Dev Psych Final

• Trauma


  An exceptional experience in which powerful and dangerous stimuli overwhelm the child's capacity to regulate emotions
• Stress responses


  How stress influences the body and brain
• 30% of children are exposed to trauma at some point in their lives
• 33% of children exposed to trauma develop PTSD
• PTSD persists over time
• Those who recover from PTSD can go on to develop anxiety, depression, substance abuse
• To receive a PTSD diagnosis

  There must be a traumatic event, but predispositions matter too
• Traumatic events can be uniquely distressing for young children
• Trauma during early childhood may have even greater long-term implications than trauma that occurs in late adolescence
• Up to 50% of preschoolers suffering from PTSD following a trauma do NOT experience natural recovery
• PTSD


  Exposure to trauma and symptoms persist for over a month
• Symptom clusters for PTSD


  • Intrusive memories of the event
  • Avoiding reminders of the event
  • Marked alteration in arousal and reactivity
  • Negative alterations in cognitions
• PTSD specifiers


  • With dissociative symptoms
  • With delayed expression
• PTSD in children 6 and under


  • Symptoms expressed as actions or observable behaviors
  • Only need ONE persistent avoidance symptom or ONE negative alteration in cognition or mood
  • Symptoms must cause the child distress, and impair their relationships
  • Duration of more than ONE MONTH
• Lifetime prevalence of PTSD in children 6 and under is 1%
• As many as 5% of older adolescents have experienced PTSD
• Girls (8%) are more likely to develop PTSD than boys (2.3%)
• Effects of trauma on development


  • Physical: Sleep or eating disturbances, Regressing (speech, toileting, etc)
  • Cognitive: Cognitive regression, Poor impulse control, Lower level problem solving
  • Self & other: Helplessness, lack of trust, Overly withdrawn OR agitated, Increased fearfulness
  • Behavioral: Separation anxiety/clinginess, Decrease in coordinated play, Tantrums, power struggle
• Factors that predict the emergence of PTSD


  • Proximity to the trauma
  • Developmental level
  • Level of functioning before trauma
  • Previous life experiences
  • Level of exposure + severity
  • Parental reactions
  • Subsequent changes in living situation
  • Cognitive appraisal/coping
• Types of coping


  • Problem-focused coping
  • Escape or avoidance coping
• Childhood PTSD often persists over time
• Many youths who "recover" from PTSD continue to show sub-threshold PTSD symptoms, problems with depression and anxiety, irritability and sleep disturbances, and suicidal ideation
• Theories that explain the emergence of PTSD


  • Learning theory
  • Emotional processing theory
  • Disruption of biological and brain systems
• Psychological first aid


  • Administered by first responders or mental health professionals at the site of the trauma
  • Provides victims with a sense of safety and security meets their immediate physical, social, and emotional needs
• Principles of psychological first aid


  • Fostering a sense of safety
  • Promoting a sense of calmness
  • Increasing self‐efficacy
  • Achieving connectedness and social support
  • Instilling hope for the future
• Trauma-focused CBT


  • Teaches families about PTSD
  • Teaches the child coping skills to deal with anxiety
  • Gradually exposes children to stimuli or memories associated with the traumatic event
  • Identifies and changes children's negative cognitive behaviors associated with the traumatic event
• Pharmacologic treatments for PTSD


  • SSRIs
  • Atypical antipsychotics
  • Mood stabilizers
  • Drugs that reduce physical tension
  • MDMA
• Complex trauma


  • Is chronic
  • Begins in early childhood
  • Occurs within the child's primary care giving system and/or social environment
• Chronic stress in children

  Young children have limited capacity to manage this overwhelming stress and experience increased arousal — fear and anxiety (physical and emotional sensations)
• Effects of complex trauma


  • Physical: Slower achievement of developmental milestones, OR Regression that may turn into developmental delay
  • Cognitive: Problems with problem solving, cooperating with others, impulse control
  • Self & other: Simultaneous clinginess and withdrawal, No interest in caregivers; does not use them as a resource, Delayed development of more autonomous behavior
  • Behavioral: Tantrums, Continue parallel play beyond when is appropriate: difficulty sharing, rarely initiate play with others
• Recovery from trauma is enhanced if children can rely on secure relationships with caring adults
• If the source of the trauma is the caregiver, recovery is difficult
• Attachment


  The affectional bond that develops between a caregiver and child in the infants first year of life
• Attachment: Experience expectant


  Essential, experience expectant, for normal human development
• Attachment: Experience dependent


  Parent-child attachment is experience dependent
• Attachment behavioral system

  An evolved, innate regulator of proximity focused on a few "attachment figures"
• Bowlby's 4 phases of attachment


  • Pre-attachment phase (birth to 6 weeks)
  • Attachment-in-the-making (6 weeks to 6 months)
  • Clear-cut attachment (between 6 months and 18 months)
  • Reciprocal relationship (from 1 ½ to 2 years)
• Types of attachment


  • Secure (B): 65-70% of American Children
  • Insecure Avoidant (A): 20% of American Children
  • Insecure Resistant (C): 10-15% of American Infants
  • Insecure Disorganized (D): 5-10% of American infants
• Insecure attachment


  Have attachment figure but not an optimal one
• Attachment failure


  Don't have a consistent attachment figure, most common in institutionalized children