the biology and impacts of trauma - btcc bloomington€¦ · trauma is exposure to death,...
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The Biology and Impacts of Trauma
Robin E. Donaldson, M.A.
Indiana Youth Services Association
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Objectives
• Understand trauma and the different types of trauma
• Understand the impact of trauma on genetic
expression and brain development
• Increase knowledge regarding trauma symptoms
• Understand the impact of trauma on the ARC model
(attachment, regulation & skill competency)
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Is This Trauma
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Is This Trauma
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Is This Trauma
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Is This Trauma
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Is This Trauma
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Is This Trauma
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Trauma is exposure to death, threatened death, actual or
threatened serious injury, actual or threatened sexual violence
as follows: – DSM (V)•Direct
•Witnessing, in person
•Indirectly, by learning someone close was exposed to trauma
•Repeated or extreme indirect exposure to aversive details of the
event(s), usually in the course of professional duties
•Other diagnostic criteria• Intrusive symptoms (re-experiencing)
• Avoidance
• Negative alteration in cognitions and mood
• Alterations in arousal and reactivity
What is Trauma?
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• Acute
• Chronic
• Complex
Types of Trauma
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Acute Trauma
Acute trauma is a single traumatic event that
is limited in time. Examples include:
Serious accidents
Community violence
Natural disasters
Sudden or violent loss of loved one
Physical or sexual assault
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Chronic Trauma
Refers to the
experience of
multiple
traumatic
events…
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Complex Trauma
Describes both exposure to
chronic trauma, usually
caused by adults
entrusted with the child’s
care, and the impact of
such exposure on the
child (abuse, extreme
neglect).
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•Gene Methylation
• Chronic Stress Impact
Trauma and Gene Expression
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Trauma and Cellular Aging
Telomeres
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Trauma and the Immune System
• Microglial Cells
• Lymphatic Brain Pathway
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Moderated Stress Response
• Sympathetic Nervous
System
• Cortisol
• Adrenaline
• Default Mode Network
Trauma and the Stress Response
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Trauma and Brain Development
Changes in Brain Structures
• Amygdala
• Hippocampus
• Corpus Callosum
• Prefrontal Cortex
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Trauma and Brain Development
Changes in Neural Pathways
• Hypersensitive Amygdala
• Hyperactive SNS
• Hypoactive Prefrontal Cortex
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Trauma and Brain Development
Changes in Neurotransmitters
• Norepinephrine
• Serotonin
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• Reliving the Experience
• Avoidance and Numbing
• Increase Arousal
Trauma Symptoms
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• Recurrent images and thoughts
• Recurrent and distressing dreams
• Distress at exposure to cues that symbolize the
traumatic event
• Physiological reactivity
Re-experiencing the Trauma
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• Efforts to avoid thoughts and feelings
• Efforts to avoid activities, places or people
• Inability to recall important aspects of the trauma
• Diminished interest in activities
• Feeling detached from others
• Restricted range of affect
• Sense of foreshortened future
Avoidance and Numbing
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• Difficulty falling asleep
• Irritability or outbursts of anger
• Difficulty concentrating
• Hypervigilance
• Exaggerated startle response
Increased Arousal
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• Suspicion of others; preoccupied with perceived threat
• Defiant and/or aggressive towards peers, caregivers or adults
• Non-discerning in making friends or sharing information
• Unaware of their own emotions
• Not attuned to others’ emotions
• Avoids asking for help or communicating needs
• Needy and demanding behavior
• Allows oneself to be victimized by others
• Isolative behaviors
• Engages in loud attention seeking behavior
• Inappropriate attempts to gain intimate contact
Challenges to Positive Attachment
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• Hypersensitive to physical contact
• Hyper vigilance
• Hyper arousal
• Somatization
• Inability to be mindful
• Disturbances in regulation of bodily functions
Challenges to Self-Regulation
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• Pessimistic and hopeless outlook
• Lacking a sense of meaning or purpose in life
• Perceptions of self
• Low self-efficacy
• Low self-worth
• Difficulties in the following:
• Focusing on the task at hand
• Planning and future-oriented thinking
• Predicting consequences for one’s actions
• Setting realistic, achievable goals
• Developmental skills deficiencies
Challenges to Competency
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Questions or Comments?
Q & A
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• The Children’s Hospital of Los Angeles, Providing Shelter from the
Storm: Trauma-Informed Care
• Dr. Christoph Czermak, Society of Biological Psychiatry 66th Annual
Meeting; May 13, 2011; San Francisco, CaliforniaThe University of
Oklahoma National Resource Center, RHYTTAC, 2011, Train the
Trainers
• Hollywood Homeless Youth Partnership, The ARC Framework for
Runaway and Homeless Youth Serving Agencies
• Participants in Partnership: Adults and Youth Working Together, New
York State Youth Council from the National 4H Council Youth Adult
Partnerships Training Curriculum
Resources
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• Pietrzak RH, et al "Association of posttraumatic stress disorder with
reduced in vivo norepinephrine transporter availability in the locus
coeruleus" JAMA Psychiatry 2013; DOI: 10.1001/jamapsychiatry.2013.399.
• Volk, K.T., Guarino, K., Edson Grandin, M., & Clervil, R. (2008). What
about You? A Workbook for Those Who Work with Others.The National
Center on Family Homelessness.
http://508.center4si.com/SelfCareforCareGivers.pdf
Resources