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4991 The Effects of Trauma on Children

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Title: 4991 The Effects of Trauma on Children


1
4991The Effects of Trauma on Children
  • A Videoconference
  • Presented By
  • Oklahoma State Department of Education
  • Tuesday, September 08, 2009

2
Presenters
  • Gayle Jones
  • Director, Title IV, Safe and Drug-Free Schools,
    OSDE
  • G. Denise Pace
  • LADC, LPC, B.C.E.T.S. Diplomate, American Academy
    of Experts in Traumatic Stress, and
  • EMDR Trained Clinician

3
Purpose
  • This presentation will provide participants
    with an understanding of the enduring negative
    impact of attachment trauma on the developing
    brain.  Participants will learn how many
    behaviors displayed by the traumatized child are
    the results of a disorganized brain and an
    attempt to survive psychic pain.

4
Professional Development Credit
  • This PDA is approved for 2 contact hours.
  • To receive credit you must register and complete
    the survey at the end of the presentation.
  • This is a linear conference.
  • You cannot start and stop at will.
  • Length of Conference
  • 1 Hour and 50 Minutes

5
Conference Notes
  • Slides 6-24 are the notes for the conference.
  • You may wish to print these slides for reference
    during the conference.
  • Precede to slide 25 to begin the conference.

6
AFTEREFFECTS OF TRAUMAOKLAHOMA DEPARTMENT OF
EDUCATIONSEPTEMBER 8, 2009
  • G. Pace, LADC, LPC, B.C.E.T.S.
  • Diplomate American Academy of Experts in
    Traumatic Stress
  • EMDR Clinician
  • Children are not resilient, children are
    malleable. Bruce Perry

7
Trauma DefinedThe Diagnostic and Statistical
Manual of Mental Disorders, 4th edition, Text
Revision (DSM-IV-R) American Psychiatric
Association (APA), 2000
  • Direct personal experience of an event that
    involves actual or threatened
  • death or serious injury, or other threat to ones
    physical integrity or
  • witnessing an event that involves death, injury,
    or a threat to the physical
  • integrity of another person or learning about
    unexpected or violent death,
  • serious harm, or threat of death or injury
    experienced by a family member or
  • other close associate. The persons response to
    the event must involve
  • intense fear, helplessness, or horror (or in
    children, the response must involve
  • disorganized or agitated behavior).
  • Children are not resilient, children are
    malleable.

8
Categories of Trauma
  • Impersonal Trauma the cause is impersonal, for
  • example natural disasters
  • Interpersonal Trauma the deliberate threat or
    injury
  • in the context of an interpersonal interaction.
    ..
  • ex. stranger rape, criminal assaults, sexual
  • harassment, combatalthough this type of
  • trauma occurs outside close or intimate
    relation-
  • ships they can be profoundly damaging.
  • Attachment Trauma the deliberate threat or
    injury
  • in the context of a relationship where the
    victim
  • has some level of emotional involvement.
  • Allen, Jon G. Traumatic Relationships and Serious
    Mental Disorders, 2001

9
Types of Trauma
  • TYPE I experienced a single event
  • TYPE II repeated victimization
  • Type IIA multiple trauma w/stable backgrounds
    and
  • healthy resourcescan separate traumas
  • Type IIB overwhelmed w/multiple
    traumasunable to
  • separate one from the other
  • Type IIB(R) stable background but so over-
  • whelmed can no longer maintain
    resilience
  • Type IIB(nR) victim never developed
    resources
  • for resilience
  • Type III extreme trauma characterized by
    multiple traumatic
  • experiences that typically
    begin in early childhood

10
Childhood Trauma, the Neurobiology of Adaptation
and Use-dependent Development of the Brain How
States become TraitsTrauma Information Pages,
Articles Perry, et al. 1996
  • Trauma is an experienceUltimately, it is the
    human brain that processes
  • and internalizes traumaticexperiences. It is
    the brain that mediates all
  • emotional, cognitive, behavioral, social and
    physiological functioning. It
  • is the brain from which the human mind arises and
    within that mind resides
  • our humanity . Understanding the organization,
    function and development
  • of the human brain, and brain-mediated responses
    to threat are the keys to
  • understanding the traumatized child.

11
Use-dependent Development of the Brain
  • We now know that no single gene is responsible
    for anything
  • as complex as human behavior. Personality traits
    and patterns of
  • behavior probably involve many genes, most of
    which are
  • Influenced by environmentEven when genes
    predispose an
  • Individual to a disease, say type II diabetes,
    changes in lifestyle
  • (e.g., diet and exercise) can be the determining
    factor. Stien, P.
  • and Kendall, J.
  • Approximately one-third to one-half of our
    approximately
  • 30,000 genes (Claverie, 2001) affect the
    development and regulation
  • of the nervous systemat least half of these
    genes depend on
  • environmental stimulation to be activated (Mack,
    1996).

