What Happened to You?

What is the "Oprah Bill?"

The National Child Protection Act established a national database of convicted child abusers, signed in 1993

What does OWLAG stand for?

The Oprah Winfrey Leadership Academy for Girls

Misogyny

Dislike of, contempt for, or ingrained prejudice against women

How many babies are born every year?

More than 130 million

Who is Mike Roseman?

A veteran of the Korean War with PTSD

Symptoms of PTSD

Anxiety, sleep difficulties, depression, and episodic flashbacks

What does a model of the brain look like?

An upside-down triangle, divided into four parts. From top to bottom it reads:

Cortex

Limbic

Diencephalon (middle brain)

Brainstem

Where is the brainstem?

The lowest part of the brain

What does the brainstem control?

Less complex and mostly regulatory functions, including temperature, respiration, and cardiac functioning

What is the main purpose of the brainstem?

To receive input from inside and outside the body

Another name for the brainstem

Reptilian brain

Where is the diencephalon, or middle brain?

The second-lowest area of the brain

What does the diencephalon control?

Arousal, sleep, appetite, and movement

What is the main purpose of the diencephalon?

Regulation

Where is the limbic brain?

The second-highest area of the brain

What does the limbic brain control?

Reward, memory, bonding, and emotions

What is the main purpose of the limbic brain?

To relate and connect

Where is the cortex?

The highest part of the brain

What does the cortex control?

Creativity, thought, language, values, hope, and a sense of time

What is the cortex?

The most uniquely "human" part of the brain

What is the main purpose of the cortex?

To reason

What are evocative cues?

Any sensory input, such as light, sound, smell, taste, or touch

How does the brain receive sensory input?

Sensory input is processed from the lowest area of the brain, the brainstem, to the highest area, the cortex

What can influence fetal brain development?

The mother's stress, substance intake, diet, and patterns of activity

How many neurons are born each second during fetal development?

20 thousand neurons per second

How many neurons are born each second during adulthood?

700 neurons per second

What are sensory organs?

Ears, eyes, nose, and skin

What is interoception?

Sensory systems aware of the body's internal state

What are auditory sensations?

Sound sensations

What are tactile sensations?

Touch sensations

What are olfactory sensations?

Smell sensations

What does CPS stand for?

Child Protective Services

How many times does a heart beat per day?

115,000 beats each day

What is regulation?

Being in balance, which ensures safety.

How can regulation be achieved?

Through something rhythmic, such as walking, dancing, listening to music, or the rocking of a baby

What is dysregulation?

When a child is exposed to unpredictable of extreme stress, causing them to be hypersensitive to triggers or situations and feel discomfort or stress

What do neural networks do?

Three Rs:

1. Regulation

2. Relationships

3. Reward

What does CRN stand for?

Core Regulatory Network

What are CRNs?

Neural systems that work together to keep a person regulated in the face of various stressors

What do CRNs impact?

All functions of the brain

What does ADHD stand for?

Attention Deficit Hyperactivity Disorder

What is sensitization?

Vulnerability

Causes of sensitization

Unpredictable, extreme, or prolonged patterns of stress

What is tolerance?

Resilience

Causes of tolerance

Predicable, moderate, and controllable patterns of stress

What happens during fight or flight?

1. Brain focuses your attention on the potential threat

2. Unnecessary mental processes are shut down

3. Sense of time collapses to the moment

4. Heart rate rises

5. Muscles tense, either for fighting or fleeing

6. Adrenaline is released

What is the arousal response?

Fight or flight

What are the body's natural painkillers?

Opioids, enkephalins, and endorphins

What happens when fight or flight is inapplicable?

1. Heart rate decreases

2. Opioids are released

3. Disengagement from external world

4. Psychological engagement with inner world

5. Time seems to slow

6. Disassociation ("watching," not "feeling" events)

What is the most powerful form of reward?

Positive relational interactions

What are the three types of developmental adversity?

1. Disruption before birth

2. Disruption of the early interactions between infant and caregiver

3. Any sensitizing pattern of stress

Examples of developmental adversity prior to birth

Prenatal exposure to drugs, alcohol, or extreme maternal distress

Examples of developmental adversity during the early interactions between infant and caregiver

Chaotic, inconsistent, rough, aggressive, or absent interactions

Examples of developmental adversity caused by any sensitizing patterns of stress

Anything that can cause unpredictable, uncontrollable, or extreme and prolonged activation of the stress response system

What will developmental adversity cause?

An overly reactive stress response

What are the three types of stress for an individual?

