early childhood trauma

儿童早期创伤
  • 文章类型: Journal Article
    早期儿童创伤与年龄较大的儿童的神经认知和情绪处理缺陷有关,然而,人们对幼儿的这些联系知之甚少。幼儿期是一个重要的发展时期,在这个时期检查创伤与执行功能/情绪反应之间的关系,鉴于这些能力正在迅速发展,并且是与精神病理学发展有关的潜在诊断因素。这项横断面研究检查了累积创伤,人际关系创伤,以及执行功能的组成部分,情景记忆,和情绪反应,使用RDoC框架进行概念化,并使用基于观察和绩效的措施进行评估,在接受部分医院治疗的90名儿童(4-7岁)中。经历过两种或两种以上创伤的儿童的情景记忆得分较低,全球认知,和抑制控制在关系(但不是计算机化的)任务中测量,与创伤较少或没有创伤的儿童相比。人际关系创伤与整体认知和关系抑制控制类似。家庭情境因素并没有缓和关联。研究结果支持在儿童早期的相关意义和去语境化范式中检查抑制性控制,并强调同时调查多个神经认知和情绪过程以确定早期干预的潜在目标的重要性。
    Early childhood trauma has been linked to neurocognitive and emotional processing deficits in older children, yet much less is known about these associations in young children. Early childhood is an important developmental period in which to examine relations between trauma and executive functioning/emotion reactivity, given that these capacities are rapidly developing and are potential transdiagnostic factors implicated in the development of psychopathology. This cross-sectional study examined associations between cumulative trauma, interpersonal trauma, and components of executive functioning, episodic memory, and emotion reactivity, conceptualized using the RDoC framework and assessed with observational and performance-based measures, in a sample of 90 children (ages 4-7) admitted to a partial hospital program. Children who had experienced two or more categories of trauma had lower scores in episodic memory, global cognition, and inhibitory control as measured in a relational (but not computerized) task, when compared to children with less or no trauma. Interpersonal trauma was similarly associated with global cognition and relational inhibitory control. Family contextual factors did not moderate associations. Findings support examining inhibitory control in both relationally significant and decontextualized paradigms in early childhood, and underscore the importance of investigating multiple neurocognitive and emotional processes simultaneously to identify potential targets for early intervention.
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  • 文章类型: Journal Article
    理解和处理生活经历对于治疗人格障碍以促进个人康复和心理健康至关重要。在这份定性案例报告中,在客户之间共同创作中起草的,临床心理学家,艺术治疗师,个体治疗包括两种心理治疗干预措施,“赋权故事”和以生活故事为中心的艺术疗法,在24周的12次平行会议中。希尔达,68岁,被诊断出患有未指明的人格障碍和各种边缘性人格障碍。在长期的心理健康问题植根于创伤的早期童年后,她经历了情绪疲惫。这影响了她管理情绪和社会关系的能力,导致她的生活毫无意义。希尔达被邀请去重建她的生活经历,分为过去,转折点,和现在/未来,在一个书面和绘画的生活故事。这允许整合创伤和积极的记忆,增强自我同情,和意义制作。她发展了自我反省和内部冲突的整合,从而实现了更好的情感平衡和自我理解。艺术疗法强调自下而上的监管过程,而叙事心理学支持自上而下的监管过程。组合方法有效地整合了自下而上,经验,自上而下的感官体验,认知情绪调节过程。结果表明,心理治疗干预涉及多管齐下,互补,因此,更全面的方法可以支持人格障碍的个人康复。
    Understanding and processing life experiences are essential in the treatment of personality disorders to promote personal recovery and psychological wellbeing. In this qualitative case report, drafted in co-creation between the client, clinical psychologist, and art therapist, individual treatment consisted of two psychotherapeutic interventions, \"An Empowering Story\" and life-story-focused art therapy, in 12 parallel sessions for 24 weeks. Hilda, 68 years of age, had been diagnosed with an unspecified personality disorder and various traits of borderline personality disorder. She experienced emotional exhaustion following long-term mental health problems rooted in a traumatic early childhood. This affected her ability to manage her emotions and social relations, resulting in the sense that her life had no meaning. Hilda was invited to reconstruct her life experiences, divided into the past, turning point, and present/future, in a written and a painted life story. This allowed for the integration of traumatic as well as positive memories, enhanced self-compassion, and meaning making. She developed self-reflection and integration of internal conflicts leading to a better emotional balance and self-understanding. Art therapy emphasizes bottom-up regulatory processes, while narrative psychology supports top-down regulatory processes. The combined approach effectively integrated bottom-up, experiential, sensory experiences with top-down, cognitive emotion-regulation processes. The results suggest that psychotherapeutic interventions involving a multi-pronged, complementary, and thus more holistic approach can support personal recovery in personality disorders.
