National Advocacy Leadership Center 2018 2019 Trauma and Resilience Instructor: Shannon K. Nix, M.S., LPC Wednesday, January 23
Introduction & Agenda Who I am and what I do Objectives: Review prevalence and impact of trauma Examine the neurobiology of trauma, including impact on learning, behavior, and relationships Explore impact of trauma on nontraditional and historically marginalized students Identify how to best support healing and resiliency
Before We Start How to manage triggers/upsetting content Assumptions: You are here because you want to learn we only know what we know. Mistakes will happen and aren t intended to be malicious we don t know what we don t know. So, please ask questions! If I can t answer all of them in the time allotted, my contact information will be provided and I am happy to communicate via email or phone.
Poll On a scale of 1-100 (1=zero stress, 100=ALL the stress), how stressful would it be for you if You lost your job You made a baby The stock market crashed There was a hurricane in the Atlantic There was an earthquake in CA A parent moves in with you
What is trauma? RESPONSE
What is trauma? An event, series of events, or set of circumstances that is experienced by an individual as physically or emotionally harmful or life threatening and that has lasting adverse effects on the individual's functioning and mental, physical, social, emotional, or spiritual well-being. (SAMHSA, 2018)
Prevalence 60% of men & 50% of women experience at least one trauma in their lives ~7-8% of folks in the U.S. will have PTSD at some point 10% of women compared with 4% of men develop PTSD sometime in their lives
Prevalence of ACEs by Category for CDC-Kaiser ACE Study Participants by Sex, Waves 1 and 2 ACE Category Women Men Total Percent (N = 9,367) Percent (N = 7,970) Percent (N = 17,337) ABUSE Emotional Abuse 13.1% 7.6% 10.6% Physical Abuse 27% 29.9% 28.3% Sexual Abuse 24.7% 16% 20.7% HOUSEHOLD CHALLENGES Mother Treated Violently Household Substance Abuse Household Mental Illness 13.7% 11.5% 12.7% 29.5% 23.8% 26.9% 23.3% 14.8% 19.4% Parental Separation or Divorce 24.5% 21.8% 23.3% Incarcerated Household Member 5.2% 4.1% 4.7% NEGLECT Emotional Neglect 3 16.7% 12.4% 14.8% Physical Neglect 3 9.2% 10.7% 9.9%
ACE Score Prevalence for CDC-Kaiser ACE Study Participants by Sex, Waves 1 and 2 Number of Adverse Childhood Experiences (ACE Score) Women Percent(N = 9,367) Men Percent (N = 7,970) 0 34.5% 38.0% 36.1% 1 24.5% 27.9% 26.0% 2 15.5% 16.4% 15.9% 3 10.3% 8.5% 9.5% 4 or more 15.2% 9.2% 12.5% Total Percent (N = 17,337)
Event vs. Response 20% have significant symptoms following traumatic events Seemingly traumatic events don t always result in traumalike symptoms
Trauma & the Brain 3-part brain Hippocampus Amygdala Hormones: Adrenaline Cortisol Opiates Oxytocin Oh no! Science words!!!
3-Part Brain
Hippocampus Memory & time Key Players Brain connections Amygdala Fear Prefrontal Cortex Decision making Hormones
Hippocampus & Trauma Short-term memory impairment Sense of time distorted Memories are not stored in the standard way Lacking beginning, middle, end Broad disconnection of brain areas
Amygdala & Trauma Dominates awareness Holds memory when hippocampus is off-line Visceral and timeless More stimuli interpreted as scary
Prefrontal Cortex & Trauma Logic is not accessible Language can be lacking Long term planning impaired Attention bias for trauma related information Difficulty moderating fear from amygdala
Hormones: Adrenaline Preps body for fight or flight Increases heart rate, blood pressure, respiration Pupils enlarge & hair stands on end Reroutes blood from major organs to limbs, reduces blood flow to arteries Inhibits rational & complex thought
Hormones: Cortisol Turns the dial up in response to circumstances Gives body energy for fight or flight Decreases insulin production Belly fat/sick fat Increases blood pressure Immune system bottoms out Can lead to exhaustion Pre-existing illness(es) can be exacerbated
Hormones: Cortisol Cortisol production may shut down, leading to freeze response or types of immobility Tonic immobility, aka rape paralysis syndrome Collapsed immobility
Hormones: Opiates Pain killers, or natural morphine Released if physical pain accompanies traumatic event Blunts pain Can also blunt emotional response
Hormones: Oxytocin Also known as the bonding or love hormone Increases positive emotions Released in response to physical pain that accompanies event Leads to contradictory reactions: laughing, positive mood, etc. Can be a trigger for some
After the Stress Homeostasis The tendency of the body to seek and maintain a condition of balance or equilibrium within its internal environment, even when faced with external changes.