1. Daily challenge

2. Moderate stress

3. Distress - threat

What are the three different stress-response systems?

1. Resilient

2. Neurotypical

3. Sensitized

Five different responses to stress, in amounting order

1. Calm

2. Alert

3. Alarm

4. Fear

5. Terror

When facing a daily challenge, how might an individual respond?

1. Resilient stress response: calm

2. Neurotypical stress response: calm to alert

3. Sensitized stress response: calm to fear

When facing moderate stress, how might an individual respond?

1. Resilient stress response: calm

2. Neurotypical stress response: alert to alarm

3. Sensitized stress response: fear to terror

When facing distress or a threat, how might an individual respond?

1. Resilient stress response: calm to terror

2. Neurotypical stress response: fear to terror

3. Sensitized stress response: terror

What four things happen during the arousal response process?

Flock, freeze, flight, fight

When is the cortex unavailable?

When asleep or in a coma

What does REM stand for?

Rapid Eye Movement (during sleep)

What does DMN stand for?

Default mode network

What is DMN?

A network mostly located in the cortex that is active when an individual is thinking about others or themselves, remembering the past, or planning for the future

What are the dominant brain areas during each stress response?

Calm: cortex and DMN

Alert: cortex and limbic

Alarm: limbic and diencephalon

Fear: diencephalon and brainstem

Terror: brainstem

What arousal response occurs during each stress response?

Calm: reflect or create

Alert: flock or hypervigilance

Alarm: freeze or resistance

Fear: flight or defiance

Terror: fight

What dissociation response occurs during each stress response?

Calm: reflect or daydream

Alert: avoid

Alarm: comply

Fear: dissociate, paralysis, or catatonia

Terror: faint or collapse

What levels of understanding and thought are most present during each stress response?

Calm: abstract or creative

Alert: concrete or routine

Alarm: emotional

Fear: reactive

Terror: reflexive

What functional IQ is present during each stress response?

Calm: 120-100

Alert: 110-90

Alarm: 100-80

Fear: 90-70

Terror: 80-60

What might hypervigilance of the Alert state be mistaken for in a school setting?

ADHD

What might the resistance and defiance of the Alarm and Fear states be mistaken for in a school setting?

Oppositional defiant disorder (ODD)

What might flight behavior in a school setting cause?

Suspension from school

What might fight behavior in a school setting cause?

Assault charges

Approximately what percentage of children under 18 have experienced trauma?

50% of all children

What is the CDC?

US Center for Disease Control and Prevention

What does ACE stand for?

Adverse childhood experience

What percentage of American adults report having at least one ACE?

60%

What percentage of American adults report having at least three ACEs?

25%

How did Greek historian Herodotus describe trauma-like symptoms in soldiers following the battle of Marathon?

Hysterical blindness and emotional fatigue

What were trauma-related mental health effects known as after the American Civil War?

Irritable heart

What were trauma-related mental health effects known as after WWI?

Shell shock

What does SAMHSA stand for?

Substance Abuse and Mental Health Services Administration

What are the "three Es" of trauma?

Event, experience, and effects

What percentage of all childhood mental health disorders are related to childhood adversity?

45%

What percentage of all adult mental health disorders are related to childhood adversity?

30%

What is the ACE survey?

A ten-item questionnaire of adversities that may have occurred during childhood. The resulting score is your ACE score.

What correlation did the ACE study find?

A correlation between the ACE score and the nine major causes of death, suicide, mental health problems, and substance abuse

What does does high connectedness and low adversity during childhood do?

Lowers risk for mental, social, and physical health problems

What does high adversity and minimal connectedness during development do?

Increases developmental risk and the probability of significant problems in overall health

What does DSM stand for?

Diagnostic and Statistical Manual of Mental Disorders

Genetic mechanisms of transgenerational transmission

DNA

Epigenetic (changes in genes) mechanisms of transgenerational transmission

- Histone (protein controlling the activity of genes) modification

- DNA methylation (influencing DNA)

Intrauterine (in the uterus) mechanisms of transgenerational transmission

- Maternal milieu (environment, such as stress)

- Environmental toxins

- Other (alcohol, drugs, etc)

Perinatal (directly before and after birth) mechanisms of transgenerational transmission

Bonding and attachment (shaping primary regulatory and relational care)

Postnatal mechanisms of transgenerational transmission

- Family-mediated (language, values, and beliefs)

- Education, community, and culture mediated

How many people worldwide have diabetes?

415 million people

How many people in the US have diabetes?

34 million, or 1 in 10

How many Americans have prediabetic and cardiometabolic risk?

88 million Americans