Psychology Chapter: Childhood Trauma and Mental Health
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Questions and Answers

What is a key risk factor associated with the development of psychosis?

  • Adverse genetic predisposition
  • Familial mental health history
  • Childhood neglect (correct)
  • Higher socio-economic status

Which of the following best represents the biological mechanism linked to childhood trauma and psychosis?

  • Heightened serotonergic activity
  • Increased dopamine production
  • Enhanced synaptic pruning
  • Blunted cortisol response (correct)

Which is NOT considered a component of the 3 E's of trauma?

  • Experience
  • Effects
  • Ego (correct)
  • Events

According to the Bradford-Hill criteria, what aspect addresses whether trauma alleviation can reduce symptoms of psychosis?

<p>Temporality (D)</p> Signup and view all the answers

What does Trauma Informed Care (TIC) prioritize?

<p>Understanding the impact of trauma on individuals (B)</p> Signup and view all the answers

What is the primary goal of the 4R’s framework in trauma-informed care?

<p>To recognize and respond to the needs related to trauma (C)</p> Signup and view all the answers

In Trauma-focused CBT for Psychosis, which phase involves goal setting and psychoeducation?

<p>Phase One (C)</p> Signup and view all the answers

What was a significant finding from the audit on the REVA policy in 2016?

<p>No trusts had imposed the REVA policy effectively (B)</p> Signup and view all the answers

What does the relational focus of trauma-informed care prioritize?

<p>Creating safe and empowering relationships (B)</p> Signup and view all the answers

What impact does trauma-focused therapy aim to have on psychosis-related symptoms?

<p>Effectively address memories related to psychotic symptoms (D)</p> Signup and view all the answers

What critical feedback was received regarding the framing of trauma assessment questions in healthcare?

<p>Many patients did not recognize their experiences as abuse (D)</p> Signup and view all the answers

Which of the following is an obstacle to implementing trauma-informed care identified in staff surveys?

<p>Lack of training and support resources (A)</p> Signup and view all the answers

In the framework of trauma-informed care, what does 'resists retraumatization' imply?

<p>Preventing institutions from causing further harm (B)</p> Signup and view all the answers

According to NICE guidelines, who should deliver trauma-specific treatments?

<p>Individuals with specific training in trauma care (D)</p> Signup and view all the answers

What aspect of trauma-focused therapy is deemed unique in its application for psychosis?

<p>Integration of memory work into treatment (A)</p> Signup and view all the answers

Which factor is associated with the increased risk of developing psychosis due to childhood trauma?

<p>Duration of childhood adversity (B)</p> Signup and view all the answers

The Bradford-Hill criteria suggest that the link between childhood trauma and psychosis can be established through which aspect?

<p>Strength &amp; consistency demonstrated by randomized controlled trials (A)</p> Signup and view all the answers

What defines trauma according to the provided content?

<p>A subjective interpretation of an event (C)</p> Signup and view all the answers

Which of the following psychological responses is NOT typically associated with childhood psychological trauma?

<p>Increased grey matter volume (C)</p> Signup and view all the answers

Which principle is integral to Trauma Informed Care?

<p>Recognizing the impact of trauma on behavior and health outcomes (B)</p> Signup and view all the answers

What does the 'resists' component of the 4R’s framework primarily emphasize?

<p>Preventing the re-traumatization of individuals (C)</p> Signup and view all the answers

Which phase of Trauma-focused CBT for Psychosis involves working on beliefs and emotional regulation?

<p>Phase Three (D)</p> Signup and view all the answers

What was a significant limitation found in the 2016 REVA audit regarding trauma assessment?

<p>Lack of documentation of abuse questions (D)</p> Signup and view all the answers

What does trauma-informed care view trauma as?

<p>Everybody's business that affects multiple aspects of care (D)</p> Signup and view all the answers

What primarily distinguishes trauma-focused therapy in its application for psychosis?

