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trauma > midterm > Flashcards

midterm Flashcards

1
Q

what is trauma

A

single or repeated events that overwhelm individual’s ability to cope or integrate the ideas & emotions involved in experience

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2
Q

what determines trauma

A

individuals experience of the event and meaning they make of it

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3
Q

what does not determine trauma

A

the event

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4
Q

why is trauma hard to study

A

no true definition exists, method of research depends on how it was defined, its subjective, many have difficulty speaking about it because of stigma

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5
Q

what are the dimensions of trauma

A

magnitude, complexity, frequency, duration, cause from interpersonal or external source

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6
Q

single incident trauma

A

unexpected & overwhelming incident (accident, natural disaster, single episode of abuse)

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7
Q

complex or repetitive trauma

A

chronic, ongoing abuse: physical/sexual assault, DV

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8
Q

developmental trauma

A

early life trauma of chronic nature that may involve child’s caregiving system

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9
Q

intergenerational trauma

A

trauma impacts are essentially “passed down” from one generation to another

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10
Q

historical trauma

A

cumulative “wounding” over the lifespan from massive group trauma

collective trauma, often of a particular cultural group

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11
Q

what is an important variable of trauma

A

the age it occurs at

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12
Q

what effects can early trauma have on children

A

negative consequences, impacting the development of the brain and normal developmental progression

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13
Q

what are some common side effects of someone who has experienced trauma

A

nightmares, depression, irritability, and jumpiness

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14
Q

whar are some personal responses to trauma one may face

A

sense of safety, self and self efficacy, ability to regulate emotions and navigate relationships

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15
Q

physiological adaptations develop in response to trauma is called…

A

dysregulation

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16
Q

what is dysregulation

A

difficulty controlling or regulating emotional reactions/behaviours and imbalances in the body

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17
Q

what does dysregulation result in

A

hyperarousal, hypervigilance, listlessness and dissociation

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18
Q

why is trauma-informed practice important

A

prevents re-traumatization, gives insight into behaviours, and allows for individualized and more effective care by finding the root of the problem

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19
Q

what were the 5 personal risk factors of the ACE study

A

physical, sexual, emotional abuse, physical neglect and emotional neglect

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20
Q

what were the 5 family member risk factors of the ACE study

A

domestic violence towards mother, household substance abuse, household mental illness, parental separation or divorce, the incarceration of a household member

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21
Q

what was the most prevalent category of childhood exposure seen on the ACE study

A

substance abuse in the household

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22
Q

as the number of ACE’s increased, so did adult risk factors including:

A

smoking, alcohol and drug abuse, and severe obesity

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23
Q

what are some findings from the ACE study

A

children who suffered severe adversity more likely to duffer from long-term intellectual, behavioural, physical, and mental health problems

increased # of ACEs correlated w/ increased in risk factors for substance abuse, health risks (cancer, heart disease)

4+ categories correlated w/ 4-12 fold increased in health and substance abuse risks

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24
Q

what are the 3 categories of abuse as defined by ACE

A

sexual, emotional, physical

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25
Q

what did harlow’s monkey show

A

the devastating effects of deprivation on young rhesus monkeys. Harlow’s research revealed the importance of a caregiver’s love for healthy childhood development

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26
Q

what was found from quality of the emotional bond between infant and caregivers

A

lays foundatin for future relationships

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27
Q

what is bolby’s attachment theory

A

first 2 years of life considered “critical period” for bond to develop
children have biological need to develop close relationship with 1 key figure
when bond not form, negative effects occur in development

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28
Q

what are social releasers

A

innate behaviours exhibited by babies such as crying, smiling, vocalizing to increase proximity + contact with mother

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29
Q

what are the signs of attachment

A

social referencing, separation anxiety, stranger anxiety

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30
Q

what is social referencing

A

begins ~ 6mons when child looks to primary caregiver to determine how to respond in new/ambiguous situation

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31
Q

when does separation anxiety begin

A

6-8mon & peaks at 14-18mon

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32
Q

what is stranger anxiety

A

begins 8-10mon and peaks at 2 yrs - child anxious in the presence of a stranger especially when primary caregiver not around

