PTSD Learning List 4 PDF

**PTSD** -PTSD in children -- Nip in the Bud (October 2018, 6:41 minutes)\ https://www.youtube.com/watch?v=L0lhOoITOPA\ -Symptoms and strategies for PTSD in children and teens -- Anxiety Canada (2017, 2:54 minutes)\ https://www.youtube.com/watch?v=7HzYOxHNhNU\ \ \ \*describe various types of sympto...

**PTSD** -PTSD in children -- Nip in the Bud (October 2018, 6:41 minutes)\ https://www.youtube.com/watch?v=L0lhOoITOPA\ -Symptoms and strategies for PTSD in children and teens -- Anxiety Canada (2017, 2:54 minutes)\ https://www.youtube.com/watch?v=7HzYOxHNhNU\ \ \ \*describe various types of symptoms (with examples) that children and adolescents with PTSD\ may present with, including variation in symptoms for different age groups Physical (stomach aches) emotional (fear, sadness, panic, helplessness, anger, guilt, irritability) behavioural (nightmares, repetitive play-e.g. re-enact car crash, aggression) Young child may regress developmentally, or age inappropriate behs (e.g. wet the bed, sep. anxiety) Older child may have difficulties at school and may engage in reckless or aggressive avoidant behs\ \*describe the four symptom clusters associated with a DSM 5 diagnosis of PTSD 1\. Intrusion symptoms (distressing memories, dreams, flashbacks) 2. Avoidance of things linked to the trauma (people, activities) 3. Changes in thoughts/mood (associated w event, distorted ideas about causes of event) 4. Changes in arousal and reactivity (irritable behs, exaggerated response- e.g. to sound, on alert, angry outbursts, sleep problems, hypervigilance)\ \*describe the sex difference and the comorbidity patterns associated with PTSD Higher rates in girls starting at school-age and adolescents. some of difference related to dif. forms of trauma (sex. assault) young children-inconsistent results Children show a variety of symptoms/disorders after a trauma, PTSD is only one possibility. Anxiety, depression PTSD co-occurs with ODD (young children), separation anxiety (young children), depression (school aged), anxiety, CD and substance use (school aged and adolescents). Higher risk for suicidal and NSSI behs\ \*describe the three types of trauma factors (with multiple examples of each type) that contribute\ to a higher likelihood of developing PTSD Pre-trauma factors (e.g. previous trauma exposure, negative life events, stressors, chronic (poverty) or incidental (death) family history of psychopathology Peri-trauma factors (perceived threat, personal injury) Post-trauma factors (disability/pain, poor parent/family functioning, low social support), maladaptive coping strategies, biology: 1/3 variance of symptoms is associated w genetic functions. Females more likely to be genetically susceptible\ \*describe how disruptions in (a) emotion regulation, (b) view of self and others, and (c)\ neurobiological changes following experiences of trauma contribute to adjustment after trauma 1\. \*\*Emotion Regulation:\*\* Trauma often overwhelms an individual's ability to manage emotions effectively. This can lead to heightened emotional reactivity, difficulty calming down, or emotional numbing. Without proper regulation, individuals may struggle with anxiety, anger, or depression, which can interfere with relationships, work, and daily life. 2\. \*\*View of Self and Others:\*\* Trauma can alter how individuals see themselves and their place in the world. They may develop feelings of worthlessness, guilt, or shame, and view others as untrustworthy or threatening. These shifts can damage self-esteem, hinder the formation of healthy relationships, and lead to isolation. 3\. \*\*Neurobiological Changes:\*\* Trauma impacts the brain and body, leading to changes in stress response systems and brain regions such as the amygdala, hippocampus, and prefrontal cortex. These changes can result in heightened alertness, difficulty distinguishing between safety and danger, and problems with memory and concentration. These neurobiological effects often prolong symptoms of trauma, such as hypervigilance and flashbacks, complicating recovery. \*describe the four possible outcomes of children's and adolescents' reaction to trauma 1\. Children who show no effects 2. Temporary symptoms 3.1+ diagnoses that are temporary 4. Ongoing problems\ \*describe the rates at which the four patterns of PTSD outcomes occurred for the young children\ who had experienced unintentional burns 1\. no disorder at T1 (65%) or T2 (73%) 2. 