Lecture: Foundations of Trauma
Lecture: Foundations of Trauma V05.0203
Popular in When the Nightmare Is Real: Trauma In Childhood and Adolescence
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This 4 page Class Notes was uploaded by Brianda Hickey on Monday February 22, 2016. The Class Notes belongs to V05.0203 at NYU School of Medicine taught by Adam Brown in Spring 2016. Since its upload, it has received 15 views. For similar materials see When the Nightmare Is Real: Trauma In Childhood and Adolescence in Cinema And Media Studies at NYU School of Medicine.
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Date Created: 02/22/16
Lecture: Foundations of Trauma What is Trama? There are two parts to trauma - the event and the reaction to the event A single experience, or repeating events that completely overwhelm the individual’s ability to cope or integrate the ideas or emotions involved with that experience Bessel Van der Kolk, 1989 “Traumatization occurs when both internal and external resources are inadequate to cope with external threat " Lenore Terr, 1991 “childhood trauma is the mental result of a blow, or a series of blows, rendering the young person temporarily helpless and breaking past ordinary coping and defensive operations” Type 1 Trauma: Single exposure - Trauma that happens once Car accident, death Type 2 Trauma: Chronic exposure - continually exposed to trauma Living with poverty, neglect, abuse If a child has diﬀerent single exposures more than once, still qualiﬁes as Type 1 trauma. Is not happening every day, is not chronic Basics of Trauma: It is usually an uncontrollable event The nature of the event is usually beyond the scope of ordinary human experience (usually rare or infrequent) It is usually unpredictable in the sense of a sudden event or a sudden change in mood of a violent parent. In an eﬀort to process the event, the person is changed. Traumatic stress is mediated by Survival Circuits : Fight, Flight, Freeze Automatically go into one of three modes In the moment of danger, it is helpful…but when triggered (Post Traumatic Stress) later, it becomes problematic Basic Types of Traumatic Event Neglect Physical Abuse Sexual Abuse Medical Neglect Other Sources of Trauma Removal form home Multiple foster placements extreme neglect extreme poverty Home and community violence emotional/psychological abuse loss of signiﬁcant abuse debilitating medical or psychiatric condition primary caretaker with debilitating medical or psychiatric conditions Natural Disasters The Eﬀects of Trauma Might higher risk for emotional and behavior problems Disrupts healthy development If a baby’s needs are not being met, or being maltreated, the brain becomes wired to expect negative response from certain actions. If they do this, that happens Optimum development, requires nurturing environment/stimuli The temporal lobes (top), which regulate emotions and receive input from the senses, are nearly quiescent (i.e. inactive). When a traumatized person is reminded of their trauma, they react in an emotional way rather than rationally - their speech is eﬀected Social & Emotional defects in Maltreated Children Maltreated children have lower social competence Have less empathy for others Have diﬃculty in recognizing other’s emotions Are less able to recognize their own emotional states Are more likely to be insecurely attached to their parents Trauma can be hard o diagnose because it looks like to many other things - Depression, PTSD< Phobias, ADHD, Risk Taking, Bipolar Disorder etc. How does Childhood Maltreatment exert Such Powerful eﬀect? It occurs during sensitive developmental periods It impacts on fundamental development processes Childhood is a time for learning (languages, music, motor skills most easily acquired) Number of synapses increases dramatically after birth Environment-stimulated neuronal activity is critical for elaboration of synaptic territories and ‘proper’ connections A child’s brain (When experience maltreatment) Does not develop currently, but due to brain elasticity with the current help it may be corrected ACE Study In the Adverse Childhood Experiences (ACE) study of over 17,000 enrollees in an insurance plan, a host of challenging childhood events were the most signiﬁcant predictors of adult ischemic heart disease, cancer, chronic lung disease, skeletal fractures, and liver disease People were given a questionnaire to ﬁll out, indicating which traumatic event they experienced Upper middle class people - a general population The greater Adverse experience, the more likely to antidepressant prescription, smoking alcoholism perpetrate domestic violence Developing health conditions GRAPH Very important to get help, if not…can lead to many problems There are nine categories of traumatic childhood events psychological, physical and sexual abuse; violence against the mother, living as a child with a household member who abused substances, was suicidal or mentally ill, or was ever imprisoned absence of one or both parents; and physical or emotional neglect Inter-generational Transmission of child abuse and neglect A child abused makes them more likely to hurt themselves (dugs, alcohol, social behavior etc) and eventually hurt others -> children Factors that ‘increase’ Trauma eﬀect Exposure to direct life threat Injury to self – extent of physical pain Witnessing of mutilating injury/grotesque death (especially to family or friends) Hearing unanswered screams or cries of distress Being trapped or helpless Unexpectedness or duration of the experience Number and nature of threats during episode Degree of violation of physical integrity of child Degree of brutality and malevolence Low IQ Absence of supportive adult, meaningful relationshiop Being female Being young Several factors are believed to make an event traumatic for an individual, including: Abiltiy to prepare Severity of abuse/perceived violation Duration (length of incident and number of times) Degree of humilation or helplessness Was the support system damaged? Being exposed to trauma may lower IQ The Challenger Study Children might be traumatized by events that do not directly aﬀect their personal safety or the safety of their loved ones Closeness to the traumatic event plays a role in the severity of symptoms Adolescents may have fewer symptoms because they can place the event within a larger context Emotional involvement and frequency of exposure play a role in the development of post traumatic symptoms Although many children don’t meet full criteria for a psychiatric disorder, they have frequently signiﬁcant symptoms
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