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33
Q

patterns of attachment is invented by

A

ainsworth

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34
Q

what is secure attachment

A

IDEAL attachment: caregivers consistent, appropriate responses to child’s attachment behaviours, child feels confident to explore when caregiver present, becomes mildly upset when primary caregiver leaves and seeks contacts upon return

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35
Q

what are the types of insecure attachment:

A

anxious-ambivalent, anxious-avoidant, disorganized

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36
Q

describe anxious-ambivalent attachment

A
  • child both clings to and resists care providers
  • child is anxious of exploration and strangers, even w/ primary caregiver present
  • extremely distressed when caregiver leaves, but is ambivalent to when they return
  • clingy, passive aggressive when caregiver returns (punish caregiver)
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37
Q

What is anxious-avoidant attachment?

A
  • child largely ignores caregiver
  • shows little reaction upon leaving or return
  • child treats caregiver similar to strangers
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38
Q

What is disorganized attachment?

A
  • child exhibits fear of caregiver
  • often appears in a daze
  • often a consequnce of mistreatment from caregivers
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39
Q

what are the adult attachment styles

A

secure, dismissing, preoccupied, fearful

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40
Q

What is secure attachment? (Adults)

A

Received reliable caregiving in childhood, positive view of self and others, able to form trust in others
- trusts others, healthy view of self, shares wants & needs easily, interdependent, not triggered easily, can manage and cope when triggered

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41
Q

What is dismissive attachment? (Adults)

A

Received unresponsive caregiving in childhood. Considers themselves self sufficient; refuses to rely on others
- wants love but is fearful, doesn’t trust easily, builds up walls, ultra independent

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42
Q

What is preoccupied attachment? (Adults)

A

Received inconsistent caregiving in childhood, feels “unlovable”, can become “clingy”
- high anxiety, codependency, insecure, fear of abandonment, fear of being alone, chronic survival mode (me)

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43
Q

What is fearful attachment? (Adults)

A

Had rejecting experience w/ caregivers, have desire for intimacy but fear rejection, may alternate between approaching and avoiding ppl
- unsure if want love (sometimes do & sometimes don’t), push pull dynamic, confused about love, downplays relationships, trouble feeling emotions

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44
Q

True of false: secure attachment is believed to protect against trauma

A

True: it is thought to increase resilience

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45
Q

What is the relationship between trauma and attachment?

A
  • interpersonal trauma appears to be more closely ass w/ attachment insecurities than non-interpersonal trauma
  • dismissive attachment style appeared to be the lowest associated w/ PTS
  • PTS symptoms could erode attachment security
  • insecure attachment appears to increase risk for PTS symptoms
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46
Q

which type of attachment style would be described by the child’s needs have not been met by the caregiver which is why there is no reaction when the caregiver comes/goes

A

anxious-avoidant

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47
Q

secure attachment could have what kind of factors

A

protective (buffer system)

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48
Q

insecure attachment can have heightened

A

vulnerability

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49
Q

how is trauma informed care defined

A

strengths-based framework thats grounded in understanding & responsiveness to impact of trauma, emphasizing physical, psychological, and emotional safety for both providers and survivors & creates opportunities for survives to rebuild sense of control and empowerment

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50
Q

trauma & violence - informed care defined

A

TVIC expands concept of TIC to account for the intersecting impacts of systemic & interpersonal violence & structural inequities on person’s life. this shift important as emphasizes both historical & ongoing violence & their traumatic impacts & focuses on person’s experiences of past and current violence so problems are seen as residing in both their psychological & social circumstances

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51
Q

what are trauma informed services

A
  • approach / way of being in a therapeutic relationship
  • universal precautions for trauma approach
  • place priority on individual’s safety, choice and control
  • provide treatment culture of nonviolence, learning, and collaboration
  • safety & empowerment for user are central, & embedded in policies, practices, and staff relational approaches
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52
Q

what emphasizes creation of treat where clients don’t experience further traumatization & where they can make decisions about their treatment needs at pace that feels safe for them

A

trauma informed services

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53
Q

trauma-specific services does

A

facilitate recovery through specialized counselling & other clinical interventions & generally requires some processing of traumatic experiences

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54
Q

examples of trauma specific services

A

trauma focused CBT, exposure therapy, EMDR

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55
Q

in trauma specific services, you need to consider the client’s ….