1 month later 50% of children showed distress symptoms (clingy, avoidance, irritability, temper tantrums), 35% had a psyc disorder , 25% had PTSD 3. 6 months later 27% had a psyc disorder (PTSD, ODD, sep. anxiety), 10% had PTSD. 4. 18% showed recovery, 8% showed chronic, 2% showed delayed onset Varies. Comorbidity was high with ODD and SAD. Ptsd @ 1 month more likely odd, sep anx, major dep, spec phobia. 6 month odd and sep anx NO differences by gender or size of burn A significant minority of young children developed PTSD in response to this trauma; a small group showed a chronic course of PTSD over 6 months. Elevated distress common, bbut usually most symptoms resolve, but some show psyc disorder, 25% PTSD\ \*describe the probable diagnosis of PTSD rate patterns for (1) youth who were present during\ the Fort McMurray wildfire versus not present; (2) youth who saw the fire in person versus did\ not see the fire; and (3) youth who had their home destroyed versus did not have their home\ destroyed (Brown et al., 2019) 3\) higher rates of probable diagnoses in the home destroyed 2)higher for saw fire 1)no sig. differences **ASD** -Autism Spectrum Condition: Nip in the Bud (October 2020, 11:30 minutes)\ https://www.youtube.com/watch?v=8Z5Gh\_e3Hw4\ -Meet TJ and Mom Dorothy: Autism Speaks Canada (2023, 2:51 minutes)\ https://www.youtube.com/watch?v=8gzkEHblq2c\ -Autism Spectrum Disorder: 10 things you should know (July 2017, 3:34)\ https://www.youtube.com/watch?v=DZXjJVrm1Jw\ \ \ \*describe the core characteristics of ASD, including various behaviours that illustrate these\ characteristics A neurodevelopmental disorder defined by significant differences in two areas: Social communication/social interaction: difficulty interacting w others, may be indifferent to physical contact, make little/no eye contact; use gestures or facial expressions infrequently, may not imitate others, isolated and unimaginative play, play may be more repetitive, may not understand or respond to other ppls emotions, no interest in making friends, difficulty recognizing faces (focus on eyes, mouth, not whole face) Restricted/repetitive behaviours/interests, activities (RRBs): fascination w light and movement (spinning), extreme responses to sensory input (vacuum noise), self-stimulatory behs (rocking, hand flapping), repetitive movements and use of objects, touch or smell, insistence on sameness, criteria that only makes sense to them (lining up objects, routines), attachment to unusual objects, distress when sameness disrupted, narrow interests, [echolalia]: repeat the word just heard\ \*describe associated characteristics of ASD Cognitive: 30-40% have an intellectual disability; differences in executive functions are common. E.g. inhibition of inappropriate or aggressive behs, hard time with feedback, difficulty organizing, planning, generalizing info learned Language: 35-40% do not develop communicative speech (usually develop speech by 5y/o), language may be marked by echolalia, pronoun reversal (I and you confused), unusual intonation, concrete and literal language, unrelated to situation Motor: 50-80% have difficulties with gross motor skills (walking on toes, throwing ball, bike), fine motor skills (using utensils, pencil, zipping jacket), or coordination or balance Behavioural: about 30% show self-injurious behaviours. E.g. head banging, hand biting, excessive scratching or rubbing, more likely if comorbid intellectual disability Physical/health: problems with sleep and/or with eating (picky, higher rate of GI problems, nausea, pain), about 25% develop seizures (later adolescence/adulthood more common onset)\ \*describe how differences in executive functions and in central coherence may be evident in\ autistic children Associated chara\ \*describe the sex difference in ASD and describe how ASD symptoms change with age\ (preschoolers, school-age children, adolescents) Sex: more common among boys (4:1) core symptoms same; girls (underdiagnosed or at older age) may show fewer RRBs and higher (better) scores on language skills and social motivation Preschool: classic symptom pattern; school ages: more responsive socially, but odd behs and self stimulation/injury more common. Adolescence: symptoms continue (or worsen or developmental gain), hyperactivity and self injury may worsen\ \*describe the roles of biology and environment in the development of ASD Current view: biologically based neurodevelopmental disorder