Neurobiological and development research, chapter 2

Question 1

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

Answer 1

• 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

Question 2

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?

Answer 2

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)

Question 3

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…?

Answer 3

Survival

Question 4

The learning brain is enganged in..?

Answer 4

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

Question 5

The survival brain is engaged in?

Answer 5

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.

Question 6

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

Answer 6

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

Question 7

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?

Answer 7

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)

Question 8

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

Answer 8

Stress response system

Question 9

The stress response system operates automatically to maintain what?

Answer 9

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

Question 10

The stress response system includes the?

Answer 10

Autonomic nervous system

Question 11

What does the Autonomic nervous system control?

Answer 11

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

Question 12

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?

Answer 12

Norepinephrine (NE)

Question 13

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

Answer 13

Increasing arousal in the body systems

Question 14

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

Answer 14

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

Question 15

The stress response system directly influences which other system?

Answer 15

Immune system, brain system

Question 16

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

Answer 16

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.

Question 17

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

Answer 17

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).

Question 18

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

Answer 18

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

Question 19

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

Answer 19

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

Question 20

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

Answer 20

Developmental trajectories

Question 21

What are the 3 processes of brain development in traumatization?

Answer 21

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

Question 22

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

Answer 22

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

Question 23

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

Answer 23

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).

Question 24

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

Answer 24

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

Question 25

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

Answer 25

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.

Question 26

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...?

Answer 26

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

Question 27

The learning brain is engaged in?

Answer 27

Exploration, acquisition of new knowledge and neuronal/synaptic connections

Question 28

The survival brain seeks to?

Answer 28

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

Question 29

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

Answer 29

Brainstem, midbrain, amygdala

Question 30

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

Answer 30

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

Question 31

The stress response system includes the autonomic nervous system, which controls the body's...?

Answer 31

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

Question 32

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?

Answer 32

Noradrenaline (aka norephinephrine, NE)

Question 33

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

Answer 33

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

Question 34

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

Answer 34

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

Question 35

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

Answer 35

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

Question 36

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?

Answer 36

Succumbing to exhaustion, injury, or illness

Question 37

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

Answer 37

Developmental trajectories

Question 38

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

Answer 38

Hippocampus

Question 39

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...

Answer 39

Extremely difficult to alter

Question 40

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

Answer 40

Early chilldhood and adolescence

Question 41

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.

Answer 41

danger and survival rather than on trust and learning

Question 42

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?

Answer 42

Brainstem (Medulla, pons, midbrain, locus coeruleus) | Activates by producing neurotransmitters (dopamine, NE)

Question 43

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

Answer 43

Striatal (putamen, caudate, nucleus accumbens) brain areas

Question 44

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

Answer 44

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.

Question 45

Modulation of emotions involves the? Which focuses on?

Answer 45

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).

Question 46

The survival brain is fixated on?

Answer 46

Automatic, nonconscious scanning for and escape from threats

Question 47

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

Answer 47

Brainstem (medulla, pons, midbrain, locus coeruleus)

Question 48

Experiencing core emotions through the brainstem by producing which neuromtransmitters?

Answer 48

Dopamine, NE

Question 49

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

Answer 49

Familiar persons and objects, and fear of the unfamiliar emerges

Question 50

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

Answer 50

Self-regulation is enhanced

Question 51

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?

Answer 51

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

Question 52

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 ...?

Answer 52

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

Question 53

Persistent neglect or maltreatment in toddlerhood can lead to?

Answer 53

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

Question 54

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?

Answer 54

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

Question 55

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

Answer 55

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.

Question 56

What is reflective awareness?

Answer 56

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)

Question 57

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..?

Answer 57

Ego control, and inhibition control.

Question 58

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..?

Answer 58

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

Question 59

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 ?

Answer 59

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

Question 60

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

Answer 60

Attempts to avoid them

Question 61

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

Answer 61

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

Question 62

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?

Answer 62

Thalamus and orbital/medial PFC

Question 63

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

Answer 63

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

Question 64

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

Answer 64

To mediate the body's arousal level

Question 65

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

Answer 65

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

Question 66

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

Answer 66

Blocking learning and memory of active escape behaviors

Question 67

“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?

Answer 67

Directly to the amygdala or enthorhinal cortex.

Question 68

Amygdala activation is associated with learning of both?

Answer 68

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

Question 69

PTSD is associated with a smaller volume of?

Answer 69

Hippocampus

Question 70

What hormone is systematically increased in PTSD?

Answer 70

Norepineprhine (NE)

Question 71

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

Answer 71

Vagus nerve, to bodily organs

Question 72

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

Answer 72

Oxytocin and Vasopressin

Question 73

Oxytocin (peptide) contributes to what functions?

Answer 73

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

Question 74

Vasopressin contributes to what functions?

Answer 74

Defensive activities, attention and learning

Question 75

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

Answer 75

Emotion and somatic self-regulation and information processing

Question 76

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

Answer 76

Increased hypothalamic production of stress hormones

Question 77

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

Answer 77

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

Question 78

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

Answer 78

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

Question 79

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

Answer 79

Stress hormone and cortical dysregulation

Question 80

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

Answer 80

Increases automaticity | Reduces self-reflective autonomy

Question 81

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

Answer 81

Reduce Automaticity | Enhance reflective self-awareness

Question 82

Enhancing reflective self-awareness may involve?

Answer 82

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

Question 83

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

Answer 83

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

Question 84

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?

Answer 84

``` Bodily sensations Perceptions Thuoghts Intentions Plans Appraisals ```

Question 85

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?

Answer 85

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