BKS Ch. 9 & 10 (childhood trauma)
BKS: Ch. 9
1. What is the value of a psychiatric diagnosis? (pp. 139, 144-145)
diagnosis informs treatment, and getting the wrong treatment can have disastrous effects
a diagnosis provides a set of symptoms for people to identify with, and treatment strategies developed specifically for that set of symptoms
you can’t develop a treatment for a condition that doesn’t exist
how are clinicians supposed to treat their patients if a diagnosis for their symptoms isn’t formally recognized?
2. Summarize researchers’ general findings about the relationship between borderline personality disorder (BPD) and childhood abuse and neglect. (pp. 140-142)
BPD is marked by clinging but unstable relationships, extreme mood swings, and self-destructive behavior
the problems from the group of patients with BPD, according to their symptoms, had likely started off as ways of dealing with overwhelming emotions and inescapable brutality
81% of the patients diagnosed with BPD at the hospital they conducted research reported sever histories of child abuse and/or neglect
the majority had abuse before the age of 7
3. Summarize researchers’ general findings about the relationship between childhood abuse and neglect and self-harm. (pp. 143-144)
having a history of childhood sexual and physical abuse was a strong predictor of repeated suicide attempts and self-cutting
self-destructive patients stated that they don’t remember feeling safe with anybody as a child’ they reported feeling abandoned and left to their own devices
4. Describe some of the main findings from the large-scale ACEs (Adverse Childhood Experiences) study. (pp. 147-149)
traumatic life experiences during childhood and adolescence are far more common than expected
only 1/3 of respondents reported no adverse childhood experiences
adverse experiences are interrelated, even though they’re usually studied separately
more than half of those with scores of four or higher reported having learning or behavioral problems
compared with 3% of those who scored a zero
chronic depression, suicide attempts, alcoholism, and rape (for women) rise dramatically with a higher ACE score
BKS: Ch. 10
5. Summarize Suomi’s general findings about attachment patterns in rhesus monkeys.
two personality types of the monkeys that ran into trouble:
uptight, anxious monkeys who become fearful, withdrawn, and depressed even in situations where other monkeys will play and explore
females in this group don’t play well with others and thus often lack social support when they give birth and are at high risk for neglecting or abusing their firstborns
but when they’re part of a stable social group they often become diligent mothers
in some cases, being an anxious mother can provide much needed protection
highly aggressive monkeys, who make so much trouble that they’re often shunned, beaten up, or killed
these aggressive mothers don’t provide any social advantages
lots of hitting, kicking, and biting. if the infants survive, their mothers usually keep them from making friends with their peers
both of these types are biologically different from their peers
abnormalities in arousal levels, stress hormones, and metabolism of brain chemicals like serotonin
neither their biology nor their behavior tends to change as they mature
young monkeys who are taken away from their mothers at birth and brought up solely by their peers become intensely attached to them
they cling to one another and don’t engage enough in healthy exploration and play
conclusion: at least in monkeys, early experience has at least as much impact on biology as heredity does
6. Describe the profile (common characteristics) of Developmental Trauma Disorder (DTD). (p. 160)
a pervasive pattern of dysregulation
problems with attention and concentration
difficulties getting along with themselves and others
7. Summarize Sroufe’s general findings about attachment patterns from the Minnesota Longitudinal Study of Risk and Adaptation. (pp. 162-163)
the key issue was the nature of the parent-child relationship: how parents felt about and interacted with their kids
combination of vulnerable infants and inflexible caregivers made for clingy, uptight kids
insensitive, pushy, intrusive behavior on the part of the parents at six months predicted hyperactivity and attention problems in kindergarten and beyond
caregivers not only help keep arousal within manageable bounds but also help infants develop their own ability to regulate their arousal
children who were regularly pushed into overarousal and disorganization didn’t develop proper attunement of their inhibitory and excitatory brain systems and grew up expecting that they would lose control if something upsetting happened
8. Summarize Putnam and Trickett’s general findings regarding the long term effects of incest. (pp. 163-165)
compared with girls of the same age, race, and social circumstances, sexually abused girls suffer from a large range of profoundly negative effects, including cognitive deficits, depression, dissociative symptoms, troubled sexual development, high rates of obesity, and self-mutilation
before puberty, the abused girls rarely had close friends, girls or boys, but adolescence brings many chaotic and often traumatizing contacts with boys
abused, isolated girls with incest histories mature sexually a year and a half earlier than he nonabused girls
9. What are some of the potential benefits of including the Developmental Trauma Disorder (DTD) diagnosis in future versions of the DSM? (pp. 168-170)
it would focus research and treatment on the central principles that underlie the protean symptoms of chronically traumatized children and adults: pervasive biological and emotional dysregulation, failed or disrupted attachment, problems staying focused and on track, and a hugely deficient sense of coherent personal identity and competence
BKS: Ch. 9
1. What is the value of a psychiatric diagnosis? (pp. 139, 144-145)
diagnosis informs treatment, and getting the wrong treatment can have disastrous effects
a diagnosis provides a set of symptoms for people to identify with, and treatment strategies developed specifically for that set of symptoms
you can’t develop a treatment for a condition that doesn’t exist
how are clinicians supposed to treat their patients if a diagnosis for their symptoms isn’t formally recognized?