<p>Incorporation of memory work and contextualization (C)</p> Signup and view all the answers

Which of the following is a common challenge faced by professionals implementing trauma-informed care?

<p>Insufficient training and support for staff (C)</p> Signup and view all the answers

In trauma-informed care, what is the primary focus of relational interactions?

<p>Building relationships that are safe and empowering (A)</p> Signup and view all the answers

What is the primary recommendation for delivering trauma-specific treatments?

<p>Trained professionals with specific experience in trauma care (B)</p> Signup and view all the answers

Which emerging evidence suggests a potential benefit of trauma-focused therapies in psychosis?

<p>They may improve memories related to hallucinations. (A)</p> Signup and view all the answers

What aspect of the 4R’s framework addresses identifying trauma effects that may need further care?

<p>Recognizes (A)</p> Signup and view all the answers

Which factor influences the severity and impact of childhood psychological trauma?

<p>The age of the child during the trauma (D)</p> Signup and view all the answers

What does the concept of psychological trauma primarily rely on?

<p>The individual's interpretation of the event (B)</p> Signup and view all the answers

Which of the following aspects relates to the biological gradient within the Bradford-Hill criteria?

<p>The amount of trauma correlating with symptom severity (C)</p> Signup and view all the answers

Which process is most likely altered in individuals exposed to childhood trauma, as indicated by research?

<p>Cortisol response (C)</p> Signup and view all the answers

According to the principles of Trauma Informed Care, which aspect is emphasized when interacting with a client?

<p>Recognizing and understanding the impact of trauma (B)</p> Signup and view all the answers

What core principle does the 4R’s framework consider when addressing trauma in organizational settings?

<p>Understanding the impact of trauma (B)</p> Signup and view all the answers

What does the 'responds' aspect of the 4R’s framework primarily involve?

<p>Offering trauma-specific or focused therapy (D)</p> Signup and view all the answers

Which phase of Trauma-focused CBT for Psychosis is particularly dedicated to memory work?

<p>Phase Two - Trauma focused CBT (A)</p> Signup and view all the answers

What was a significant issue identified in the implementation of the REVA policy based on the 2016 audit?

<p>No trusts ordered implementation and poor documentation (B)</p> Signup and view all the answers

Which aspect of trauma-focused therapy distinguishes it as particularly significant for psychosis treatment?

<p>Memory work (A)</p> Signup and view all the answers

What challenge do healthcare professionals face when assessing trauma in psychosis, as mentioned in the content?

<p>Low confidence in trauma assessment skills (A)</p> Signup and view all the answers

What emerging evidence suggests a beneficial impact of trauma-focused therapies on psychosis?

<p>Trauma-focused therapy addressing memories related to voices (B)</p> Signup and view all the answers

What crucial aspect of trauma-informed care does the relational focus emphasize?

<p>Safe and empowering relationships (C)</p> Signup and view all the answers

What significant recommendation is indicated regarding trauma-specific treatments?

<p>They should be delivered by trained professionals (C)</p> Signup and view all the answers

What can complicate the assessment of trauma in individuals with psychosis?

<p>Difficulty distinguishing between trauma experience and symptoms (A)</p> Signup and view all the answers

Which of the following factors is NOT associated with the severity and impact of childhood psychological trauma?

<p>Socioeconomic status (C)</p> Signup and view all the answers

Under the Bradford-Hill criteria, what aspect examines the link between the severity of trauma and the intensity of symptoms?

<p>Biological gradient (D)</p> Signup and view all the answers

Which statement best reflects the definition of trauma according to the content?

<p>Trauma is characterized by subjective interpretations that vary by individual. (B)</p> Signup and view all the answers

Which psychological response is NOT likely to occur in individuals exposed to childhood trauma?

<p>Increased cortisol production (D)</p> Signup and view all the answers

What is a key principle of Trauma Informed Care (TIC)?

<p>Recognizing the wide array of individual trauma experiences (A)</p> Signup and view all the answers

Which of the following statements accurately reflects the impact of trauma in organizational settings?

