Psych - Effects Of Childhood Trauma And Neglect

Front 1

Sexual abuse more common in...

Back 1

females. It is the most common cause of female PTSD.

Front 2

neglect and physical abuse more common in...

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neither. equal for boys and girls.

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Most common thing -

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neglect. and most of the sufferers of all these bad things are less than 7 years old.

Front 4

Most protective factor resulting in child less likely to have sequelae of abuse/neglect

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Attachment to a caregiver

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Worst factor resulting in child most likely to have sequelae of abuse/neglect

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Having no one the child feels safe with.

Front 6

Younger the abuse...

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the greater the long term impact.

Front 7

Sequelae of abuse/neglect

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Low self-esteem
Anger/acting out
depression
substance abuse
eating disorders
Personality disorders (borderline and antisocial).
PTSD
Disorders of attachment
Self mutilation
Somatization disorder
Conversion disorder
Dissociative disorder
Increased rate of suicide.
MRI changes in brain
Changes in urinary free cortisol and catecholamines.

Front 8

PTSD trauma result from...

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situation observed or experienced where well-being was threatened and there was no escape.

Front 9

Abuse/neglect results in major changes in...(4)

Back 9

physiological arousal, emotion, memory, cognition.

Front 10

Dissociation

Back 10

Physiological arousal, emotion, memory, cognition are disconnected in some way.

The normally integrated self-protective system is overwhelmed.

Front 11

Notes for this lecture...

Back 11

are very good. read them.

Front 12

Neurobiology of PTSD

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Lasting effects on HPA axis and norepinephrine system.

Recent research suggests that genetic variation in the FKBP5 gene, which is involved in glucocorticoid signal transduction, may alter sensitization of the stress-response pathway during development, placing those individuals who have had significant child abuse at significant risk for PTSD in the face of other traumatic experiences.

Front 13

Self mutilation theory

Back 13

Endogenous opioid system may develop as a result of good attachment with mother.

So with severe neglect or poor attachment, hyperstim/pain may finally give self-soothing.

Front 14

Somatization disorder

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Highest correlation with early life sexual abuse.

Front 15

Dissociation in the extreme is...

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Multiple personality disorder

Front 16

Ketamine

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Acts on the glutamate system to produce dissociation. Does this by inactivation of large neurons (associative fibers)

Front 17

PET scan during a flashback

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Inactivation of areas of the brain associated with language and communication.

Front 18

Prognostic significance of dissociation

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Risk factor and predictor for later development of PTSD.

Front 19

Dissociative amnesia

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Inability to recall extensive amt of info (usually of traumatic or stressful nature).

Not due to DID, dissociative fugue, PTSD, acute stress disorder, or somatization. Also not due to substance or general medical condition.

Front 20

Dissociative fugue

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Sudden unexpected travel from home with inability to recall past.

Confusion about personal identity or assumption of a new identity.

Not due to DID, substance or general medical condition.

Front 21

Dissociative Identity Disorder (DID)

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Presence of two or more distinct IDs or personalities.

At least two of them recurrently take control of behavior.

Inability to recall personal info that is too extensive to be explained by ordinary forgetfulness.

Not due to substance or general medical condition.

Front 22

Dissociation also occurs in:

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Acute stress disorder (presents as dissociative amnesia)

PTSD as avoidance sx. Inability to recall important aspect of the trauma (dissociative amnesia)

Somatization disorder as a pseduoneurological sx.

Trance states or possession states that aren't accepte as normal part of collective cultural or religious practice.

Front 23

2 types of PTSD

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One without dissociation where there is undermodulation of emotional responses. This one is due to failure of prefrontal inhibition on limbic regions.

Dissociative type - Overmodulation on limbic regions by midline prefrontal inhibition.

Front 24

2/3 of psych patients have history of...

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physical or sexual abuse.

Front 25

PTSD patients urine has more...

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cortisol, dopamine, NE.

Front 26

MRI of maltreated children

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Smaller intracranial and cerebral volumes--correlates with age of onset and total duration of abuse.

Front 27

Trauma has most impact in which decade of life?

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1st

Front 28

Suicide, cutting and other self-injurious behavior associated with...

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Borderline.

NOT with anti-social, narcissistic, schizoid PD, and bipolar II.

Front 29

Abuse in early childhood correlates well with...

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Suicide attempts and total self-injurious behavior

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Abuse in adolescence corr with...

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Suicide attempts and anorexia.

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History of sexaul abuse corr with...

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continued suicide attempts and cutting, but not other self-injurious behavior.

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Most powerful predictor of self-destructive behavior

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Trauma

Front 33

Moderate association of trauma with...

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Eating disorders.

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Trauma contributes heavily to the initiation of self-destructive behavior, but lack of secure attachments maintains it.

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(not a question)