Psychological Disorders of Childhood Exam 3: Trauma and Eating/Feeding

Exam 3: Trauma and Eating/Feeding

Childhood Maltreatment

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

What are the types of childhood maltreatment?

Physical, sexual, psychological, and neglect

Polyvictims

Abuse and neglect or multiple forms of maltreatment at once

— in — are polyvictims

1 in 5, most severe trauma experiences

Racial disparities of Childhood Maltreatment

-Maltreatment most common in whites

-But black children at highest risk

One or both parents are most likely to perpetrate maltreatment. T or F

True

Who’s most likely to perpetrate sexual abuse?

Non-parents, fathers, male caregivers

— to — million children referred each year to child protective services

2.6 to 7.8

There are up to __ million investigations yearly

3.5

— to — cases substantiated yearly

678,000 to 900,000

— to — % of children/adolescents maltreated every year

0.9 to 1.3%

Neglect

Failure to provide basic physical, education and emotional needs of children

What are the consequences of neglect?

Growth stunting, medical problems (diabetes, allergies, failure to thrive)

Failure to thrive

Not just being off the curve of growing, but you’re going down. Most the time it’s parents neglect and not giving them proper nutrition

There are sex differences in neglect and it’s mostly in small children. T or F

False, no sex differences and it’s more common in pre-adolescents

Physical Abuse

Any form of physical harm directed toward child, often resulting from overly harsh discipline or corporal punishment

— in — youth are victims of physical abuse

1 in 10

There are no sex differences in physical abuse victims and it’s more common in pre-adolescents. T or F

True

Consequences of Physical Abuse

-Injuries (bruises, cuts, burns, broken bones)

-PTSD

-Disruptive behavior problems

Psychological Abuse

Threats, put-downs, be-litting, name-calling directed towards a child

Psychological Abuse is also known as…

Emotional Abuse

Psychological Abuse is more common in… and there’s …

Pre-adolescents, no sex differences

Sexual Abuse

Intercourse, rape, molestation or exploitation experienced by children

— in — girls are victims of sexual abuse

1 in 4

— in — people are victims of sexual abuse

1 in 20

Sexual Abuse is more common in…

adolescents

— neither report not show symptoms fo sexual abuse

1/3

Consequences of Sexual Abuse

Substance Use Disorders, anxiety disorders, eating pathology, PTSD, suicidal ideation/behavior, self-harm, depressive disorders

What does sexual abuse increase the risk of?

School drop out, medical problems, unintended pregnancy, revictimization

Traumatic Sexualization

Knowledge of and engagement in age-inappropriate sexual behavior

Girls are less likely to be abused by male family members. T or F

False, more likely

Boys are more likely to be abused by male non-family members. T or F

How often are strangers perpetrators of sexual abuse?

2%

What are predictors of perpetrating maltreatment in physical abuse

A. Consequences of social information processing errors

B. Unfamiliarity with their roles as parents and with what is developmentally appropriate behavior for a child

C. Poor Response to coercive child behavior

D. Cycle of Violence

E. All of the Above

E. All of the above

What is a predictor of perpetrating for neglect?

Maladaptive coping with parenting responsibilities via avoidance/disengagement

What is a predictor of perpetrating for sexual abuse?

Social and relationship deficits, comorbid psychiatric disorders, SUD, low self-esteem, neurodevelopmental deficits, history of experiencing sexual abuse

Trauma

Exposure to actual or threatened harm or fear of death or injury, uncommon or exteme stressors

As many as cc - cc% of adolescents in the US have experienced at least one serious trauma

25-30%

What are some examples of trauma

Physical/sexual abuse, violent crime, auto accidents, home fires, natural disasters, domestic violence, life threatening illnesss

Most of those exposed to trauma do develop PTSD. T or F

False, do NOT

Others show symptoms, even meet criteria of PTSD, but symptoms fade by…

6 months

__ % of adolescent boys and __ % of adolescent girls develop and maintain PTSD

4%, 6%

Posttraumatic Stress Disorder

Exposure to actual or threatened death, serious injury, or sexual violence and having the presence of one+ intrustion symptoms

What are some examples of intrusion symptoms?

Distressing memories, dreams, or flashbacks

People with PTSD have persistent avoidance of stimuli associated with the traumatic event. T or F

True

With PTSD, there are positive alterations in cognitions and mood associated with the traumatic event (point D). T or F

False

What are some examples of marked alterations in arousal and reactivity associated with PTSD?