<p>Organizations must acknowledge the widespread effects of trauma on everyone involved. (A)</p> Signup and view all the answers

What is the main purpose of the 'responds' element in the 4R’s framework?

<p>To access trauma-specific care that responds sensitively to individual needs. (A)</p> Signup and view all the answers

Which phase in Trauma-focused CBT for Psychosis involves memory contextualization?

<p>Phase Two: Trauma-focused cognitive behavioral therapy. (A)</p> Signup and view all the answers

What challenge was noted about the implementation of the REVA policy in the audit conducted in 2016?

<p>No training was provided to staff for implementing trauma questions. (D)</p> Signup and view all the answers

Which statement best captures the relational focus of trauma-informed care?

<p>Collaboration and trust are critical in building relationships that mitigate harm. (D)</p> Signup and view all the answers

In what way is the trauma-focused therapy for psychosis uniquely beneficial?

<p>It includes memory work to address trauma directly related to psychotic experiences. (B)</p> Signup and view all the answers

What common difficulty arises when assessing trauma experiences in individuals with psychosis?

<p>There is often confusion about whether trauma symptoms are from trauma or psychotic experiences. (C)</p> Signup and view all the answers

What is the primary goal of trauma-informed care within the context of the UK mental health policies?

<p>To ensure a safe and supportive environment for individuals affected by trauma. (A)</p> Signup and view all the answers

Which of the following is a recognized obstacle to implementing trauma-informed care, according to staff surveys?

<p>Lack of confidence in skills and insufficient training. (D)</p> Signup and view all the answers

According to the findings on trauma treatment effectiveness, which of the following therapies showed small effects on psychotic symptoms?

<p>Trauma-focused therapies targeting memory processing. (C)</p> Signup and view all the answers

Flashcards

Childhood Trauma and MH disorders

Events in childhood, like abuse or neglect, can significantly impact mental health later in life.

Trauma-Informed Care (TIC)

A type of care or treatment that understands trauma's effect and tailors approaches accordingly.

How Trauma Affects the Brain

Childhood trauma might cause changes in the brain (e.g., grey matter), impacting the body's stress response, and possibly increasing risk of mental illness, like psychosis.

Bradford Hill criteria

A set of guidelines used to determine the link between a cause and effect, especially useful in assessing the strength of a link between childhood trauma and psychosis.

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Trauma Definition

Trauma is a subjective interpretation of an event. The importance is not the event itself, but the perception of the individual. This is uniquely important for individuals with neurodiversity..

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4R's of Trauma-Informed Care

A framework for organizing systems to address trauma-related needs and reduce re-traumatization. It involves: realizing the widespread impact of trauma, recognizing trauma, responding with appropriate care, and resisting re-traumatization.

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Trauma-Focused CBT for Psychosis (Tf-CBTp)

A combined approach that integrates trauma-focused therapy with CBT for psychosis. It aims to address the trauma experienced by the patient in tandem with treating psychosis.

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Routine Enquiry about Trauma (REVA)

A policy requiring routine inquiry about past trauma experiences.

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Trauma-Informed Care (TIC) in MDTs

Implementing TIC within multidisciplinary teams (MDTs) which involves training for staff, improved case note keeping & identifying obstacles to TIC implementation.

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Trauma-Focused Therapy

Therapy specifically designed to address trauma where memory work is an important component.

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CBT for Psychosis

A type of therapy that can be trauma-informed. It focuses on thoughts, feelings and behaviours.

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Trauma effects

A careful investigation or evaluation of symptoms that appear to be caused by trauma.

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Phase One of Tf-CBTp

The initial phase that involves assessment, goal setting, formulation, and psychoeducation.

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Phase Two of Tf-CBTp

Focuses on working through specific traumatic memories and elaborating on them.

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Phase Three of Tf-CBTp

Involves CBTp approaches to address thoughts, feelings, and behaviors related to past trauma to improve management of symptoms.