2. Summarize researchers’ general findings about the relationship between borderline personality disorder (BPD) and childhood abuse and neglect. (pp. 140-142)
BPD is marked by clinging but unstable relationships, extreme mood swings, and self-destructive behavior
the problems from the group of patients with BPD, according to their symptoms, had likely started off as ways of dealing with overwhelming emotions and inescapable brutality
81% of the patients diagnosed with BPD at the hospital they conducted research reported sever histories of child abuse and/or neglect
the majority had abuse before the age of 7
3. Summarize researchers’ general findings about the relationship between childhood abuse and neglect and self-harm. (pp. 143-144)
having a history of childhood sexual and physical abuse was a strong predictor of repeated suicide attempts and self-cutting
self-destructive patients stated that they don’t remember feeling safe with anybody as a child’ they reported feeling abandoned and left to their own devices
4. Describe some of the main findings from the large-scale ACEs (Adverse Childhood Experiences) study. (pp. 147-149)
traumatic life experiences during childhood and adolescence are far more common than expected
only 1/3 of respondents reported no adverse childhood experiences
adverse experiences are interrelated, even though they’re usually studied separately
more than half of those with scores of four or higher reported having learning or behavioral problems
compared with 3% of those who scored a zero
chronic depression, suicide attempts, alcoholism, and rape (for women) rise dramatically with a higher ACE score
BKS: Ch. 10
5. Summarize Suomi’s general findings about attachment patterns in rhesus monkeys.
two personality types of the monkeys that ran into trouble:
uptight, anxious monkeys who become fearful, withdrawn, and depressed even in situations where other monkeys will play and explore
females in this group don’t play well with others and thus often lack social support when they give birth and are at high risk for neglecting or abusing their firstborns
but when they’re part of a stable social group they often become diligent mothers
in some cases, being an anxious mother can provide much needed protection
highly aggressive monkeys, who make so much trouble that they’re often shunned, beaten up, or killed
these aggressive mothers don’t provide any social advantages
lots of hitting, kicking, and biting. if the infants survive, their mothers usually keep them from making friends with their peers
both of these types are biologically different from their peers
abnormalities in arousal levels, stress hormones, and metabolism of brain chemicals like serotonin
neither their biology nor their behavior tends to change as they mature
young monkeys who are taken away from their mothers at birth and brought up solely by their peers become intensely attached to them
they cling to one another and don’t engage enough in healthy exploration and play
conclusion: at least in monkeys, early experience has at least as much impact on biology as heredity does
6. Describe the profile (common characteristics) of Developmental Trauma Disorder (DTD). (p. 160)
a pervasive pattern of dysregulation
problems with attention and concentration
difficulties getting along with themselves and others
7. Summarize Sroufe’s general findings about attachment patterns from the Minnesota Longitudinal Study of Risk and Adaptation. (pp. 162-163)
the key issue was the nature of the parent-child relationship: how parents felt about and interacted with their kids
combination of vulnerable infants and inflexible caregivers made for clingy, uptight kids
insensitive, pushy, intrusive behavior on the part of the parents at six months predicted hyperactivity and attention problems in kindergarten and beyond
caregivers not only help keep arousal within manageable bounds but also help infants develop their own ability to regulate their arousal
children who were regularly pushed into overarousal and disorganization didn’t develop proper attunement of their inhibitory and excitatory brain systems and grew up expecting that they would lose control if something upsetting happened
8. Summarize Putnam and Trickett’s general findings regarding the long term effects of incest. (pp. 163-165)
compared with girls of the same age, race, and social circumstances, sexually abused girls suffer from a large range of profoundly negative effects, including cognitive deficits, depression, dissociative symptoms, troubled sexual development, high rates of obesity, and self-mutilation
before puberty, the abused girls rarely had close friends, girls or boys, but adolescence brings many chaotic and often traumatizing contacts with boys
abused, isolated girls with incest histories mature sexually a year and a half earlier than he nonabused girls
9. What are some of the potential benefits of including the Developmental Trauma Disorder (DTD) diagnosis in future versions of the DSM? (pp. 168-170)
it would focus research and treatment on the central principles that underlie the protean symptoms of chronically traumatized children and adults: pervasive biological and emotional dysregulation, failed or disrupted attachment, problems staying focused and on track, and a hugely deficient sense of coherent personal identity and competence
