Week 7: Child Maltreatment and Psychopathology Flashcards
Diathesis Stress Models
Genetic predispositions interacting with maltreatment to lead to later psychopathology
EXAMPLES INCLUDE
Conduct disorder
Caspi et al. 2002
MAOA activity interacting with maltreatment
Low MAOA activity and maltreatment predicting antisocial behavior in
adulthood
Diathesis Stress Models
Significant life stress
Depression
Serotonin transporter gene 5 HTTLPR
2 versions: short allele and a long allele
Three genotypes: S/S, S/L, L/L
In adults, short allele is associated with increased depression, but only for those who experience significant life stress
Diathesis short allele
Stress life stress
SHORT ALLELE IS DIATHESIS
Serotonin Transporter Gene x
Maltreatment
Does genotype moderate the association between maltreatment and depression?
DV - probability of a major depressive episode
IV - s/s, s/l, l/l alleles
Level of maltreatment
RESULTS
No main effect of genotype
Main effect of maltreatment
Interaction between genotype and maltreatment amount
Serotonin Transporter Gene x
Maltreatment replication and social support
A second study replicated the Caspi et al. finding
- Social support played a protective role
- Maltreated children with a short allele and poor social support had rates of depression 2x higher than maltreated children with a short allele and social support
Serotonin Transporter Gene x
Maltreatment replication
Meta analysis
A number of studies did not find the interaction between life stress (more broadly) and the serotonin transporter gene
2018 meta analysis
- 13,000 to 29,000 participants
- Main effect of stress
- No main effect of genotype
- No interaction between genotype and stress
Still being debated
Diathesis
Stress Models
Maltreatment is a risk factor for the development of
psychopathology
Multifinality
- Depression versus antisocial behavior
- Perhaps one trigger can lead to multiple outcomes
Different diatheses
Individual differences may make some people more vulnerable to development of psychopathology than are others
May shape the form of psychopathology
Post Traumatic Stress Disorder
Anxiety after an extremely traumatic experience
Actual or threatened death, serious injury, sexual violation
Direct experience
Witness it in person
Learns that it happened to a close family member or friend
Experiences repeated exposure to details of event
E.g., first responders, jury members
Post-Traumatic Stress Disorder DSM-5
Four core features
Symptoms must persist for at least one month
Intrusion (1 required)
Recurrent, involuntary, memories (may see this in children as play episodes);
flashbacks, nightmares, intense physical distress to reminders of the events,
marked physiological reactivity to stressor
Avoidance (1 required)
Avoiding thoughts or feelings related to the trauma; avoiding stimuli related
to the trauma
Extreme arousal (two required)
Difficulty falling or staying asleep, irritable/aggressive behavior, hypervigiliance , easily startled, difficulty concentrating, self destructive
behavior
Negative cognitions and mood (two required)
Inability to recall key features of the event, persistent negative beliefs about
self or world; distorted blame of self or others; persistent negative trauma
related emotions (e.g., horror, shame); diminished in activities; alienation from
others; inability to experience positive emotions
PTSD in Children 6 years of age and younger
Presence of one or more symptoms of intrusion
One or more symptoms of avoidance and/or negative cognitions (compared to 3 in older youth and adults 1 avoidance and two
negative cognitions/mood)
Two or more symptoms of extreme arousal
Symptoms may be expressed through play
Reenactment
More behaviorally anchored
“Feelings of detachment or estrangement from others”= social withdrawal
“Persistent inability to experience positive emotions”= Persistent
reduction in expression of positive emotions
Irritability expanded to include tantrums
Prevalence of Post Traumatic Stress Disorder
Limited data with children
With adolescents:
National Comorbidity Survey of Adolescents
Lifetime prevalence of PTSD is 5%
Other work has suggested that the majority of youth who experience trauma experience some symptoms of PTSD
85% of youth who experienced a significant trauma reported at
least one symptom of PTSD
