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Treating Complex Traumatic Stress Disorder > Neurobiological and development research, chapter 2 > Flashcards

Neurobiological and development research, chapter 2 Flashcards

1
Q

Developmental adverse interpersonal traumas in early childhood (or developmental trauma) include which forms of traumas?

A
  • Sexual
  • Physical
  • Emotional abuse
  • Abandoment by caregiver(s)
  • Chronic and severe neglect
  • Domestic violence
  • Death
  • Grusome injuries as a result of community violence
  • Terrorism
  • War
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2
Q

Psychological traumas are developmentally adverse if they block or interrupt the normal progression of psychological development in periods when a child (usually in infancy and early childhood) is aquiring the fundemental psychological and biological foundations necessary for all subsequent development. What are the necessary foundation for development?

A
  1. Attention and learning
  2. Working (short-term), declarative (verbal), and narrative (autobiographical) memory
  3. Emotion regulation
  4. Personality formation and integration
  5. Relationships (attachment)
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3
Q

In essence, when psychological trauma interferes with or derails normal psychobiological development, particularly in infancy and early childhood, there is a shift from a brain (and body) focused on learning to…?

A

Survival

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4
Q

The learning brain is enganged in..?

A

Exploration. Driven and reinforced by a search for an optimal balance between novelty and familiarity

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5
Q

The survival brain is engaged in?

A

Anticipate, prevent, or protect against the damage caused by potential or actual dangers, driven and reinforced by a search to identify threats, and an attempt to mobilize and conserve bodily resources in the service of this vigilance and defensive adjustments to maintain bodily functioning.

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6
Q

The learning and survival brain differs in their way of interpreting information. What does the survival brain rely on?

A

• Rapid automatic processes that involve the primitive portions of the brain (e.g. brainstem, midbrain, parts of the limbic system, such as the amygdala)

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7
Q

The learning and survival brain differs in their way of interpreting information. Which function and part of the brain is not being fully developed by the survival brain?

A

The more complex adaptations to the environment (learning, e.g., anterior cingulate, insula, prefrontal cortex, other parts of the limbic system, such as the hippocampus)

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8
Q

The organizing brain-body system for survival is the…?

A

Stress response system

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9
Q

The stress response system operates automatically to maintain what?

A

The inner balance of all body systems (homeostasis) by adjusting the systems activity.

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10
Q

The stress response system includes the?

A

Autonomic nervous system

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11
Q

What does the Autonomic nervous system control?

A

The body’s arousal levels to achieve a balance of mobilization and restoration of bodily energy and organ activity.

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12
Q

A part of the symphatetic branch of the autonomic nervous system known as which neurotransmitter is responsible for increaing arousal in many body systems (e.g. cardiovascular, pulmonary, gastrointestinal), as well as the brain?

A

Norepinephrine (NE)

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13
Q

Norepinephrine (NE) is responsible for which reaction in traumatization?

A

Increasing arousal in the body systems

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14
Q

The parasymphatetic branch of the autonomic nervous system operates via the vagus nerve and functions as what in the context of traumatization?

A

Functions as a brake on arousal, enabling the body to conserve energy.

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15
Q

The stress response system directly influences which other system?

A

Immune system, brain system

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16
Q

If the immune system is compromized by the stress response system, what happens?

A

Immune system generally reduces its level of activity and potentially compromising its ability to detect and fight off pathogens, and promote tissue and organ healing, as well as increasing autoimmune responses that can damage bodily integrity.

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17
Q

What effect does the stress response system have on the brain system?

A

Overrides it and reduces the functionality that is necessary for:
• Learning, including brain systems that promote seeking rewards (dopamine )
• Managing distress (serotonin)
• Making conscious judgments and plans (executive functions involving emotion and information processing, which involve the prefrontal cortex).

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18
Q

A surviving brain operates automatically to defend against external threats, but what is the downside of this action?

A

It diverts crucial resources from brain-body systems that are essential to prevent the body from succumbing to exhaustion, injury, or illness and to promote learning

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19
Q

Which different parts of learning are hindered during a ‘survival brain’?

A
  • Reward seeking
  • Distress tolerance
  • Emotion awareness
  • Problem solving
  • Episodic/narrative memory
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20
Q

The changes in the body and personality that evolve as a person grows and both copes with and learns from experiences is called?

A

Developmental trajectories

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21
Q

What are the 3 processes of brain development in traumatization?

A
  1. Current experiences and bodily changes
  2. “Consilidation of structure over development”
  3. Psychobiological structures become consolidated, “cascading constraints” emerge, and new structures (pathways, networks) are less and less likely to develop
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22
Q

The 1st process of brain development in traumatization deals with “Current experiences and bodily changes”, what does this mean?

