NR606 Week 7 (in class activity 24/25)

NR606 Week 7 (in class activity 24/25) Adverse childhood experiences (ACEs) - traumatic events that occur before a child reaches age 18 -Growing up in a family with mental health or substance use problems can also cause traumatic injury -ACEs, stressful or traumatic experiences • sexual or domestic violence, physical or emotional abuse, or neglect • home environment that cause them to feel unsafe or under constant threat growing up in a family with substance misuse or mental health problems • situations that create instability death, divorce, separation, or incarceration of family members ___ in ___ adults have experienced four or more types of ACEs - one in six Trauma- and Stressor-Related Disorders - Post-traumatic stress disorder Acute stress disorder Adjustment disorders Reactive attachment disorder Prolonged grief disorder freeze vs. shutdown trauma responses - -Freeze • client is HYPERaroused. • muscles are tense, full of energy, but can't release it. • similar levels of sympathetic & parasympathetic activation. • Increased heart rate/BP. • pt might say, "I feel stuck," "I can't move," or "I feel like I am encased in cement." • Eyes widen. • body is ready to return to fight/flight as soon as the threat passes. -Shutdown/Collapse • client is HYPOaroused. • muscles are flaccid & loose. • parasympathic nervous system is dominant. • Decreased heart rate/BP/temp. • pt may not be able to speak at all. • Blank stare. • Sensory info stops at the thalamus. It doesn't reach the cortex. pt less aware of their internal & external world. • Endorphins release to numb pain. Dynorphins release, which can make the client feel detached from their body. • Can result in fainting. How Trauma Impacts Four Different Types of Memory: Semantic Memory - -What it is: memory of general knowledge & facts. -Explicit Memory -Example: You remember what a bicycle is. -How trauma can affect it: Trauma can prevent info (like words, images, sounds, etc.) from different parts of the brain from combining to make a semantic memory. -Related brain area: The temporal lobe and inferior parietal cortex collect information from different brain areas to create semantic memory. How Trauma Impacts Four Different Types of Memory: Episodic Memory - -What it is: The autobiographical memory of an event of experience - including the who, what, and where. -Explicit Memory -Example: You remember who was there and what street you were on when you fell off your bicycle in front of a crowd. -How trauma can affect it: Trauma can shutdown episodic memory and fragment the sequence of events. -Related brain area: The hippocampus is responsible for creating and recalling episodic memory. How Trauma Impacts Four Different Types of Memory: Emotional Memory - -What it is: The memory of the emotion you felt during an experience. -Implicit Memory -Example: When a wave of shame or anxiety grabs you the next time you see your bicycle after the big fall. -How trauma can affect it: After trauma, a person may get triggered and experience painful emotions, often without context. -Related brain area: The amygdala plays a key role in supporting memory for emotionally charged experiences. How Trauma Impacts Four Different Types of Memory: Procedural Memory - -What it is: The memory of how to perform a common task without activtely thinking about it. -Implicit Memory -Example: You can ride a bicycle automatically without having to stop and recall how it's done. -How trauma can affect it: Trauma can change patterns of procedural memory. For example, a person might tense up and unconsciously alter their posture, which could lead to pain or even numbness. -Related brain area: The striatum is associated with producing procedural memory and creating new habits. Four Key Ways Collapse/Submit response to trauma Can Present in a Client. - 1. Compliance / Obedience: -going through the motions of life on autopilot -feel detached from bodily experiences -feelings no longer guide their actions • Ex: domestic violence pt may no longer be aware of fear, which keeps the person in the situation. 2. Treatment-Resistant Depression: -ongoing, inescapable traumatic stress can lead to treatment-resistant depression. • defining feature: learned helplessness. 3. Interpersonal Conflict: -difficulty engaging with others &/or setting boundaries. 4. Social Avoidance / Desire to Isolate: C -difficult to engage in basic daily activities • making meals or personal hygiene -may withdraw socially. Brain-based approaches to help clients after trauma - -Top-down approaches • Encourage different ways of thinking • Cognitive-Behavioral Therapy (CBT) • Dialectical-Behavior Therapy (DBT) • Mindfulness-based Cognitive Therapy (MBCT) -Bottom-up approaches • Ways to cope with emotions and defenses • Eye Movement Desensitization and Reprocessing (EMDR) • Yoga • Trauma Resiliency Model (TRM)® greater risk of experiencing four or more ACEs. - Females and racial/ethnic minority groups ACEs statistics - -almost half U.S. children (about 35 million) have had 1+ ACEs -over 1/4 of child abuse/neglect is children <3 • victimization most common for children under a year Tips when working with traumatized children - -establish a daily routine • predictability can be calming -concentrate on support -help build self-regulation • schedule regular brain breaks to help children stay focused