A

readiness to engage in the services

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56
Q

what is meant by client readiness

A

have good coping skills since opening up about what has happened people tend to unravel

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57
Q

what are the trauma informed practice principles

A
  • trauma awareness
  • emphasis on safety & trustworthiness
  • opportunity for choice, collaboration & connection
  • strengths based & skill building
  • recognition of cultural, historical, gender and sexuality issues
  • promotion of people with lived experience (peer involvement)
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58
Q

what is trauma awareness

A
  • building awareness about prevalence of trauma, its effects, & how ppl cope
  • how symptoms & behaviours represent adaptations to trauma
  • recognizes potential for vicarious/secondary trauma & emphasizes self-care
  • promotes awareness of relationship b/w trauma & health
59
Q

what is emphasis on safety & trustworthiness

A
  • physical, emotional & cultural safety essential to address the survivors tendency to feel unsafe
  • recognizes survivors often in unsafe situations
  • staff safety also stressed
60
Q

examples of practices that promote safety & trustworthiness

A

confidentiality, body language, active listening, genuine, honesty, informing ppl know what is happening with their care

61
Q

examples of practices/policies that promote safety & well-being for staff

A

open-door policy with leader, having actual policies like debriefing

62
Q

what is oppprtunity for choice, collaboration & connection

A
  • foster self-efficacy, self-determination, dignity & personal control
  • open-communication, equalize power imbalances, encourage expression of feelings, non-judgmental approach, provide options, work collaboratively w/ clients
  • connection among families, peers and community encouraged
63
Q

what is strength-baed and skill building

A
  • assisted to identify strengths & develop coping skills & foster resiliency
  • teaching/modeling of skills for recognizing triggers, calming, centering, grounding
64
Q

recognition of cultural, historical, gender and sexuality has trauma rooted in societal issues like

A
  • racism, classism, sexism & homophobia/transphobia
  • retraumatization in HC can increase stereotyping, social exclusion, discrimination
65
Q

what is promotion of people with lived experience

A
  • meaningful participation of ppl with experience essential in design & implementation of services
  • feedback is crucial & should be ongoing
  • integration of peer support in HC promotes safety
  • talking to clients allow us to provide better trauma informed care
66
Q

why is normal brain development called “bottom up” process

A

starts with most primitive functions of body & concludes with most complex (brainstrem —> cortex)

67
Q

t/f: at 6 years old, your brain is 90% the size of your adult brain

A

TRUE

68
Q

what is formed at an alarming rate during early childhood (0-3)

A

synapses or neural connections

69
Q

what does pruning mean

A

synapses are discarded based on the child’s learning and experiences

70
Q

what is myelination

A

formation of a insulating sheath around brain cells that make nerve impulse transmission more efficient (also bottom up process & influenced by experiences

71
Q

when does the brain stop growing/developing

A

mid 20’s

72
Q

during teenage years, what happens to synapses

A

pruning & increased white matter forms

73
Q

which area of the brain lags development in adolescents

A

frontal lobe

74
Q

what occurs when the frontal lobe develops after the physical development of brain in adolescents

A

poor impulse control, decision making and increase risk-taking behaviour due to using lower level of brain

75
Q

what part of the brain is growing and which part of the brain is underdeveloped in adolescents

A

limbic system & cortex

76
Q

what is the limbic system

A

responsible for emotions

77
Q

what is the cortex

A

responsible for reason, abstract thinking

78
Q

what can occur when the limbic system trumps the cortex

A

emotion-based interpretations and reactions

79
Q

neuroplasticity allows the brain to be…

A

adaptive

80
Q

what is neuroplasticity

A

rewiring brain by forming new connections & weakening old ones

81
Q

how are memories formed

A

experiences strengthen neuron pathways, they become encoded which leads to memories & responses become more automatic

82
Q

implicit memories

A

perception of environment & recall of experiences unconscious (babies born with this)

83
Q

explicit memories

A

conscious memories & is tied to language (develops ~ 2 yrs)