12
Four Periods of Major Structural Change in Brain
Development (Dr. Ornitz, 1996, UCLA Medical
School) Stien, P. and Kendall, J. (2004)
Psychological Trauma and The Developing Brain The
Hawthorn Press, Inc., Binghamton, NY
  • First Period of Remolding15 months to 4 years
  • Second Period of Remolding6 years to 10 years
  • Third Period of Remoldingprepuberty
  • Fourth Period of Remoldingmidadolescence
    (dramatic overproduction in early adolescence
    rivals growth observed in first years of life
    (Thompson, et al., 2000). Around 11 for girls
    and 12 for boys. Building and stabilizing
    connections between several key systems.
  • The single most significant distinguishing
    feature of all nervous tissue of neurons
  • is that they are designed to change in response
    to EXTERNAL signals. Bruce Perry

13
Biological Effects of Childhood TraumaHeide, K.
M. and Solomon, E. P. (2006) Biology, childhood
trauma, and murder Rethinking justice.
International Journal of Law and Psychiatry 29,
220-233
  • The brain does not complete development until
    adulthood
  • Childhood trauma interferes with normal brain
    development
  • Childhood trauma can cause long-term changes in
    the brain
  • EEG (electroencephalogram) abnormalities
  • Effects on the corpus callosum
  • Effects on the limbic system
  • Effects on neurotransmitters
  • Traumatic memories get stuck in the limbic
    system
  • The limbic system remains on red alert
  • Remembering traumatic experiences can cause
    speechless terror
  • 4. Childhood trauma causes long-term changes in
    the endocrine system
  • A positive feedback loop intensifies aggressive
    behavior
  • Trauma causes a disconnect between the mind and
    body
  • Genetics plays a role

14
Functions and Characteristics Associated with the
Right and Left Cerebral HemispheresCorpus
callosum is a neural band of tissue that connects
two hemispheres
  • Left Hemisphere
  • Positive, optimistic emotions
  • Motivational tendency to approach, explore and
    take action
  • Involved in the processing of verbal
    communication, words numbers
  • Has the capacity to analyze, problem solve
    process information sequentially
  • Allows for elaboration provides detailed
    perspective
  • Right Hemisphere
  • Negative, pessimistic emotions
  • Motivational tendency to withdraw and avoid
  • Involved in the processing of nonverbal,
    emotional communication, imagery visual-spatial
    information
  • Limited capacity to think analytically
  • Provides global perspective

15
Triune BrainEvolutionary perspective of brain
development, by Paul MacLean, which emphasizes
that the human brain evolved from the bottom up.
Each new layer added new functions, that helped
in the struggle to survive and dominate.
  • Brainstem Cerebellum
  • Reptilian brain (resembles the brain of modern
    reptiles)
  • Regulates cardiovascular respiratory functions
  • Contains some of the nuclei that regulate arousal
  • Limbic System
  • Emotional brain source of our urges, needs
    emotions
  • Primary role in the functions necessary for
    self-preservation (fleeing, fighting, freeze,
    submit food reproduction)
  • Evaluates experience for emotional significance
  • Hub for memory system

16
Schole, Allan (2001). The Effects of a Secure
Attachment relationship on Right Brain
Development, Affect Regulating, Infant Mental
Health. Infant Mental health Journal, 22, 7-66
  • Limbic System

Cingulate
Thalamus
17
THE LIMBIC SYSTEM (gut brain)Bremner, J.
Dounglas (2002) Does Stress Damage the Brain? W.
W. Norton Company, Inc., New York, N. Y.
  • Amygdala alarm system which matures very
    quickly in the infants brain and is much closer
    to full formation than other structures at birth.
    One of the important appraisal centers
    assigning emotional meaning to incoming data and
    can take control over the thinking brain.
  • Hippocampus does not develop until 16-18 months
    and its main purpose is learning and short term
    explicit or declarative memory. Elevated
    cortisol can damage this areas ability to learn
    new information. The role of this structure is
    not only to store new facts but to provide
    context of space and time to a memory and to help
    integrate experiences by relating prior
    information with present information.
  • Hyplothalamus gateway from the brain to the
    body. The amygdala relays an emotional message
    to the hypothalamus and the motor centers of the
    brain, where it gets transformed into a bodily
    response. The hypothalamus sends neural signals
    to the body (via ANA) and releases hormones into
    the blood. The hypothalamus activates CRH which
    actives the pituitary gland to release ACTH which
    activates the adrenal glands to release cortisol.
    The cortisol will halt the alarm reaction once
    the event is over bringing the body back into
    balance.
  • Thalamus (back ally to amygdala)screens what is
    and is not necessary a central relay point where
    information from the senses come in and is
    distributed to different parts of the brain.
  • Cingulate (COO of limbic system) Anterior
    cingulate is involved in concentration, empathy,
  • inhibition of responses, normal emotion and
    planning and executing of behavior. The
    posterior cingulate is involved in processing
    information in space and time., which may be
    important for rapid response to life-threatening
    situations.
  • Orbitofrontal and Medial Prefrontal Cortexes
    Regulates emotions, social behavior and a sense
    of right and wrong.