After the Trauma
The Response: A Review Hippocampus can shrink and struggle Amygdala becomes overreactive Cortisol levels stay high (other hormones too, depending on what was activated during trauma response) Thinking brain not functioning optimally Integration between parts of brain and between brain and body impaired Over time, more efficient at being stressed
Goal of Brain: SURVIVAL Efficiency over Accuracy To survive in a complex, unpredictable environment, brain needs shortcuts to react quickly in dangerous situations Learn fear response Generalize dangerous stimuli
Goal of Brain: SURVIVAL Negative Bias Focus on threats keeps us alive More likely to react to threats than neutral stimuli More likely to recall bad memories that have a stronger emotional stamp
Post-Trauma Experiences Arousal Thinking is difficult Impaired decision making Triggers Impaired sense of self Strained relationships Increased physical symptoms Overgeneralizations
Trauma in Marginalized Populations: Racial or Race-Based Trauma African Americans have a 9.1% PTSD prevalence rate vs 6.8% in European Americans In part due to the experience of cumulative racism, which leads to PTSD symptoms Microaggressions: pervasive and subtle acts of racial discrimination against minority groups, including vague insults, non-verbal exchanges, or brief remarks that denigrate people of color
Trauma in Marginalized Populations LGBQ & Transgender populations High rates of discrimination & violence Disproportionate rates of IPV victimization, particularly in the bisexual and transgender populations Nontraditional students May include veterans, students with families Faculty/staff Some university advocacy programs service faculty & staff as well
Resilience Factors PTSD risk factors: Before: ACEs, pre-existing mental disorder, family member with mental disorder During: severe, life-threatening/violent, interpersonal trauma, witnessing violence (ACEs) After: lack of healthy coping skills, blame/dismissive responses by others PTSD protective factors: supportive responses from others
How to Support & Help Heal Teach grounding techniques Empower Don t take it personally Refer to counseling Teach them to become their own advocate Service secondary survivors
Contact Information Shannon Nix Associate Director, Sexual Assault and Violence Intervention & Prevention (SAVIP) at the University of South Carolina nixs2@mailbox.sc.edu (803)777-8248
References Centers for Disease Control. (2016). The CDC-Kaiser Permanente Adverse Childhood Experiences (ACE) Study [Data file]. Retrieved from https://www.cdc.gov/violenceprevention/acestudy/about.html Harris, R. (2016, July 20). The Three Main Parts of Your Brain [Video file]. Retrieved from https://www.youtube.com/watch?v=5cpry9-miha Hopper, J. (2016, September 15). Dog in and out of tonic immobility [Video file]. Retrieved from https://www.youtube.com/watch?time_continue=3&v=rgulhxif0ey How Common is PTSD in Adults? (2018). In National Center for PTSD online. Retrieved from https://www.ptsd.va.gov/understand/common/common_adults.asp Kozlowska, K., Walker, P., McLean, L., & Carrive, P. (2015). Fear and the Defense Cascade: Clinical Implications and Management. Harvard Review of Psychiatry, 23, 263-287. doi:10.1097/hrp.0000000000000065 Post-Traumatic Stress Disorder: Risk & Protective Factors. (2017). In Substance Abuse and Mental Health Services Administration online. Retrieved from https://www.samhsa.gov/treatment/mentaldisorders/post-traumatic-stress-disorder#risk-factors Sawyer, B., Williams, M.T., DeLapp, R. C. T., & Davis, D. M. (2016). Posttraumatic Stress Disorder. In A. Breland-Noble, C. S. Al-Mateen, & N. N. Singh (Eds.), Handbook of Mental Health in African American Youth. Springer. ISBN: 978-3-319-25501-9. Trauma and Violence. (2018). In Substance Abuse and Mental Health Services Administration online. Retrieved from https://www.samhsa.gov/trauma-violence Williams, M. T., Printz, D. M. B., & DeLapp, R. C. T. (2018, October 1). Assessing Racial Trauma With the Trauma Symptoms of Discrimination Scale. Psychology of Violence. Advance online publication. http://dx.doi.org/10.1037/vio0000212
Presentations Tips NOVA Campus Advocacy Training (NCAT) is a, 24-hour advanced training for campus victim advocates and community-based advocates working in higher education NCAT classes are limited to 40 students to promote student interaction and skill-building Slides should maintain a formula of 3 minutes per slide (i.e., for a 2-hour training block, you should have approximately 40 slides)
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