84
Q

how does trauma impact brain

A
  • positive experiences assist healthy brain development, negative experiences can have consequences on brain development
  • includes changes to structure & activity of brain & can lead to alterations in emotional& behavioural functioning
85
Q

what are some factors that influence trauma’s impact on brain

A

age (early more severe), single incident vs chronic, type & severity, role/identity of abuser when trauma is interpersonal (ex. attachment figure vs stranger)

86
Q

how does trauma impact the cortex

A
  • decreased activity
  • danger = limbic system activated b4 prefrontal cortex (less developed) can assess danger
  • staying in heightened danger response prevents prefrontal cortex to be activated which causes problems with problem-solving & learning
87
Q

how does trauma impact the limbic system

A
  • increased activity
  • initiates fight, flight & freeze
  • amygdala processes emotions & instigates release of hormones based on emotional responses (fear)
  • after trauma, amygdala may remain activated & continue to sound alarm inappropriately
88
Q

what does the limbic system control

A

fundamental emotions & survival instincts

89
Q

what structures are found within the limbic system

A

amygdala & hippocampus

90
Q

how does trauma impact the hippocampus

A

decreases volume
- stress hormones released by amygdala’s alarms suppresses hippocampus, losing function
- info not passed to cortex

91
Q

what does the hippocampus do

A

processes info & gives time & spatial context to memories/events
transmits info to cortex, for interpretation

92
Q

what is decreased volume of hippocampus closely correlated with

A

PTSD & depression

93
Q

what is the corpus callosum

A

info pathway between right and left hemispheres of brain

94
Q

impact of trauma on corpus callosum

A

smaller corpus callosum in abused children = less integration of hemisphere

contribute to greater fluctuations in mood or personality changes

95
Q

what is the neuro-endocrine system

A

interaction b/w brain and the hormones in the body

96
Q

what does the neuro-endocrine system help regulate

A

mood, stress responses, immunity, digestion

97
Q

what is chronic neuro-endocrine dysregulation linked to

A

prolonged exposure to trauma, and has been identified as a significant factor in many of its longterm effects

98
Q

alternations in what occurs in both children and adults who have experienced abuse

A

cortisol production

99
Q

stressful prenatal environment may lead to alternations in

A

cortisol levels

100
Q

low cortisol levels can lead too

A

decreased energy, impacting learning and socialization as well as increased risk of autoimmune disorders

101
Q

high cortisol levels are linked to

A

cognitive problems, mood problems and reduced immune response

102
Q

children who have experienced trauma may have difficulty

A

retaining or accessing explicit memories but implicit memories of the trauma remain resulting in nightmares, flashbacks

103
Q

during extreme trauma, info is not processed in the same way and the brain stores it as a different kind of memory called

A

trauma memory

104
Q

brain and body respond quickly to danger which results in

A

the hippocampus going offline

105
Q

a trauma memory is

A

not organized, sequential, fragmented, little control over retrieval, come back involuntarily and situationally accessible

106
Q

how is a trauma memory situationally accessible

A

triggered by reminders in the environment

107
Q

since trauma memories aren’t time tagged, it makes it

A

hard to place when they happened, feels like frozen in time, when come back - feels like occurring again in present which is associated with all same emotions & unpleasant physiological sensations

108
Q

how do people try to prevent trauma memories from recurring

A

avoid anyone/thing that may trigger, develops strategies to block and suppress (drugs & alcohol, distractions so no space to feel)

109
Q

the more you try and block and suppress trauma, the more . . .

A

it comes back

110
Q

what is epigenetics

A

biological mechanisms that will switch genes on and off

how DNA interacts with multitude of smaller molecules found within cells which can activate and deactivate genes

111
Q

life events can cause genes to

A

be silenced or expressed over time

112
Q

child maltreatment can cause what (genes)

A

epigenetic mods in victims

113
Q

epigenome is

A

set of all chemical tags attached to the genome of given cell

114
Q

positive stress is

A

moderate, brief, normal part of life, learning to adjust essential component of healthy development

115
Q

tolerable stress

A

events have potential to alter developing brain negatively, occur infrequently & give brain time to recover

116
Q

toxic stress

A

strong, frequent & prolonged activation of body’s stress response

117
Q

adult trauma survivors report more

A

physical symptoms of concern, poorer overall health, and lower health-related quality of life than non-traumatized counterparts and higher healthcare costs