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What is a risk factor?

A risk factor is something that increases the chance of developing a particular illness or condition. In the context of psychosis, childhood trauma is a risk factor, increasing the likelihood of developing psychosis 3 times higher than those without childhood trauma.

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What are the 3 E's of Trauma?

The 3 E's of Trauma are Events, Experiences, and Effects. Events refer to any event that's psychologically or physically threatening. Experiences encompass the range of reactions to the event, including cognitive, emotional, behavioral, physiological, and interpersonal responses. Effects refer to the lasting consequences, including cognitive, emotional, behavioral, physiological, and interpersonal changes.

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What is the Bradford Hill criteria?

The Bradford Hill criteria are a set of guidelines used to determine the strength of the association between a cause and effect, helping to understand if something is indeed a contributing factor. It looks for factors like consistency of findings, temporality, dose-response, and a biological mechanism.

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What are examples of childhood trauma?

Childhood trauma encompasses adverse experiences during childhood, including neglect, physical abuse, sexual abuse, or emotional abuse. The impact of trauma can vary depending on the duration, number, and type of adversities, as well as the child's developmental stage.

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What is Trauma-Informed Care?

Trauma-Informed Care (TIC) is a way of providing services and support by understanding that trauma is common and can have lasting impacts. This involves recognizing the signs of trauma, responding appropriately to trauma, and avoiding re-traumatization. It emphasizes a person-centered approach and focuses on building safety and trust.

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TIC: 'Everybody's Business'

TIC emphasizes that everyone in an organization should be aware of trauma and its impact on individuals. It's not just the responsibility of specialized professionals.

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Tf-CBTp Phases

This therapy is structured in three phases: assessment & goal setting, trauma memory work, and CBTp for managing thoughts, feelings, and behaviors.

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Routine Trauma Enquiry (REVA)

A policy that requires healthcare professionals to ask patients about their experiences of trauma, even when it's not directly related to the main reason for seeking help.

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REVA Implementation Challenges

The initial REVA policy had limitations, including a lack of effective training for staff and a potentially problematic framing of the inquiry around 'abuse'.

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TIC in MDTs

Implementing TIC within multidisciplinary teams (MDTs) requires training staff, improving case notes, and identifying obstacles to effective implementation.

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Evidence for Trauma-Focused Therapy in Psychosis

While research is ongoing, evidence suggests that trauma-focused therapy can have a positive impact on psychosis, particularly in reducing hallucinations and delusions.

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Future Directions for TIC

Future research needs to focus on evaluating the optimal TIC approach and understanding the complexities of incorporating it into healthcare systems.

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Childhood Trauma

Adverse experiences during childhood, including neglect, physical, sexual, or emotional abuse, that can have lasting impacts on mental health.

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Trauma and Psychosis

Childhood trauma is a significant risk factor for developing psychosis, increasing the likelihood by 3 times compared to those without such experiences.

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The '3 E's' of Trauma

Events, Experiences, and Effects. Events refer to traumatic occurrences. Experiences are the individual's reactions. Effects are the lasting consequences.

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4Rs of TIC

The four core principles of trauma-informed care: Realize the impact of trauma, Recognize trauma signs, Respond with appropriate care, Resist retraumatization.

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Memory Work in Tf-CBTp

A crucial part of Tf-CBTp involving examining and understanding traumatic memories to help people process and cope with them.

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Trauma-Informed Care in MDTs

Incorporating TIC principles within multidisciplinary teams (MDTs) to provide more sensitive and effective care to people who've experienced trauma.

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Challenges of Implementing REVA

Early REVA policy had issues: lack of training for staff, framing the inquiry around 'abuse' was problematic.

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STAR Trial

A research study (RCT) that investigates the effectiveness of trauma-focused therapy for psychosis.

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Childhood Trauma Risk

Experiences like neglect, abuse, or adversity in childhood significantly increase the risk of developing psychosis, making it three times more likely.