that involves genetic and environmental factors. Bio: family, twin, gene studies show sig. heritability (up to.8) likely involving single and multiple gene mutations. Neuro: larger brain volume, more white and grey matter, specific structural abnormalities (frontal lobes, cerebellum, amygdala), decreased blood flow in some regions (frontal, temporal lobes), and disrupted (LACK) connectivity and communication among brain regions\*\*\* Gene expression is affected by environmental factors beföre, during, and/or after fetal brain development (e.g., older parental age, medication or drug exposure, low birth weight (risk for different difficulties nit jusy asd)). Multiple factors affect how process info, interact w their environment \*describe some features of early interventions and how these interventions may affect autistic\ children \#\#\# Features of Early Interventions: 1\. \*\*Developmentally Oriented Programs\*\*: Evidence-based behavioral services, such as Applied Behavior Analysis (ABA) and naturalistic developmental approaches, target skills like communication, social interaction, and adaptive functioning. These programs often use a combination of structured (discrete trial training) and flexible (incidental teaching) methods to teach essential skills. 2\. \*\*Parental Involvement\*\*: Parents play a central role in implementing interventions at home. For instance, programs like AIM HI (An Individualized Mental Health Intervention) provide strategies to teach children emotion regulation and adaptive skills while equipping caregivers with tools to create supportive environments. 3\. \*\*Focus on Social and Communication Skills\*\*: Interventions prioritize teaching social behaviors, peer interaction, and communication strategies. Programs like UCLA PEERS target social skills for teens, enhancing areas such as cooperation, social awareness, and peer relationships. 4\. \*\*Individualization\*\*: Tailored interventions address the unique needs of each child, emphasizing both their challenges and strengths to ensure they can thrive in their environments. 5\. \*\*Educational and Speech Therapy Support\*\*: Educational plans and speech-language therapy focus on preparing children for mainstream settings, improving communication, and teaching adaptive skills. \#\#\# Effects on Autistic Children: 1\. \*\*Improved Skills and Independence\*\*: Interventions help children develop skills for daily life, such as communication, emotional regulation, and social interaction. These gains can enhance their independence and ability to function in non-autistic settings. 2\. \*\*Reduction in Challenging Behaviors\*\*: Targeted approaches reduce behaviors such as tantrums or aggression, promoting adaptive responses to stress or frustration. 3\. \*\*Enhanced Quality of Life\*\*: By fostering both core skill development and family coping mechanisms, interventions support children in achieving a higher quality of life and engaging more fully in their communities. 4\. \*\*Potential Limitations\*\*: While many children benefit, the degree of improvement varies. Masking strategies, which help children conform to societal norms, may lead to burnout and distress, emphasizing the need for interventions that respect neurodiversity and focus on acceptance. Goals: Reduce/minimize impact of core differences, maximize independence and quality of life, help the person and the family manage the diagnosis. Highly structured skills-oriented strategies (tailored to the child) have shown rhe most success. +education and support to the families Lack of services after childhood, lifelong condition, not one treatment P.212-217\ \*describe three things we have learned from prospective longitudinal studies of infant siblings of\ children who have been diagnosed with ASD Recurrence risk of ASD in infant siblings= up to 20%. Which is 10X higher than prevalence rate, higher when younger sibling is male, older child is female, more than one sibling w ASD Many behavioural markers emerge around 12 months; social abilities (smile, look at ppl) before 12 months do not rule out ASD development High-risk siblings who do not develop asd by 36 months may have other developmental challenges (symptoms of ASD, language delay, cognitive delay)\ \*identify any four myths/bits of misinformation that persist about autistic individuals -children don't outgrow autism (lifelong condition neurodevelopmet) -people on the spectrum have a great deal of empathy (have hard time communicating but can understand clear emotions) -many have quality friendships -not all have savant skills (only 10% do) -autism is not caused by vaccination **Eating Disorders** -Understanding Eating Disorders (Nip in the Bud, December 2021, 8:28 minutes)\ https://www.youtube.com/watch?v=DatYiiSxxUE\ -Teen Mental Health First Person Experience: Amy (July 2013, 5:40 minutes)\ https://www.youtube.com/watch?v=Ymqo4u-Sh\_k\ -Bulimia: Susannah's Story (Nip in the Bud, March 2022, 9:12 minutes)\ https://www.youtube.com/watch?v=9dQQrsoJM-g\ \ \*distinguish the core features of anorexia nervosa, bulimia nervosa, and binge eating disorder AN: persistent restriction of food intake (sig. low bodyweight), intense fear of gaining weight or becoming fat, and a disturbed body image. Feel overweight generally or in specific body parts, doesn't involve a loss of appetite, is deliberately attained, purging, exercise.. can result in death, present as malnourished. Physical; prominent cheek bones, sunken eyes, dry skin and hair, sensitivity to cold, cardiac arrythmias (irreg hearbeats), electrolyte imbalances. Psychological; achievement oriented, high need for approval, sensitive to criticism, value self-control, weightloss is an achievemtn and weigth gain is a failure of self control. Indifferent to medical impplications BN: recurrent episodes of binge eating, recurrent use of purging behs to maintain bodyweight(vomiting, laxatives); self-evaluation influencned by weight/shape. Binge eating may or may not be planned, usually in secret, usually triggered by dysphoric mood (stressor, bad mood), within 10% of expected bodyweight. Physical; fatigue, headaches, swollen cheeks, salvatory glands enlarged, eroded dental enamel (from stomach acid), bruised knuckles, muscle cramping, dehydration, cardiac, electrolytes. Psychological; impulsive, moody, think in absolute terms (black and white) BED: recurrent episodes of binge eating, normal and over weight. Psychological: tend to feel ashamed, attempt to conceal symptoms, often in secret, triggered by negative affect, lower self esteem, higher depressed mood\ \*describe physical and psychological characteristics of adolescents with AN and BN\ \*describe age differences in the onset of AN, BN, and BED Peak risk period of AN 14 yr and 18yr, BN 14-19, BED around 19. Presence of risk factors and adapting to new stressors around those ages leads them to manage stress by excessive control over eating. Dieting after comment about weight, change in ohysical appearance, reinforcement by positive comment about losing weight, binge eating oftem after dieting, dieting follows development of binge, opposite for BN and AN\ \*describe the comorbidity patterns associated with AN, BN, and BED AN: depressive (may reflect body's state, around 50%) and anxiety disorders (before ED) most common, also OCD and substance use disorders. Depression persists after recovery BN: depressive and anxiety disorders; also substance BED: depressive and anx disorders and substance ALL: higher suicide risk (thinking, attempts more w bulimia, death more w anorexia)\ \*describe how biological, individual, and environmental factors contribute to the onset of Eds Bio: MINOR role in BN and AN (more maintenance than onset), family twin studies, genetic component, (higher rates same sex female twins or female relatives) abnormal neurotransmitter/hormone regulation (serotonin, norepinephrine) Phys: assertion of control, body dissatisfaction, perfectionism/ocd behs, rigid personality, child sexual abuse risk factor Social family: focus on weight, compliments, teasing, criticism, dieting, smoking, achievement, parent sub use and obesity Social peer: comments teasing abt weight and shape, appearance, focus on appearance, establish peer group norms (all thin), stronger influence on body dissatisfaction may be stronger than parents Sociocultural: western emphasis on personal freedom, instant gratification, availability of food, cultural ideals of attractiveness and use of diet/exercise for weight loss link appearance to womens success/happiness. Communication w parents and peers are stronger predictors of body diss. (\>social media)\ \*describe the course/outcome of diagnoses of AN, BN, and BED Youth may experience different ed diagnoses at diff times; crossover from bed to others is uncommon. \>1/3 of anorexia (restricting type) develop bulimia. bulimia to anorexia however often revert to bulimia. AN\