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  • 文章类型: Editorial
    The author provides an overview of the psychodynamics of addiction, diverging from outdated conceptualizations such as orality and regression, and emphasizing the clinical relevance of the self-medication hypothesis. Rado and Bion paved the way for Khantzian\'s self-medication hypothesis by describing the drug user\'s need to escape unpleasure and seek self- containment. The author reviews research corroborating the relevance of the self-medication hypothesis and other relevant constructs such as self-deceptive attempts at adaptation, inability to prioritize self-care or delay gratification, excessive hedonism and novelty seeking, and impulsivity. Adverse childhood experiences, abuse and neglect are known to cause epigenetic changes altering gene expression, which may endure throughout life and be transmitted intergenerationally. Effective psychotherapeutic interventions have the potential to reverse DNA methylation and other epigenetic changes triggered by trauma and co-morbid psychopathology. Lastly, this editorial also introduces the psychodynamically informed clinical recommendations of Baurer and Gottdiener, further described in separate articles in this issue of Psychodynamic Psychiatry.
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  • 文章类型: Journal Article
    The Trauma Symptom Checklist for Young Children (TSCYC) is a 90-item caregiver-report measure of childhood traumatic stress and abuse-related experiences in children, ages three to twelve years old.
    UNASSIGNED: The objective of this review is to examine the current empirical evidence (n = 22) regarding the psychometric properties of the TSCYC.
    UNASSIGNED: A variety of study designs were reviewed for psychometric evidence supporting the reliability and validity of the TSCYC.
    UNASSIGNED: The psychometric evidence for the TSCYC indicates it is a reliable scale. However, evidence of validity is moderate and focuses on older children.
    UNASSIGNED: Clinicians may utilize the TSCYC to support a PTSD diagnosis in children. Further psychometric exploration would strengthen the body of evidence for younger children (ages 3-5) who have had traumatic experiences.
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  • 文章类型: Journal Article
    本文讨论了遭受儿童早期创伤的成年人的风险因素,特别关注情感虐待,并讨论了童年创伤的负面长期后果,如抑郁症,焦虑,压力,和神经质人格。这项研究预测,那些报告情绪虐待的人会有更高的抑郁症疮,焦虑,压力,和神经质人格相比,那些只报告身体的人,只有性,或结合身体和性虐待。使用NEO五因素清单,抑郁焦虑和压力量表,和童年创伤问卷,748名大学生参加了东南大学的在线调查。正如预测的那样,这项研究发现,那些报告情感虐待的人抑郁得分更高,焦虑,压力,和神经质人格相比,那些只报告身体的人,只有性,或结合身体和性虐待。研究表明,情感虐待可能是最具破坏性的虐待形式,会导致不良的发育后果,或者比,其他形式的滥用(Hart等人。1996).因此,本文讨论了公众意识运动的必要性,以提高公众和社区的意识,以及有证据的基础治疗,以帮助情绪虐待导致的心理后果。
    This article discusses risk factors for adults who have suffered early childhood trauma, specifically focusing on emotional abuse, and discusses the negative long-term consequences from childhood trauma such as depression, anxiety, stress, and neuroticism personality. This research study predicts that those who report emotional abuse will have higher sores for depression, anxiety, stress, and neuroticism personality compared to those who reported only physical, only sexual, or combined physical and sexual abuse. Using the NEO Five-Factor Inventory, Depression Anxiety and Stress Scale, and Childhood Trauma Questionnaire, 748 college students participated in an on-line survey at a Southeastern university. As predicted, this study found those who reported emotional abuse had higher scores for depression, anxiety, stress, and neuroticism personality compared to those who reported only physical, only sexual, or combined physical and sexual abuse. Studies show emotional abuse may be the most damaging form of maltreatment causing adverse developmental consequences equivalent to, or more severe than, those of other forms of abuse (Hart et al. 1996). Therefore, this article discusses the need for public awareness campaigns to raise public and community awareness and evidenced based treatments that help with the psychological consequences resulting from emotional abuse.
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  • 文章类型: Journal Article
    Children\'s executive function (EF) may be negatively affected by their exposure to traumatic events. However, few investigations have examined the relations between EF and the associated developmental outcomes of young children exposed to trauma. Likewise, although growing evidence highlights intergenerational associations between caregiver and child EF, these associations remain unexplored among preschool-aged children exposed to trauma. The current study used a multimethod approach to test the direct and indirect associations of children\'s trauma symptomatology, caregiver and child EF, and children\'s concurrent behavioral and cognitive functioning in a sample of trauma-exposed, preschool-aged children (N = 109; Mage = 52.11 months, SD = 12.19) and their caregivers. Results indicated positive associations between children\'s trauma symptomatology and their behavior problems, positive associations between caregiver and child performance on tasks of EF, and positive associations between children\'s EF and a latent factor of cognitive functioning indicated by children\'s performance on standardized tests of IQ and receptive vocabulary. However, the hypothesized indirect effects of caregiver and child EF were not supported. Implications for clinical interventions with young children and families exposed to trauma are discussed.