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Study Notes

Freud's Perspective on Childhood Trauma and Mental Health

  • Freud's work in the 1890s linked childhood sexual abuse to mental health disorders, suggesting that early experiences have lasting impacts.
  • More research is needed to understand the mechanisms.

Childhood Psychological Trauma

  • Adverse experiences during childhood increase risk of psychosis by threefold.
  • Neglect, physical, sexual, or emotional abuse are key adverse events.
  • Duration, number, and type of adversity matter.
  • Timing of adversity (childhood, adolescence, adulthood) influences impact.
  • Population risk with childhood trauma is 30%.

Mechanisms Linking Trauma and Psychosis

  • Several psychological and neurological processes are involved.
  • Childhood trauma is linked to grey matter volume alterations.
  • Individuals with psychosis and a history of childhood trauma often show a blunted cortisol response.
  • Trauma can induce epigenetic changes that increase psychosis risk.
  • Strong, consistent relationships (meta-analysis) between childhood trauma and psychosis.
  • Trauma precedes symptoms (reversed link needs investigation).
  • Dose–response relationship (more severe trauma, more severe symptoms).
  • Biological mechanisms (HPA axis, brain alterations, dopamine system).

Trauma-Informed Care (TIC)

  • A system-wide approach, not a stand-alone intervention, ensuring trauma-related needs are met and risk of re-traumatization is reduced.
  • Applicable to any organization.
  • Emphasizes a relational focus (safe, trustworthy, collaborative, empowering).
  • Recognizes the "widespread impact" of trauma.
  • Aims to "respond" sensitively and provide trauma-focused interventions.
  • "Resists" retraumatization.
  • Uses a "routine inquiry" approach which is a crucial part of this.

Defining Trauma

  • Trauma is subjective; what constitutes trauma depends on individual interpretation (especially those with neurodiversity).
  • Trauma in relation to psychosis can come before, occur alongside, or as a result of it.
  • The '3 Es': Events, Experience, and Effects. Effects are most important clinically.

Trauma-Informed Care for Psychosis & Recommendations and Challenges

  • Trauma-informed mental health policies are essential (e.g. NHS).
  • Trauma-specific/focused therapies are important for those with specialized training.
  • CBT for psychosis can be a trauma-informed approach.
  • Trauma-focused CBT includes memory work, unique to this treatment approach.

Trauma-Focused CBT for Psychosis: Structure and Phases

  • Assessment, goal setting, formulation, and psycho-education (Phase One).
  • Memory exploration to contextualize and elaborate trauma memories (Phase Two).
  • Cognitive restructuring and emotional regulation associated with beliefs, experiences, and appraisals (Phase Three).

Research on TIC in the UK

  • Routine enquiry about trauma (REVA policy).

  • Current version of REVA policy does not adequately account for or account for discrimination.

  • A version exists but its implementation and practical application require improvement.

  • Difficulties in assessing trauma for psychosis: distinguishing trauma from psychotic symptoms (e.g. delusions).

  • Staff lack of confidence, training, and resources are roadblocks, and REVA does not offer specific support for trauma-informed care.

  • Further development is needed to ensure thorough implementation, support, and training.

Efficacy of Trauma-Focused Therapy in Psychosis

  • Limited evidence of significant long-term positive impacts on hallucinations or negative symptoms.
  • Emerging evidence shows some benefits in managing delusions and hallucinations.

Future Directions

  • Research into optimal TIC approaches for psychosis is necessary.
  • Trauma’s multifaceted nature makes studying TIC challenges.
  • STAR trial (randomized controlled trial of trauma-focused therapy for psychosis).

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Description

Explore the significant connections between childhood trauma and mental health issues through the lens of Freud's theories. This quiz delves into the mechanisms of trauma, the impact of adverse childhood experiences, and their links to psychosis. Understand the psychological and neurological changes that arise from traumatic experiences in childhood.

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