Sept 30 Flashcards
Dr Rich Lee on Racial Trauma
how families respond to racial trauma = critical to health and wellbeing and to addressing racism
silence is often how families respond to disc - but this isn’t a good coping strategy
social support as a moderator for effects of racial trauma
what component does the DSM-5 require in order to diagnose someone with PTSD?
a criterion A stressor
criterion A stressor
A. exposure to ACTUAL or THREATENED DEATH, SERIOUS INJURY, or SEXUAL VIOLENCE in one (or more) of the following ways:
A1: DIRECTLY experiencing
A2: WITNESSING in person as it occurred to others
A3: LEARNING they occurred to close fam member or friend
A4. EXPERIENCING REPEATED/EXTREME EXPOSURE to aversive details of traumatic events
- ie. first responders collecting human remains
- police repeated exposure to child abuse details
NOTE: criterion A4 doesn’t apply to exposure through electronic media, tv, movies, pictures, UNLESS this exposure is work related
important note regarding DSM 5’s Criterion A stressor
A4 - doesn’t apply to exposure through ELECTRONIC MEDIA, TV, MOVIES, or PICS
UNLESS this exposure is WORK-RELATED
PTSD symptoms
physical symptoms develop after traumatic event
don’t fade, may get worse with time
4 groups of symptoms
4 groups of PTSD symptoms
- intrusive
- avoidance
- altered mood & cognition
- altered reactivity & arousal
how does racial trauma FIT or NOT FIT within the DSM 5?
more serious major discrimination events may qualify outright as criterion A stressor
but MANY experiences DON’T
ie. DSM says criterion A trauma can’t be an ONLINE EXPOSURE (unless work related)
- inconsistent with trauma symptoms reported by people who see frequent examples on TV and media of ingroup members being exposed to violence or police brutality
criterion A traumatic event - conceptual boundaries
many calls for DSM to EXPAND criteria to include TRAUMAS resulting from RACISM and MARGINALIZATION
these are often lower level, MORE CHRONIC
but have LARGE CUMULATIVE effects across lifespan
racism leads to many of the symptoms listed for PTSD
criterion A traumatic event - can lead to possible mis…
MISDIAGNOSIS
of depression or anxiety
instead of PTSD symptoms
criterion A traumatic event - argument against expanding criterion A
argument that expanding the definition will reduce INTEGRITY/VALIDITY of the diagnosis
ICD-10 (international classification of diseases - system used in Europe) doesn’t restrict the types of experiences that can result in PTSD
stress sensitization and stress proliferation are additional…
aspects of cumulative effects
stress sensitization
exposure to earlier life adversity DYSREGULATES physiological and neural systems
makes individuals MORE SENSITIVE to negative impacts of later adverse experiences
stress proliferation
stress exposure leads to MORE & DIFFERENT TYPES of stress exposure
ie. get fired at work (stressor)
now experience family problems because of this (new stressor)
and also are accruing debt (new stressor)
and experiencing food insecurity (new stressor)
historical trauma definition
cumulative emotional and psychological wounding ACROSS GENERATIONS and OVER LIFESPAN
emanating from MASSIVE GROUP TRAUMA experiences
those with historical trauma exposure may start life…
more sensitized to stress
because of marks on epigenome (think back to DNA methylation and histone acetylation)
how many generations back can historical trauma be rooted?
unsure
at least 3 generations
epigenetics of historical trauma
trauma influences epigenome of GERM CELLS (sperm/egg)
if during pregnancy baby is a girl, will also influence BABY’s OWN germ cells (XX chromosome)
leads to GENES in offspring being turned ON or OFF
epigenetics evidence
some evidence of NEUROENDOCRINE DIFFS among children of Holocaust survivors versus “non-exposed” Jews
historical trauama is also spread through…
culture
narratives, beliefs, practices
parenting, family environment, parental behaviours
historical trauma - survivors passing down narratives of their experiences
- often draw parallels between past events and present
- memory lives on as representation of group-lived trauma
historical trauma - cycle of intergenerational transmission - A repeat
racism impacts parental mental health and parenting practices
related to youth mental and physical health
ie. parental mental health, undesirable parenting, negative affect of parent
leads to child/youth distress
SUMMARY historical trauma
historical trauma has LASTING IMPACTS across generations from traumatized groups
- mixed but promising evidence for EPIGENETIC IMPACTS
- clear unequivocal impacts on PARENTING, FAMILY ENVIRONMENT
- premature birth and BIRTH COMPLICATIONS
all of the above impact YOUTH MENTAL HEALTH and predispose them to INCREASED RISK (via sensitization) for PTSD and other MH problems following trauma exposure
how is discrimination related to ACTUAL TRAUMA SYMPTOMS
racist events >
- re-experiencing intrusion
- avoidance
- negative mood & cognition
- psychological arousal
Kirkinis et al - SYSTEMATIC REVIEW of racial discrimination & trauma literate - SETUP
28 studies - not meta-analysis but compiled a bunch of studies and looked at trends
100% from the US - need to expand beyond
50% of studies came out since 2011 - only recent data
93% cross-sectional
7% longitudinal