18
Norepinephrine and Epinephrine
  • Functions
  • Sharpens focus
  • Raises fear level
  • Quickens heart rate
  • Raises blood pressure
  • Stimulates verbal emotional
  • memory
  • Blood sugar for energy
  • Helps to form descending path-
  • ways to lower brain centers
  • Dysregulation
  • Learned helplessness
  • Flashbacks

19
Cortisol
  • Function
  • Increases blood pressure
  • Increases heart rate cholesterol
  • Raises blood levels of norepinephrine
  • and epinephrine
  • Redistributes energy of the body
  • Exaggerated Levels of Cortisol
  • Thin lining of stomach (gastric ulcers)
  • Thinning of bones (osteoporosis)
  • Impairment in reproduction
  • Heart disease
  • Stroke

20
Neurotransmitters and HormonesChemical
Changes Linked to TraumaStien, Phyllis and
Kendall, Joshua (2004) Psychological Trauma and
The Developing Brain The Haworth Press, Inc.
Binghamton, NY
  • Elevated levels of norepinephrine/epinephrine,
    which contributes to core PTSD systems such as
    hyperarousal, flashbacks, intrusive memories, and
    nightmares
  • Changes in the hormones of the hypothalamic-pituit
    ary-adrenal (HPA) axis, which impairs the
    adaptability of the stress response, including
    the bodys ability to return to a calm state.
  • Altered concentrations of neuropeptides (e.g.,
    endogenous opioids) which contribute to bodily
    and emotional anesthesia.
  • Changes in related neurotransmitter systems
    (e.g., dopamine, serotonin, and central amino
    acids) and in the receptors for stress-related
    neurotransmitters and hormones, which further
    intensifies the dysregulation of the stress
    response.

21
Brain Impairments Associated with Complex
PTSDStien, Phyllis and Kendall, Joshua (2004)
Psychological Trauma and The Developing Brain
The Haworth Press, Inc. Binghamton, NY
  • Dysregulation of the Stress Response System and
    Limbic Irritability
  • Amygdala
  • Neurotransmitters (serotonin, dopamine,
    epinephrine and norepinephrine)
  • Hormones (CRF, ACTH and coritsol)
  • Prefrontal Cortex
  • Hippocampus
  • Anterior Cingulate
  • Sympathetic and parasympathetic arousal
    (freezing and dissociation)
  • Decrease in Hippocampal Volume and Abnormal
    Activity in the Cerebellar Vermis
  • Hippocampus
  • Cortisol
  • Cerebellar Vermis
  • Underdevelopment of the Left Hemispheres and
    Communication Problems Between Brain Hemispheres
  • Myelinization
  • Corpus Callosum
  • Lateralization
  • metacognition
  • Neuroendocrine and Immune System Dysfunction
  • Growth related hormones

22
The Effects of Maltreatment on a Childs
PsycheStien, P. and Kendall, J. (2004) The
Haworth Press, Inc. Binghamton, NY
  • Problems Regulating Emotions and Arousal
  • Alterations in Consciousness and Memory
  • Damage to Self-Concept and Identity
  • Disruption of Cognitive Capacities
  • Hyperactivity and Attention Problems
  • Relationship Problems
  • Alteration in the System of Beliefs

23
Complex PTSDJudith Herman
  • Alteration in regulation of affect and
  • impulses
  • Chronic affect dysregulation
  • Difficulty modulating anger
  • Self-destructive or suicidal behaviors
  • Difficulty modulating sexual involvement
  • Impulsive and risk-taking behaviors
  • 2. Alterations in attention or consciousness
  • Amnesia
  • Transient dissociative episodes
  • Depersonalization
  • 3. Somatization
  • Digestive system problems
  • Chronic pain
  • Cardiopulmonary symptoms
  • Conversion symptoms
  • Sexual symptoms
  • Panic

24
Stress Warning Signs and Symptoms
  • Cognitive Symptoms
  • Memory Problems
  • Inability to Concentrate
  • Poor Judgment
  • Seeing only the Negative
  • Anxious or Rolling Thoughts
  • Constant Worrying
  • Physical Symptoms
  • Aches and Pains
  • Diarrhea or Constipation
  • Nausea, Dizziness
  • Chest Pains, Rapid Heartbeat
  • Loss of Sex Drive
  • Frequent Colds

25
Begin Conference
  • Please click the link below to register.
  • (You may need to maximize your screen to activate
    the link. Or you may need to copy the link and
    paste it in your browser.)
  • http//www.surveymonkey.com/s.aspx?sm_2fzp3zgWnzx
    hmlECDlAdyVA_3d_3d

26
Link to PDA Survey
  • Please click the link below to complete The
    Effects of Trauma on Children Survey.
  • http//www.surveymonkey.com/s.aspx?smc2jGfoQkfvoG
    whAnVioIiw_3d_3d

27
Your Conference Is Complete
  • Thank you for viewing
  • The Effects of Trauma on Children.
  • If you have questions about the conference,
    please contact Lois Howard.
  • E-mail howardl_at_bps-ok.org
  • Phone 918-335-2931

28
Link to Conference
  • http//164.58.238.140/tcs/?idD75A1211-0750-4F0E-A
    1CF-8717AEC115D3
  • http//164.58.238.140/tcs/?idD75A1211-0750-4F0E-A
    1CF-8717AEC115D3
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