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  • 文章类型: Journal Article
    The period from birth to age six represents a time of significant risk for exposure to trauma. Following trauma exposure, children may experience significant negative and lasting psychological, cognitive, and physical effects. Over the last two decades, the demand for and availability of evidence-based treatments (EBTs) for children under the age of six who have experienced trauma has dramatically increased. Three of the most well-supported and widely disseminated EBTs for early childhood trauma are Trauma-Focused Cognitive Behavioral Therapy, Parent-Child Interaction Therapy, and Child-Parent Psychotherapy. Increasingly, clinicians are receiving training in more than one EBT. This paper provides an overview of each intervention; presents clinicians with various child, caregiver, and environmental factors to consider when deciding amongst these three EBTs; and applies these considerations to three composite cases.
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  • 文章类型: Journal Article
    In animals, adverse early experience alters oxytocinergic and glucocorticoid activity and maternal behavior in adulthood. This preliminary study explored associations among childhood trauma (loss of a parent or sexual abuse in childhood), maternal self-efficacy, and leukocyte gene expression (mRNA) of oxytocin and glucocorticoid receptors (OXTR and NR3C1) in mothers of infants.
    62 mothers (20 with early life trauma) with healthy 3-month old infants reported maternal self-efficacy, depression, infant temperament, and overall social support; the effects of early trauma on these measures were assessed. Of these, 35 mothers (14 with early trauma) underwent blood draws after 2 infant feeding times; their OXTR and NR3C1 mRNA was compared to a control group of 25 no-infant women without early trauma, and also was examined for associations with self-efficacy.
    OXTR mRNA was increased in mothers of infants versus no-infant controls (p < 0.0003), and mothers with greatest prior maternal experience had higher OXTR than those with less experience (0-2 vs. 3+ older children, p < 0.033). Mothers with early trauma and less maternal experience had lower OXTR mRNA than no-trauma mothers (p < 0.029) and lower NR3C1 mRNA than controls (p < 0.004). Mothers with depression also had lower NR3C1 than other mothers (p < 0.003) but did not differ in OXTR. Mothers with early trauma also reported their support network to be less helpful and more upsetting and unpredictable than other mothers (p < 0.035-p < 0.005). Regarding maternal behavior, in mothers with early trauma, helpful support networks increased self-reported nurturing self-efficacy when babies were not fussy but decreased it with fussy babies (p < 0.05). Support was unrelated to self-efficacy in no-trauma mothers. Similarly, among mothers with low OXTR or NR3C1 (-1SD, most having early trauma and lower maternal experience), greater support was associated with lower self-efficacy (p < 0.05), while mothers with high OXTR or NR3C1 (+1SD) tended to have higher self-efficacy with greater support.
    These preliminary findings need confirmation in a larger sample but suggest that childhood trauma influences maternal behavior and both OXTR and NR3C1 pathways in mothers of infants, and that both depression and prior maternal experience may be other important factors. Effects on maternal behavior appear to require more complex modeling.
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  • 文章类型: Journal Article
    OBJECTIVE: The regulation of strong emotions is an essential skill for traumatized patients. The present instrument was developed for the measurement of the self-soothing ability in traumatized patients.
    METHODS: The psychometric properties of the SBS were investigated in a clinical sample of patients with childhood trauma (N = 143). In addition, the study explored the factorial structure, internal consistency, retest reliability, convergent validity, and responsiveness of the instrument.
    RESULTS: Results of an exploratory factor analysis indicated a two-factor structure: \'self-soothing\' and \'impulse control\', explaining 55% of the variance. The total score showed a good internal consistency (α = .83) and re-test reliability (rtt = .87) as well as good validity and responsiveness.
    CONCLUSIONS: The 7-item SBS is a suitable instrument for the measurement of self-soothing ability in traumatized patients.
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  • 文章类型: Journal Article
    由大学研究伙伴进行的问题分析可以为社区提供数据驱动的选择,以解决当地严重青年和帮派暴力的驱动因素。位于伍斯特,马萨诸塞州,本文描述了在儿童早期创伤之后如何被认定为青少年和年轻成人暴力的潜在驱动因素;使用当地数据进行的问题分析证实,12岁之前作为创伤事件的受害者或证人,与青春期或年轻成年期的暴力参与显著相关.虽然有大量的文献关于早期儿童创伤和后来的犯罪之间的关系,直到研究伙伴使用该市自己的警察记录来证明该市问题的严重程度,当地决策者才认为这一知识是可操作的。严谨的问题分析,在从业者和学术研究伙伴之间合作进行,有助于推动地方变革,并确保战略解决了正确的风险因素,并为适当的目标人群提供了服务。
    Problem analysis conducted by a university-based research partner can provide communities with data-driven options to address the local drivers of serious youth and gang violence. Situated in Worcester, Massachusetts, this article describes how subsequent to early childhood trauma being identified as a potential driver of adolescent and young adult violence; problem analysis using local data confirmed that being the victim or witness of a traumatic incident before the age of 12 years was significantly correlated with involvement in violence in adolescence or young adulthood. Although there is a robust literature on the relationship between early childhood trauma and later delinquency, local decision makers did not consider this knowledge actionable until the research partner used the city\'s own police records to demonstrate the extent of the problem in the city. Rigorous problem analysis, conducted collaboratively between practitioners and an academic research partner, helped to compel local change and ensured that strategies addressed the right risk factors and directed service to the appropriate target population.
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