Trauma & Stress Related Disorders

Question 1

Neglect
Paradoxical dilemmas of abused children (3)
Most common in what types of parenting?

Answer 1

Emotional needs were not met
—
- Victim wants to stop violence but also wants to belong to family abusing them
- Attention/Affection may coexist w/ violence/abuse
- Physical violence may decrease over time or may increase
—
Authoritarian and uninvolved

Question 2

Effect of abuse/neglect on mood/affect (3)
Maltreated infants/toddlers at risk of what?

Answer 2

• Symptoms of depression, emotional distress, suicidal ideation
• Greater risk for substance abuse
• Sexual abuse can lead to eating disorders (AN and BN)
  —
  At risk of poor emotion regulation (difficulty understanding/labelling/regulating internal emotional states + learn ti inhibit emotional expression)
• Caused by insecure-disorganized attachment

Question 3

Affect of child abuse on:
- Brain structures (2)
- Norepinephrine system

Answer 3

• Hypothalamic-pituitary-adrenal axis (HPA axis)
• Hippocampus
• Prefrontal cortex
• Amygdala
  —
  Becomes sensitive to stress

Question 4

Reactive attachment disorder vs disorganized attachment

Answer 4

RAD: Absent or minimal attachment to any caregiver
Disorganized: Developed attachment relationships w/ primary caregiver

Question 5

Reactive attachment disorder (RAD) vs Disinhibited social engagement disorder (DSED)

Answer 5

RAD:
- Emotionally withdrawn from caregivers
- Low social responsiveness to others
- Rare in institutionalized children, almost never seen in adopted children
- Lacks clear attachment relationship
- Prognosis good if adopted by sensitive parents early
—
DSED:
- Lack of social inhibition
- Approaches/interacts w/ unfamiliar adults
- Sometimes seen in institutionalized, adopted exposed to multiple fosters, maltreated children
- Attachment to caregivers, may be secure
- Overly friendly behav can persist into childhood/adolescence
—
Both exp:
- Social/emotional neglect/deprivation
- Repeated changes of primary caregivers
- Reared in institutions w/ high child:caregiver ratios

Question 6

Acute stress disorder
Adjustment disorder

Answer 6

Acute:
- Developed within 1 month after exposure to extreme traumatic stressor
- At least 9 symptoms related to intrusion, negative mood, dissociation, avoidance, arousal

Adjustment:
- React to more common + less severe forms of stress in unusual/disproportionate manner

Question 7

Psychological first aid 5 steps
(PTSD)

Answer 7

1) emphasize child is safe from physical harm
2) remain calm and tell child their family has been notified and is on the way to be w/ them
3) increase their self-efficacy by giving them as much control over the situation as possible + providing then w/ objects that might make them more comfortable
4) achieve connectedness + social support by uniting them w/ their parents and other supportive family members as soon as possible
5) remain hopeful about the future by reassuring them that things will now be okay

Question 8

Best treatment for PTSD
- 2 types

Answer 8

Exposure-based therapy
- Grief and trauma intervention for children
- Trauma-focused cognitive-behavioural therapy (TF-CBT)

Question 9

Emotional neglect + eating disorders:
- Types of associated neglect
- Why is there a link?

Answer 9

• Emotional and physical
  —
• Neglect causes loss of the ability to regulate intensity of feelings and impulses
• Eating symptoms can be coping strat to regulate overwhelming affective states + avoid trauma-related memories and negative cognitions