118
Q

what does multiple types of trauma do

A

increase negative health conditions

119
Q

2 types of ways that trauma affects the body

A

lifestyle factors (behavioural pathway) & direct physical effects (biological pathway)

120
Q

describe lifestyle factors and how it affects the body

A

attempts at coping may lead to maladaptive strategies including use of alcohol and other substances, smoking, over-eating or eating an unhealthy diet, and other high-risk behaviours that contribute to health problems

121
Q

describe direct physical effects and how it affects the body

A
  • exposure to trauma lead to chronic hyperarousal of stress-response, damaging the brain and other systems & resulting in wide range of health problems
  • chronic stress = elevated levels of stress hormones which taxing to body (suppressing immune functioning & chronic inflammation)
122
Q

which area is most studied related to trauma affects

A

pain

123
Q

trauma & pain outcomes

A
  • high rate PTSD & physical pain
  • correlation b/w chronic pain in adulthood & childhood abuse
  • PTSD & pain = resistant to PTSD treatment
124
Q

sexual abuse =

A

high outpatient visits for chronic/acute pain

125
Q

possible explanations for the relationship b/w trauma and pain

A
  • experience of pain serve as reminders of event & worsen experiencing symptoms
  • shared vulnerability model
126
Q

what did Bartoszek study show

A

only pain caused by traumatic events themselves triggered experiencing symptoms (memories w/ emotions, flashbacks)

127
Q

what is the shared vulnerability model (Asmundson)

A

psychological & biological vulnerabilities interact w/ traumatic experience to produce emotional response characterized by hypervigalence, cognitive biases & avoidance.
attentional bias for threat serves as shared cognitive vulnerability for PTSD & chronic

128
Q

somatization refers to

A

development of somatic (body-based) symptoms for which no organic caused is found

129
Q

somatoform symptoms have been linked to

A

traumatic exposure, trauma victims tend to score higher on self-reports of somatic complaints than controls

130
Q

possible influences for somatization

A

neurobiological changes, increased physiological arousal, poorer health behaviour in the aftermath of trauma

131
Q

somatization may be related to other psychological consequences of trauma such as

A

depression, anxiety, dissociation, PTSD

132
Q

relationship b/w PTSD & somatization may be explained by

A

lowered responsiveness towards external stimuli combined with an increased awareness of internal stimuli (found in ppl with PTSD)

132
Q

relationship b/w PTSD & somatization may be explained by

A

lowered responsiveness towards external stimuli combined with an increased awareness of internal stimuli (found in ppl with PTSD)

133
Q

patients with dissociative disorders & PTSD patients present with more

A

somatoform symptoms

134
Q

it has been proposed that dissociation somehow mediates…

A

relationship b/w PTSD & somatization

135
Q

research has found …. with relationship to GI disorders

A

correlation b/w physical & sexual abuse & GI complaints like abdominal pain, nausea & vomiting, pelvic pain, ulcers

136
Q

what is functional GI disorders

A

chronic or recurrent GI symptoms that are not explained by structural or organic abnormalities

137
Q

what has been correlated with maltreatment & an example

A

functional GI disorders, ex: irritable bowel syndrome

138
Q

who came up with research about trauma and GI disorders

A

Sowder, Knight, Fishalow (2017)

139
Q

possible explanations for trauma & GI disorders

A
  • stress may over-activate the nerves that connect brain & gut
  • chronic state of sympathetic nervous system arousal we have associated with trauma is thought to be basis for digestion related problems
140
Q

what happens when the amygdala is setting off alarm to the GI

A

muscle tension clamps down on vagus nerve resulting in blood pump out of gut to prepare for fight or flight, stopping digestion

141
Q

chronic stress state produces what in the GI

A

all phases of digestion are interrupted or altered

142
Q

what are the outcomes of trauma and the cardiovascular system

A
  • ACE study linked childhood abuse, neglect, and household dysfunction to ischemic heart disease
  • later studies replicated this finding, even when controlling for lifestyle factors
  • study linking childhood maltreatment & cardiovascular disorders found stronger relationship for women than men

trauma (2 decks)

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