A

The system lays down traces that permenantly alter the structure of the system. This changes the activity of neurons or pathways interconnecting them, in which they become increasingly or decreasingly sensitized

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23
Q

The 2nd process of brain development in traumatization deals with “Consilidation of structure over development”, what does this mean?

A

That the pathways and networks linking brain neurons are selectively strengthened and increasingly fiexed (they become the biological and psychological “structure” that defines the individual’s identity and way of approaching life experiences).

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24
Q

The 2nd process of brain development in traumatization deals with “Psychobiological structures become consolidated”, what does this mean?

A

That cascading constraints emerge, and new structures (pathways, networks) are less and less likely to develop

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25
Q

The 3 processes of brain development in traumatization tends to do what with children?

A

Limit the brain’s ability to aquire new trajectories, casing a loss of ‘degrees of freedom’ that limits the child’s potential but results in the development of a consistent, integrated self.

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26
Q

When psychological trauma interferes with or derails normal psychobiological development, particularly in infancy and early childhood, there is a shift from a brain (and body) focused on…. to…?

A

From learning to a brain (and body) focused on survival

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27
Q

The learning brain is engaged in?

A

Exploration, acquisition of new knowledge and neuronal/synaptic connections

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28
Q

The survival brain seeks to?

A

Anticipate, prevent, or protect against the damage caused by potential or actual dangers, driven and reinforced by a search to identify threats

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29
Q

The survival brain relies on rapid automatic processes that involve primitive portions of the brain, such as?

A

Brainstem, midbrain, amygdala

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30
Q

The learning brains processes are bypassed by the surviving brain, which more complex adaptations to the environment is involved for the learning brain?

A

Anterior cingulate, insula, prefrontal cortex, other parts of the limbic system (not amygdala) such as hippocampus

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31
Q

The stress response system includes the autonomic nervous system, which controls the body’s…?

A

Arousal levels to achieve a balance of mobilization and restoration of bodily energy and organ activity

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32
Q

The symphatetic branch of the autonomic nervous system and which neurotransmitter are responsible for increasing arousal in many body systems (eg. cardiovascular, pulmonary, gastrointestinal) as well as in the brain?

A

Noradrenaline (aka norephinephrine, NE)

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33
Q

The parasymphatetic branch of the autonomic nervous system operates via which nerve, and has which function on arousal?

A

Vagus nerve.

Functions as a brake on arousal, enabling the body to conserve energy

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34
Q

The stress response system directly influences immune system activity, generally reducing its level of activity and potentially compromising its ability to?

A

Detect and fight off pathogens, and promote tissue and organ healing, as well as incerasing autoimmune responses that can damage bodily integrity

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35
Q

The stress response system also tends to override and reduce the functionality of brain systems that are necessary for learning, including brain systems that…?

A 
Promote seeking rewards (dopamine)
Managing distress (serotonin)
Making conscious judgments and plans (executive functions involving emotion and information processing, which involve prefrontal cortex)
36
Q

Thus, a survival brain operates automatically to defend against external threats, but in so doing it diverts crucial resources from brain-body systems that are essential to prevent the body from?

A

Succumbing to exhaustion, injury, or illness

37
Q

The changes in the body and personality that evolves as a person grows and both copes with and learns from experience is called?

A

Developmental trajectories

38
Q

Higher-order symoblic thought and memory is among other places found in the?

A

Hippocampus

39
Q

If psychological trauma occurs during these transitional periods, the lasting traces (most of which are not in the person’s conscious memory) and fixed structures (i.e., relatively automatic habit patterns and fixed beliefs/ expectations) can be…

A

Extremely difficult to alter

40
Q

Experience can shape the brain or alter neural networks at any time in life, but never as much as in..?

A

Early chilldhood and adolescence

41
Q

Thus, the most complex occurrences of psychological trauma tend to involve interactions with people who teach the child or adolescent to focus on …..? during transitional periods in which lasting changes in the personality and self occur. If traumatic events push the brain’s trajectory of development away from creative exploration and learning toward defensive states geared to promote survival, the child’s biological and psychological flexibility and ability to change may be diminished or largely lost.

A

danger and survival rather than on trust and learning

42
Q

Experiencing core emotions states (e.g. anger, fear, sadness, joy, love, interest) involves which part of the brain? And how does this part of the brain activate the body?

