Abnormal child phychology - ch 12 Trauma and Stressor Related Disorders

Prevalence of maltreatment types?

75% neglect -> 17% physical -> 8% sexual -> other

Types of maltreatment?

ABUSE: physical, sexual, emotional/psychological/verbal

NEGLECT

What is physical abuse?

hitting the kid, often the result of severe physical punishment

What is sexual abuse?

exposing child to sexual, exploiting, etc.

What is emotional abuse?

degrading child, prevent age-appropriate actives, (domestic) violence near child

Types of neglect?

emotional, education, supervision, basic needs, medical, moral, parents using drugs/alcohol

How is maltreatment defined?

Any (failure to) act on the part of a caretaker which results in death, (imminent risk of) serious physical/emotional harm, sexual abuse or exploitation.

Who is disproportionately affected by trauma and maltreatment?

vulnerable, disadvantaged, impoverished, minority children

Most common victim of neglect?

younger children, greater need for care

Most common victim of abuse?

younger children, parental conflict

Most common victim of sexual abuse?

older children, 80% girls

Educational tools of healthy parenting?

child development knowledge, coping skills, behavior management skills

Relational tools of healthy parenting?

secure attachment with child, shared parenting responsibilities

Social tools of healthy parenting?

access to social and health services, available support

Infant requirements for a healthy environment?

protective, nurturing adults, and opportunities for socialization & stimulation

Older children requirements for a healthy environment?

supportive family, peer contact, opportunities to explore/master environment

Requirements of healthy parenting?

age-appropriate responsibilities, child takes on child role

Definition of traumatic event?

exposure to actual or threatened harm or fear of death or injury

The outcome of traumatic events?

increased allostatic load

Definition of stressful event?

more common and less extreme; may be a single event or may involve multiple, ongoing stressful events or situations

The outcome of stressful events?

manageable ones can enhance biological and psychological competence

What is RAD?

Reactive attachment disorder: pattern of inhibited, emo withdrawn toward caregivers,

Behavior towards caregivers in RAD?

child minimally responds to (and minimally seeks) comfort when distressed. May be Irritable, sad, or fear in nonthreatening interactions with caregivers.

Other characteristics of RAD?

social & emotional disturbance:

May be minimal emotional response to others.
may have Low posative affect.

Cause of RAD?

chronic insufficient care such as social neglect, change of primary caregiver, rearing in unusual setting

What is DSED?

disinhibited social engagement disorder, child actively approaches and interacts with unfamiliar adults and meets two of criteria

Characteristics of DSED?

Not reserved in interacting with strangers.

Excessive behavior reserved for family.

Does not check back in with caregiver. 

Does not hesitate to follow a stranger.

Cause of RAD?

chronic insufficient care such as social neglect,

change of primary caregiver,

rearing in unusual setting

Criteria for PTSD?

Exposure to traumatic event,

marked alterations in arousal and Reactivity.

Intrusion symptoms,

negative alterations in Cognition and mood,

Avoidance of associations with the event,

Specifiers for PTSD?

with dissociation symptoms of either depersonalization or derealization.

What is acute stress disorder?

within 1 month after exposure to an extreme traumatic stressor of at least nine symptoms associated with intrusion, negative mood, dissociation, avoidance, and arousal

What is adjustment disorders?

The development of emotional or behavioral symptoms in response to an identifiable stressor(s) (more common, less severe) occurring within 3 months of the onset of the stressor(s)

Protective factors for youth who have experienced maltreatment?

individual characteristics (high IQ), positive relationship with 1+ important, consistent person who provides support and protection

What parts of the brain are affected by chronic stress?

hippocampus, amygdala, prefrontal cortex, HPA axis (norepinephrine systems)

What does it mean for a child to be hyperresponsive to stress?

excessive threat vigilance and impaired self-regulation

What does it mean for a child to be hyporesponsive to stress?

underreacting to signs of danger or threat

What is allostatic load?

chronic activation of the biological FFF systems to the point of overload, often resulting in hyper or hypo response

Impact of removing child from home?

stressor, worsens problems

Impact of stress on emotion intelligence?

Have difficulty understanding, labeling, and regulating internal emotional states

Impact of stress on emotion expression?

suppress emotional expression/regulation, so more fearful and on alert

Post stress relationship qualities?

no trust, no safety, more violent

Permanent effects of child maltreatment?

revictimization, normal development and self-awareness and self-protection severely compromised

Reason for sexual abuse?

primarily a premeditated act - the adult offender plays a purposeful and intentional role

Reason for neglect?

relational disorder, during periods of stress

Reason for abuse?

not adult psychopathology, stress/lack of skill, abusive/difficult childhoods

Environmental contributors to child maltreatment?

poverty (severe restrictions), social isolation (family problems)

Chronic contributors to child maltreatment?

Disadvantage -> stress/limited options -> impair family’s coping abilities

What is behavioral exposure?

Exposure to break cycle of avoidance in order to process trauma

How does exposure help with PTSD?

it breaks down the cluster of symptoms: intrusions, cognition/emotions, arousal reactivity

How might behavioral exposure be explained to children?

The splinter analogy — dealing with the “splinter” (trauma memory) hurts really bad, but you need to take it out to prevent it getting worse

Components of TF-CBT?

P - Psychoeducation and Parenting skills

R - Relaxation ready

A - Affective actions (emotion regulation)

C –challenging Cognitions

T - Trauma narrative

I - In vivo exposure

C - Conjoint parent/child sessions

E – Enhancing empowerment