on account of relationship breakdown
Who conducted the ACE study?
Felitti et al.
What did Felliti et al. do in the ACE study?
Presented a connection between adverse childhood experiences and experiences in adulthood
9,508 Americans completed an ACE questionnaire as part of routine medical evaluation
7 categories of ACE were studied (psychological, physical or sexual abuse, violence against the mother, or living with family members who were substance abusers, mentally ill or suicidal, or ever imprisoned)
What did Felliti et al. discover in the ACE study?
1) More than half of respondents (52%) experienced at least 1 category of adverse childhood experiences
2) Approximately a quarter reported at least two ACE exposure
3) 6.2% of respondents reported ≥ 4 exposures
To conclude = The more traumatic adverse childhood experience one has, the more difficult one’s adulthood seemed to be
Adverse childhood effects are associated with what?
Associated with a graded/dose response to many adverse health outcomes
A relationship that suggests that for
each increase in the ‘dose’ of a risk factor, there is a corresponding increase in the probability of developing a certain condition or problem
This is known as…?
Graded / dose-response relationship
What is graded / dose-response relationship?
A relationship that suggests that for
each increase in the ‘dose’ of a risk factor, there is a corresponding increase in the probability of developing a certain condition or problem
When is graded / dose-response relationship important?
When we are trying to establish potentially causal relationships
Many studies have shown that people with greater ‘doses’ of ACE (e.g. > 4) are …?
At considerable heightened risk for a range of health outcomes
How common are adverse (potentially traumatic) childhood life experiences in England?
The English Adverse Childhood Experiences (ACE) study by Bellis et al conducted a national household survey with nearly 4,000 participants (aged 18-69 years) from across England in 2013
Results:
- Nearly half (47%) of respondents reported at least 1 adverse childhood life experience
- Approximately 1 in 10 people (9%) reported four or more adverse childhood life experience
How common are adverse (potentially traumatic) childhood life experiences in Wales?
The Welsh Adverse Childhood Experiences (ACE) study by Public Health Wales presented a representative survey of Welsh households with 2000 participants (aged 18-69 years) with comparable results to the English ACE study
Results:
- Nearly half (47%) of respondents reported at least 1 adverse childhood life experience
- 13% report four or more adverse childhood life experience
What are the 3 factors that impact adverse experiences/circumstances?
1) Biological
2) Psychological
3) Social
The impact of adverse experiences/circumstances can be biological. What does this mean?
- ACE can impact one’s sensitivity to stress
- ACE can affect your biological makeup due to stress and stop your natural growth/development and biological processes to prepare for a fight or flight response
- ACE can also impact key brain areas involved in emotion and stress regulation (frontal cortex, amygdala) and memory (hippocampus) etc
The impact of adverse experiences/circumstances can be psychological. What does this mean?
- ACE may lead to negative beliefs about self, others and the world
- ACE may lead to one’s sense of threat
- ACE may lead to ‘Maladaptive’ thinking styles (rumination and worry) etc
The impact of adverse experiences/circumstances can be social. What does this mean?
- ACE may lead to difficulties in relationships
- ACE may lead to a lack of social support
- ACE may lead to reduced access to opportunities (education, work etc.) etc
What have governments done to aid individuals with ACEs?
Governments have increased their investment in activities aimed at preventing or reducing ACEs