Adverse Childhood Experiences
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- Candice Jennings
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1 Adverse Childhood Experiences Jon Ebert, PsyD Associate Professor Vanderbilt Department of Psychiatry (615) Attachment relationships are formative because they facilitate the development of the brain s self-regulatory mechanism, which in turn allow the individual to perform effectively in society In fact, the whole of child development is the enhancement of self-regulation (Fonagy & Target, 2002) HEALTHY ATTACHMENTS INTERNAL WORKING MODEL Anticipates future responsiveness with relationships TRUST Relationships are predictable Lower arousal Child bolsters Affect Regulation CAREGIVER RESPONSIVE TO NEED CHILD NEED EXPRESS NEED Crying Reaching Talking/Calling Running 1
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5 Installing Emotional System Please be patient as the system configures. This might take several years. 5
6 UNSAFE ATTACHMENTS INTERNAL WORKING MODEL Anticipate future harm, Hypervigilent, suspicion or closed off to relationships FIGHT, FLIGHT, FREEZE Relationships are unpredictable, dangerous, and/or chaotic Child feels Out of control (Affect Dysregulation) CAREGIVER NEGLECT ABUSE DISTRESS CHILD NEED EXPRESS NEED Crying Reaching Talking/Calling Running Installing Emotional System Setup was unable to find a safe & available caregiver, system may not work properly THE STRESS RESPONSE Mobilization of Energy Increased Cardiovascular Tone (heart rate) Suppression of digestion Suppression of growth Suppression of reproduction Suppression of immune system Sharpening of cognition, alertness, and pleasure. Robert M. Sapolsky. Why Zebras Don't Get Ulcers: An Updated Guide To Stress, Stress Related Diseases, and Coping. 2nd Rev Ed, April 15,
7 THE STRESS RESPONSE Mobilization of Energy Increased Cardiovascular Tone (heart rate) Suppression of digestion Suppression of growth Suppression of reproduction Suppression of immune system Sharpening of cognition, alertness, and pleasure. Fat cells & liver to empty the bank This places sugar in the bloodstream Robert M. Sapolsky. Why Zebras Don't Get Ulcers: An Updated Guide To Stress, Stress Related Diseases, and Coping. 2nd Rev Ed, April 15, 1998 THE STRESS RESPONSE Mobilization of Energy Increased Cardiovascular Tone (heart rate) Suppression of digestion Suppression of growth Suppression of reproduction Suppression of immune system Sharpening of cognition, alertness, and pleasure. Accelerate movement of sugars through blood Increase intake of oxygen for bloodstream Robert M. Sapolsky. Why Zebras Don't Get Ulcers: An Updated Guide To Stress, Stress Related Diseases, and Coping. 2nd Rev Ed, April 15, 1998 THE STRESS RESPONSE Mobilization of Energy Increased Cardiovascular Tone (heart rate) Suppression of digestion Suppression of growth Suppression of reproduction Suppression of immune system Sharpening of cognition, alertness, and pleasure. Digestion is slow and expensive shut down Mouth dry shut down secretion of saliva Robert M. Sapolsky. Why Zebras Don't Get Ulcers: An Updated Guide To Stress, Stress Related Diseases, and Coping. 2nd Rev Ed, April 15,
8 THE STRESS RESPONSE Mobilization of Energy Increased Cardiovascular Tone (heart rate) Suppression of digestion Suppression of growth Suppression of reproduction Suppression of immune system Sharpening of cognition, alertness, and pleasure. Robert M. Sapolsky. Why Zebras Don't Get Ulcers: An Updated Guide To Stress, Stress Related Diseases, and Coping. 2nd Rev Ed, April 15, 1998 THE STRESS RESPONSE Mobilization of Energy Increased Cardiovascular Tone (heart rate) Suppression of digestion Suppression of growth Suppression of reproduction Suppression of immune system Sharpening of cognition, alertness, and pleasure. Fighting infection is not priority all resources to mobilized to deal with stressor. Robert M. Sapolsky. Why Zebras Don't Get Ulcers: An Updated Guide To Stress, Stress Related Diseases, and Coping. 2nd Rev Ed, April 15, 1998 THE STRESS RESPONSE Mobilization of Energy Increased Cardiovascular Tone (heart rate) Suppression of digestion Suppression of growth Suppression of reproduction Suppression of immune system Sharpening of cognition, alertness, and pleasure. Robert M. Sapolsky. Why Zebras Don't Get Ulcers: An Updated Guide To Stress, Stress Related Diseases, and Coping. 2nd Rev Ed, April 15,
9 CHRONIC STRESS The stress response continues to be active uses all resources to stay in stay alert (at the expense of using resources for other systems). The neurohormones released are good for short stress periods but can become harmful when in the system for long periods of time. Each recurring stress event causes subsequent sensitivity to the sympathetic response so that the individual becomes more vulnerable to depression and anxiety (Post, Rubinow, & Ballenger 1986) When stress is prolonged or chronic, changes occur in the baseline production, availability, and homeostasis regulation of these neurochemicals. (Cozzilino 2002) The more a neural system is activated the more the system changes to reflect the pattern or activation. (Perry 2001) 9
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11 BRAIN PROCESS IN TYPICAL CONDITIONS (Arvidson, 2011) ACT OBSERVE INPUT INTERPRET PLAN EVALUATE OPTIONS PROCESS ALARM SYSTEM Short Cut Road (Arvidson, 2011) ACT OBSERVE INPUT INTERPRET PLAN EVALUATE OPTIONS PROCESS 11
12 ALARM SYSTEM Short Cut Road CHRONICALLY USED BECOMES THE MAIN ROAD (Arvidson, 2011) ACT OBSERVE INPUT INTERPRET PLAN EVALUATE OPTIONS PROCESS STRESS IMPACTS CHOICE 12
13 Given a 2-Digit Number to Remember 7 3 Given a 7-Digit Number to Remember
14 2x Given a 7-Digit Number to Remember The Adverse Childhood Experiences (ACE) Study The largest study ever done to examine the health and social effects of adverse childhood experiences 18,000 participants 14
15 Source: Centers for Disease Control and Prevention Credit: Robert Wood Johnson Foundation 12% 4 OR MORE 9% THREE 36% ZERO 16% TWO 26% ONE 15
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17 Teicher, M. (2007) Neurobiological Consequences of Different Forms of Child hood Maltreatment. International Trauma Conference, Boston, MA. 17
18 ACE Study Death Early Death Disease, Disability, & School Problems Adoption of Health Risk Behaviors Social, Emotional, & Cognitive Impairment Disrupted Neurodevelopment Conception Adverse Childhood Experiences Mechanisms by which Adverse Childhood Experiences Influence health and well-being through the lifespan Jon Ebert, Psy.D. VANDERBILT UNIVERSITY MEDICAL SCHOOL Felitti (1998) Relationship of Childhood Abuse and Household Dysfunction to Many of the Leading Causes of Death in Adults, American Journal of Preventative Medicine 18
19 Fisher et al,
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