2. Child Maltreatment

Front 1

forms of maltreatment:
-abuse
-neglect

Back 1

abuse: physical, sexual, emotional

neglect: physical, emotional, medical, educational

infants & toddlers are physically vulnerable
-most cases of abuse-related eath were perpetrated by father or other male caregiver

-most cases of neglect were perpetrated by mothers
-more than 1/3-neglect only; often multiple maltreatment

Front 2

neglect in US

Back 2

most common form of maltreatment
-defined as "inadequately meeting a child's needs"
-state jurisdiction
-def. of abuse & neglect set by the state
-neglect less likely to be detected (no signs like abuse)

Front 3

four types of unresponsive care

Back 3

occassional inattention, chronic under-stimulation

legal issue: severe neglect in a family context, severe neglect in an institutional setting

Front 4

mandated reporting

Back 4

if you suspect abuse you must call DCF

Front 5

maltreatment impact on coping with a challenging task
-barrier box at 3 1/2 years
-box with a key locked insie, no keys work
-->how do kids handle the situation-how did they solve the task

Back 5

neglected children showed lowest scores on creativity and confidence & assertivness

neglect: issues of modeling, delays in brain development

abuse: could have the positive interaction with the parent
--for these domains, neglect seems to ahve a worse impact

Front 6

factors that affect child outcomes following maltreatment

Back 6

timing and duration (worse if it happens earlier-first 5 years are the worst)

relationship of child to perpetrator-worse if primary caregiver

severity

co-occuring risk factors-more likely to have a parent with mental health outcomes

Front 7

child maltreatment and mental health

Back 7

-children who have been maltreated show a higher incidence of bx and emotional problems (anxiety, PTSD, impaired social functioning and conduct problems)

-childhood maltreatment history is a significant risk factor for adult psychiatric disorders such as major depression and anxiety

Front 8

impacts on child functioning, ages 0-5

Back 8

school readiness
-emotional and behavioral regulation
-EFs (one of the most vulnerable parts of the brain)
attachment problems

Front 9

Bowlby's attachment theory

Back 9

human infants are biologically predisposed to form attachments with their caregivers

infant uses the caregiver as a secure base from which to explore the envt and also as a safe haven when distressed

Front 10

attachment classifications

Back 10

organized attachment
-secure-happy to reunify with mom and able to be soothed (after strange situation)
-insecure-being clingy and avoiding the mom

disorganized (both types of organized are better than this)

Front 11

disorganized attachment (5% of infants)

Back 11

results from pathogenic care

caregiver is simultaneously source of danger and source of comfort

disorganized attachment in infancy has been linked to dissociation (inconsistent & disorganized) at age 19

Front 12

frightening caregiver

Back 12

caregiver is a source of fear as well as biologically-based source of reassurance

-when infant alarmed by something else in envt, has irresolvable dilemma

-infant left to manage extreme arousal on their own-doesn't have capacity for this self-regulation
*attachment is individual specific, could be secure to mom and disorganized to abusive dad

Front 13

disorganized behaviors

Back 13

avoidance & proximity seeking simultaneously

-attachment bx suddenly followed by freezing or dazed bx

-stereotypies, bouts of frenetic activity

-freezing/stilling

-apprehension upon reunion or when parent calls or approaches

Front 14

children growing up in homes high in negative emotion

Back 14

express high levels of negative emotion

poor social skills

aggression and other bx problems (could also be difficult temperament of kids evoking negative emotions *dyadic-going both ways)

Front 15

emotional development

Back 15

difficulty in emotion labeling and emotion perspective taking

maltreated kids are exposed to an atypical emotional environment

mom's emotion expression predicts kid's emotion understanding, even among kids who are all maltreated
-->emotion perspective taking puppet show, "how is the puppet feeling"

Front 16

type of maltreatment and emotion understanding

Back 16

-on an emotion perspective taking task, physically abused kids were biased toward selecting angry faces, while neglected kids were biased toward selecting sad faces

-when shown 2 faces showing different emotions, neglected kids perceived less distinction between angry, sad, and fearful emotion expressions (7 mo olds can distinguish between pos & neg faces but not between sad & angry)

-both neglected and physically abused kids rated sad and angry faces as very similar to a neutral face

Front 17

Physically abused children and perception of anger (Pollack)
-children were shown a digitized photograph gradually morphing between 2 emotions (happy & angry)

Back 17

physically abused kids were able to detect the first signs of an angry expression well before the other kids

Front 18

Pollack ERPs

Back 18

maltreated children showed a larger response to angry stimuli than control children did, BUT only when they were attending to the angry faces
-the response to other emotions was the same across groups

Front 19

information needed for perception of emotion

Back 19

-physically abused kids perceived angry faces at an earlier stage than control children did

-physically abused kids required more information to perceived sad expressions (worse at identifying sadness-their perception is altered)

Front 20

emotional spatial cueing
-how do different emotions affect the reaction time

Back 20

-physically abused children showed evidence of difficulty disengaging from invalid angry faces but not invalid happy faces, suggesting a difference in attentional networks in this group of children

-higher score means longer reaction time on invalid (abused fixated on the angry faces)
-most studies involved perception of anger, not fear

Front 21

responses to distress of peers in abused and nonabused toddlers in the day-care setting

Back 21

abused toddlers showed significantly more maladaptive bx

Front 22

building a child's brain

Back 22

the most rapid period of brain development is in the first 5 years of life

the brain does not develop automatically as if it had an internal clock

Front 23

role of early experiences

Back 23

we now know that experiences matter for brain development and early experiences matter the most

a child's experiences with caregivers play an active role in shaping the brain's architecture

*brain very sensitive to caregiver's interactions

Front 24

caregivers help children build connections between brain regions

Back 24

playing; comforting & helping to manage stress; talking; teaching about relationships

*the neural connections that develop in the context of sensitive, responsive, care enable children to learn, to pay attention, to develop social skills, and to manage their emotions

Front 25

long term effects of child maltreatment

Back 25

harsh, neglectful, or inconsistent care also leaves an enduring imprint on the developing brain
-maltreated kids are at risk for physical disease, mental health problems, and substance abuse disorders in adulthood

-harsh or neglectful care leads to brain abnormalities which may help explain links between child maltreatment and adult psychiatric disorders

Front 26

structural and functional brain imaging studies have implicated differences in the limbic system (hippocampus & amygdala-memory and emotions) in adults who experienced childhood abuse

Back 26

patterns not found in child populations
-brain activation differs depending on the age

Front 27

adults with childhood abuse

Back 27

women who experienced sexual abuse prior to age 13 showed smaller hippocampal volumes only if they developed PTSD related to that abuse
-->interaction of psychiatric status and past abuse

Front 28

during a memory task unrelated to abuse, women with abuse-related PTSD failed to activate hippocampal regions activated by those with abuse but no PTSD

Back 28

so its not just volume, but the way that they are using the hippocampus

Front 29

corpus callosum

Back 29

the volume of the corpus callosum is significantly reduced in children suffering abuse or neglect relative to age-matched controls

-the top of the distribution is missing int he abused kids

Front 30

structural MRI measures

Back 30

maltreated children also show:
-smaller overall brain volume
-abnormalities in prefrontal cortex which manages emotional/cognitive functioning
-abnormalities in cerebellum, involved in learned fear

Front 31

links between brain abnormalities and emotional problems

Back 31

orbitofrontal cortex (part of social & reward) is smaller in physically abused kids

this brain abnormality is related to parent and child reports of deficits in social functioning
-->smallest where the parents & children reporting deficits