Our Agenda Review the brain structures involved in trauma response Review neurochemicals involved in brain response Discuss impact of trauma on the child s brain
Structural Response to Stress Amygdala Hyper-responsive Continued neuron growth Medial Prefrontal Cortex Hypo-responsive Loss of neural connections Hippocampus Reduced volume Loss of neural connections Overall Brain Changes -
What s really happening?
What s really happening? Traumatic event
What s really happening? Traumatic event Prolonged exposure
What s really happening? Traumatic event Prolonged exposure Altered neural circuits
Areas of the brain talk Thalamus
Areas of the brain talk Amygdala Thalamus
Areas of the brain talk Medial Prefrontal Cortex Amygdala Thalamus Hippocampus
Areas of the brain talk Medial Prefrontal Cortex Amygdala Thalamus Hippocampus
Different brain response to aggressor
Brain Chemicals and Stress Cortisol A steroid hormone, also known as the stress hormone, produced in response to low blood glucose and stress. It serves to maintain homeostasis and can cause release of norepinephrine in response to stress. Norepinephrine (NE) A neurotransmitter released in response to stress. NE affects areas of the brain for attention and response to actions. The fight or flight hormone.
Traumatic stimuli/responses can Physiology change Increased heart rate and respirations, dilated pupils, dry mouth Affective responses Helplessness, fear, horror Cognitive processing Memory can become fragmented, time distorted
Impact of the traumatic event Medial Prefrontal Cortex Amygdala Thalamus Hippocampus
Impact of the traumatic event Medial Prefrontal Cortex Amygdala Thalamus Hippocampus
Impact of the traumatic event Medial Prefrontal Cortex Amygdala Thalamus Hippocampus
Impact of the traumatic event Medial Prefrontal Cortex Amygdala Thalamus Hippocampus
Impact of Cortisol Released by kidney in response to stress Cortisol (glucocorticoid) is released into the limbic system Cortisol triggers the release of stress hormones (norepinephrine) Norepinephrine causes increased alertness and vigilance
Cortisol / norepinephrine in action Alert Energy shunted to large muscles for escape/run Pupils dilated to let in maximum light Secretions dried Vigilant
Trauma and the Child s Brain We have the most neurons at birth Pruning occurs throughout early childhood Stress impacts brain structure and chemical function Changes to the brain early in development have long-lasting effects HOWEVER, some of these changes are reversible
Structural Changes and Childhood Trauma: Problems Hippocampus Learning and memory (school) Corpus Callosum Complex information processing Cerebellum Behavior, motor and executive function Medial Prefrontal Cortex Emotional regulation, cognition and behavior Amygdala Most stimuli are perceived as threats
Severe Neglect Causes Decreased electrical activity Decreased metabolism Poor connections between key information processing areas Abnormal norepinephrine patterns persist
Structural Change due to Abuse Functional Change due to Abuse
Behaviors Result from Brain 'Injury' Persistent fear response Hyperarousal Increased internalization Decreased executive function Delayed milestones
What to Expect Frequent outbursts, can't seem to control emotions Quiet and submissive Difficulty learning Difficulty with peer relationships Unresponsive to affection
EARLY INTERVENTION, WHEN THE BRAIN IS MOST PLASTIC, IS MORE EFFECTIVE THAN REACTIVE TREATMENT AS THE CHILD AGES. PERRY, 2009
Summary Traumatic stimuli are received by the brain in a multisensory fashion. Traumatic stimuli trigger response from the brain and body. The developing brain is hypersensitive to the effect of trauma and stress Through rapid and early intervention the impact of trauma and stress can be reversed
1. All of the following are true about smell-based (olfactory) memory except 1. The stimuli effects the amygdala 2. The stimuli effects the thalamus 3. In response to stress, the thalamus triggers release of hormones through the kidney 4. Olfactory memories and visual memories are created through the same pathway 5. Olfactory memories and auditory memories are created through different pathways
2. All of the following parts of the brain are involved in trauma response 1. Brainstem 2. Medulla oblongata 3. Thalamus 4. Amygdala 5. Medial prefrontal cortex
3. A child has suffered physical neglect for two years. Which of the following are true 1. Neglect effects the amygdala less than physical abuse 2. Neglect effects the thalamus the same as sexual abuse 3. Physical abuse leads to changed brain structure; Neglect does not. 4. Physical abuse leads to changed brain structure; Neglect does. 5. Neglect does not impact cortisol release.