A

Brainstem (Medulla, pons, midbrain, locus coeruleus)

Activates by producing neurotransmitters (dopamine, NE)

43
Q

Expressing emotions in mood states and action (eg. aggression, reward seeking, mating) involves which part of the brain?

A

Striatal (putamen, caudate, nucleus accumbens) brain areas

44
Q

What are the striatal brain areas activated by in relevance to expressing emotions and what does it do?

A

By input (afferents) from the cortex and selectively alter sensory perception (via the thalamus) and intentional behavior, as well as by the hypothalamus, which modulates body stages by producing or triggering production of neuropeptides (e.g. stress hormones, oxytocin, vasopressin) and engaging the autonomic nervous system.

45
Q

Modulation of emotions involves the? Which focuses on?

A

The limbic system. Which focuses sustained attention and triggers automatic (via the brainstem and hypothalamus) and conscious (via the cortex) responses based on the emotional significance of perceptual and memory information (i.e. the amygdala).

46
Q

The survival brain is fixated on?

A

Automatic, nonconscious scanning for and escape from threats

47
Q

Experiencing core emotion states (e.g. anger, fear, sadness, joy, love, interest) involves which part of the brain?

A

Brainstem (medulla, pons, midbrain, locus coeruleus)

48
Q

Experiencing core emotions through the brainstem by producing which neuromtransmitters?

A

Dopamine, NE

49
Q

Between ages 6-12 months, evolving neural pathways from the PFC to the amygdala and hippocampus lead to the ability to discriminate between?

A

Familiar persons and objects, and fear of the unfamiliar emerges

50
Q

If an infant (between 6-12 months), has repeated success in coping with mild brief episodes of fear.. what happens?

A

Self-regulation is enhanced

51
Q

If an infant is exposed to abuse, for a prolonged period, or it exacerbates, or prevents the learning of ways behaviorally and biologically to modulate fear of the unfamiliar, novelty may become a lasting source of unmanagable distress, not because fear or novelty itself is toxic, but because?

A

Of the infant’s failure to learn how to regulate the body when experiencing fear of the unfamiliar

52
Q

If these systems’ development in the first 2 to 3 years of life is altered by significant survival threats posed by traumatic events and compromised care-giving, their neural and neurochemical circuits are likely to become …?

A

organized by stress reactivity (i.e., identifying and avoiding distress rather than exploring, learning, and engaging in relationships).

53
Q

Persistent neglect or maltreatment in toddlerhood can lead to?

A

Persistent states of extreme emotional distress (e.g. paralyzing shame, absence of empathy, anger expressed in agressive behavior) and impairment in the ability to express of modulate these affects

54
Q

Not only emotions but also bodily feelings tend to be experienced as signals of danger or, in and of themselves, as actual threats leading to?

A
  1. Persistent affective states of anxiety, anger, sadness and depression
  2. Bodily discomfort, pain, preoccupation, and loss of physical function (hysterical symptoms, such as paralysis or pseudoseizures)
  3. Associated deficits in basic self-regulation (e.g. feeding, sleep-wake cycles, self-soothing) and behavioral disinhibition (impulsivity, risk taking, aggression, addictive behaviors) that can result in severe and persistant behavioral and phsyical health problems
55
Q

To be self-aware is more than just being aware of one’s thoughts, feelings, or behavior. Self-awareness also requires?

A

Self-reflection, the ability to step back and observe one’s own processes of thinking and feeling, as well as the resultant thoughts, feelings, and behavior.

56
Q

What is reflective awareness?

A

The capacity to create, elaborate, and hold mental representations without necessarily acting upon them (e.g. to recognize emotions and intentions as distinct from impulses or behavior)

57
Q

From childhood into adolescence, CNS somatosensory cortices appear to shrink and become more efficient , whereas CNS areas activated by reward (e.g., medial/ orbital PFC) appear to grow and become complex. These brain changes are consistent with the shift in childhood away from impulsiveness and self-protectiveness towards..?

A

Ego control, and inhibition control.

58
Q

Exposure to traumatic stressors in early childhood may lead to neural networks in the brain that operate without the person’s awareness to focus his or her attention on..?

A

Preparing for and avoiding danger and reduce the person’s ability to become aware of these survival-based patterns of thinking and feeling

59
Q

People who have been exposed to traumatic stressors in early childhood are avoiding danger as well as reducing their ability to become aware of their own patterns of thinking and feeling, leading to a situation where they ?

A

The person focuses on anticipitating and reacting to threats, instead of seeking and being guided by reflective self-awareness.

60
Q

In PTSD unwanted memories (for the patient), which are intrusive reexperiencing, are dealt with the brain by?