Irritable behavior, reckless/self-destructive behavior, hypervigilance, exaggerated startle response, problems with concentration, sleep disturbance

PTSD symptoms presenting for <1 months is…

Acute Stress Disorder

What is included in PTSD with dissociative symptoms?

Depersonalization and derealization

Depersonalization

Persistent or recurrent experiences of feeling detached from one’s mental processes or body

Derealization

Persistent or recurrent experiences of unreality of surroundings

What is PTSD with delayed expression?

Full diagnostic criteria are not met until at least 6 months after the events

_ - _ % of children exposed to trauma experience acute stress disorder

10-20%

Children with greater internalizing symptoms (esp. anxiety) prior to trauma exposure are more likely to develop PTSD. T or F

True

Severity and recurrence of trauma, as well as histories of child maltreatment are…

Positively associated with PTSD, proximity to trauma matters too

__ exposure is the most harmful

Direct

Cognitive appraisal and coping of PTSD

Trauma experienced as personally relevant is more harmful

Problem-focused coping is effective in PTSD, but…

Escape/avoidance coping is not

As length of time since traumatic incident grows…

Symptoms reduce for most with PTSD

With PTSD, __ - _% continue to have symptoms

60-70%

With PTSD, there is not a risk of depression, anxiety disorders, and substance abuse increase. T or F

False, there is a risk

Comorbidities in PTSD in Boys

DBDs, aggression, school issues increase

Comorbidities in PTSD in Girls

Internalizing disorders increase

Psychological debriefing does more harm than good. T or F

True

Psychological First Aid

First responders focus on safety, promoting calmness and self-efficacy, meeting other immediate needs and encouraging support seeking

What is the treatment of maltreatment and PTSD?

Trauma-Focused CBT

Trauma-Focused CBT focuses on…

teaching coping skills and challenging negative automatic thoughts

Graduated imaginal exposure through narrative building is based on…

Memories/stimuli associated with trauma

_ in _ youth are considered “picky eaters”

1 in 4

By age 9l, girls are more concerned about…

weight/body image than boys

What is the “drive for thinness”?

Losing weight is key to overcome troubles and achieving success

What does the drive for thinness motivate?

dieting and body image concerns

During adolescence, there is also a fear of weight gain, worry about body image, chronic unrealistic dieting. T or F

True, this is a developmental perspective

Perceived fatness can predict the development of…

An eating disorder

__ % of middle-schoolers report trying to lose weight in last 7 days

60%

__% of girls report having been on a diet within the past year

67%

__% of girls are chronic dieters

10%

BMI of 85th →95th percentile =…

Overweight

__% of US youth 2-19 are considered Obese

17%

Hispanic boys and black girls are more likely to be thin than white boys and girls. T or F

False, more likely to be obese

Significant racial/ethnic disparities are not tied to SES. T or F

False, they are

Obesity is severly stigmatized

Quality of life impaired to level comparable to living with cancer

Obesity is a medical condition that casues what?

Cardiovascular problems, diabetes, high cholesterol, and chronic pain

Obesity is a product of…

Genes, diet, and exercise

Parents play important direct and indirect role. T of F

True, through modeling

Obesity is predictive of…

eating disorders, especially in girls

What are some preventions/treatments for obesity?

Increase activity for parents and kids, improve nutritional awareness and self-control

PICA

Eating things that are not food

Is Pica Common?

Yes, common in young children and children with intellectual disabilities

What are the consequences of PICA?

intestinal and bowel blockages, intestinal perforation, ingestion of harmful bacteria

What do kids with PICA eat?

Burnt matches, concrete, crayons, pencils, hair, grass, etc

You can treat PICA with operant conditioning procedures…

Caregivers are shown how to reinforce the child for desirable/replacement behaviors

ARFID is…

Avoidant/Restrictive Food Intake Disorder

What is involved in AFRID?

Do not eat enough and lack of interest in eating, avoid certain food owing to sensory characteristics

AFRID results in significant…

weight loss or failure to maintain normal growth, nutritional deficiency or dependency on supplements

For AFRID, what is the threshold for failure to thrive?

Weight below 5th percentile, and not following increasing trajectory

What is one treatment for AFRID?

Appetite manipulation (eliminating snacks)

What is contingency management?

operant conditioning and escaping extinction

Escaping Extinction

Refusing to allow avoidance of eating

Parent training of AFRID is focused on…

Increasing positivity of eating experience (modeling)