A

Attempts to avoid them

61
Q

In PTSD, in an attempt to avoid intrusive reexperiencing (memories), what are common reactions to situation for them?

A

Difficulty maintaining sustained mental concentration, frequent shifts from positive or neutral appraisals of events and people to fearful or angry appraisals (irritability, anxiety, hypervigilance)

62
Q

Within milliseconds of receiving sensory input from the external environment or the body that signals a threat, chemical messengers activate fast-acting neural receptors in the?

A

Thalamus and orbital/medial PFC

63
Q

PFC can inhibit what, and also why is it more complex?

A

Amygdala activation and reduce stress reactivity.
Feedforward from PFC to the midbrain ventral tegmental area can also trigger the release of neural-messengers in the striatum and amygdala, leading to fear-related mental disorganization and encoding of fear memories

64
Q

In long-term fear situation, what is the role of the hypothalamus?

A

To mediate the body’s arousal level

65
Q

In long-term fear situation, what is the role of the hippocampus?

A

To imprint and access the memories of contextual fear and passive avoidance

66
Q

Slow-acting hippocampal receptor activity also may impair active self-regulation by ?

A

Blocking learning and memory of active escape behaviors

67
Q

“The sensory information contained in a fear or anxiety-inducing stimulus is transmitted from peripheral receptor cells to the dorsal thalamus” except for olfactory (smell) data, which are relayed?

A

Directly to the amygdala or enthorhinal cortex.

68
Q

Amygdala activation is associated with learning of both?

A

Fear and extinction (the learning of when to be afraid and when not to)

69
Q

PTSD is associated with a smaller volume of?

A

Hippocampus

70
Q

What hormone is systematically increased in PTSD?

A

Norepineprhine (NE)

71
Q

Innate self-regulation processes depend on the brainstem areas to send and receive feedback along which nerve and to where?

A

Vagus nerve, to bodily organs

72
Q

Two peptides released in the hypothalamus appear to trigger a cascade of neural activity throughout the brain than enhances affiliation, which?

A

Oxytocin and Vasopressin

73
Q

Oxytocin (peptide) contributes to what functions?

A

Birth and lactation, and facilitates infant bonding with caregivers, female bonding as an infant caregiver, nesting, and reduced stress reactivity, as well as to adult pair-bonds, social memory and sexual receptivity

74
Q

Vasopressin contributes to what functions?

A

Defensive activities, attention and learning

75
Q

Oxytocin and vasopressin facilitate not only social contact and caregiving but also..?

A

Emotion and somatic self-regulation and information processing

76
Q

When adult animals are stressed by unreliable access to food supplies, they and their offspring experience what change in the brain?

A

Increased hypothalamic production of stress hormones

77
Q

Disorganized attachment in human children is characterized by a chaotic mix of?

A

Excessive help seeking and dependency, social isolation, and disengagement, impulsiveness and inhibition, and submissiveness and aggression

78
Q

Maltreated children also may have impaired neural development in which parts of the brain?

A

Corpus callosum,
ACC,
Frontal cortex,
and reduced maturatation of brain’s left hemisphere

79
Q

Human infants with clinically depressed mothers are at risk for what as preschoolers and adolescents?

A

Stress hormone and cortical dysregulation

80
Q

The crucial problem in complex traumatic stress disorder is that survial-based avoidance increases…? And reduces…?

A

Increases automaticity

Reduces self-reflective autonomy

81
Q

The primary focus in psychotherapy for complex traumatic stress disorder is to reduce…? And to increase…?

A

Reduce Automaticity

Enhance reflective self-awareness

82
Q

Enhancing reflective self-awareness may involve?

A

Increase attunements to thoughts, emotions, body states (sensorimotor psychotherapy), self-states, or self-defining roles and involvement in relationships.

83
Q

With enhanced emotion and information processing comes a corresponding increase in the capacity to choose not to avoid but instead to…?

A

Confront, to recall fully, and to reconstruct distressing current experiences and past memories

84
Q

Treatment modalities for complex traumatic stress disorders are most effective if the clinician focuses on using them as a vehicle for enhancing self-reflective processing of emotion and information such as?

A 
Bodily sensations
Perceptions
Thuoghts
Intentions
Plans
Appraisals
85
Q

PTSD symptoms originate or rapidly become largely automatic, because the child either does not have or cannot mobilize conscious self-protective defenses. The result is psychoform or somatoform dissasociative fragmentations of consciousness, for example?

A

Compartmentalized, disonnected parts of the self, each of which is defined by a distinct dominant motivation or set of motivations.

Treating Complex Traumatic Stress Disorder (1 decks)

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