Pscyh/Neurobiological Consequences of Child Abuse (6473CLASS)
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Universiteit Leiden (UL)
Dit document bevat alle tentamenstof voor het vak Psychological and Neurobiological consequences of Child Abuse. Alle literatuur wordt uitgebreid samengevat. Daarbij een volledige uitwerking van College 1 t/m 6 (de rest volgt zodra de colleges geweest zijn).
Pscyh/Neurobiological Consequences of Child Abuse (6473CLASS)
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Psychological and Neurobiological Consequences of Child
Abuse
Background knowledge
Stress Response
When faced with a stressor, our bodies react with a very effective and what supposed to be a temporary response. The
stress response has two complementary parts (ANS and HPA-axis). One has immediate effects, the other takes more time to
kick in, but is longer lasting.
- Both parts are set in motion by the hypothalamus at the same time.
Autonomic Nervous System
1)When faced with a stressor:
- Amygdala alerts the hypothalamus
- The hypothalamus gets the message, and activates the sympathetic nervous system (SNS), the mechanism we need
for fight/flight response -- > in order to survive.
- In fight/flight response the nerve endings of the SNS release epinephrine and norepinephrine -- > these
Neurotransmitters provide immediate and quick action to meet our stressor in fight/flight response.
o Epinephrine by nerve endings in adrenal gland
o Norepinephrine by nerve endings in the rest
of the body
Sympathetic Nervous system
- The system that is activated during the stressresponse
- Your heart will accelerate, the bronchi of lungs will
dialate (-- > more oxygen), glucose is available for
energy, epinephrine and norepinephrine is released
by nerve endings to speed your responses.
Parasympathetic Nervous system
- When the stress is over, the PNS kicks in, to calm and
relax -- > bring you back to homeostasis
Hypothalamic-Pituitary-Adrenal Axis (HPA-axis)
2) When faces with a stressor
- This part of the stress response, which takes longer to kick in, but stays
longer, is also initiated by hypothalamus
- The hypothalamus sends corticotropin releasing hormone (CRH) to the
pituitary gland -- > it causes the pituitary gland to release adrenal
corticotropin hormone (ACTH).
- This travels through the bloodstream to the adrenal cortex (= adrenal
glands) and it takes about 10-15 sec. the adrenal gland releases
glucocorticoids (like cortisol).
o These work slowly, it takes minutes for them to be released, but
they last much longer than epinephrine and norepinephrine.
- The hypothalamus also releases other stress hormones, including
vasopressin, oxytocin & prolactin.
Glucocorticoids (cortisol)
The adrenal glands release glucocorticoids (like cortisol) in response to a stressor, as part of the HPA-axis.
- This are steroid hormones – and they act similar as Epinephrine/norepinephrine -- > but slower/longer
- Glucocorticoids increase the amount of calcium entering neurons
o Neurons communicate by releasing NT into a synapse, where they cross over to the post-synaptic
receptors, where they bind to the receptors and communicate the signal.
o The amount of NT released by the pre-synaptic neuron is dependent on the amount of calcium that is able
to enter the pre-synaptic neuron to free the NT.
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, o Glucocorticoids increase the amount of neurotransmitters that are released -- > this helps to produce extra
vigilance and arousal during stress.
- They also help to store energy to mobilize it for use during stressful situations.
Control and Regulation of the HPA-axis
When you first perceive the threat, it is the amygdala that signaling that starts the HPA stress-response.
- The amygdala starts signaling the hypothalamus -- > the stress response starts when the amygdala starts releasing
CRH.
But the amygdala is not the only part of the brain that controls this stress response.
- The brain, especially the limbic system, is composed of many feedback loops, which regulate emotional responses
and emotional memories.
- Hippocampus can also regulate the HPA-axis -- > it has receptors for glucocorticoids -- > part of the feedback loop:
it can signal back to the hypothalamus to slow down, or even stop the release of CRH.
- ANS -- > can also influence the functioning of HPA-axis: anxiety feedback loop: the amygdala gets the SNS going,
the arouse in the SNS can signal the amygdala -- > the anxiety feeds on itself. The PNS can also exercise power and
control -- > it can work to deactivate the amygdala and reduce anxiety.
o The more anxious, the more cortisol will be released.
When the threat is over, the PNS would calm you down, and return you to your normal homeostatic state. The stress
response is possible and adaptive. Easier to survive.
Part 2. Genes & Genotype
Your body is made up of many cells.
Each cell is a copy of a single cell that divided itself to make all of the cells in your body (-- > it starts with one cell)
Your DNA, genes and chromosomes work together to tell your body how to form and function.
A gene is the basic physical and functional unit of heredity in human cells (the building blocks)-- > every person has two
copies of each gene (alleles), one from both parents. Once you receive a pair, your genes divide and copy themselves until
your body has enough genes.
o Some genes act as instructions to make molecules, called proteins -- > proteins decide what kind of
physical characteristics you have (→ genotype)
o However, many genes do not code for proteins, they code for RNA (no functions)
- Genes are made up of DNA = hereditary material in humans.
- Alleles are forms of the same gene with small differences in their sequences of DNA bases (A,C,G,T) -- > these
differences contribute to each person’s unique physical features.
DNA
- DNA is the material that exists in every cell in your body that holds your genetic code.
o 99% of the DNA bases are identical in every person, just 1% in DNA makes you unique.
o Most of the DNA is located in the cell nucleus (nuclear DNA), but a small amount is found in the
mitochondria (mitochondrial DNA).
- Information on DNA is stored as a code made up of four chemical bases. The sequence of these bases determines
the information available for building and maintaining an organism. Like letters form words.
1. Adenine (A)
2. Guanine (G)
3. Cystocine (C)
4. Thymine (T)
- A & T and C & G pair up to form base pairs. Each base is also attached to sugar molecule and phosphate molecule --
> together this makes up a nucleotide.
o This is like writing the manual: base pairs creates the words in the instruction manual of your own body.
- Nucleotide: two long strands that form a spiral. It is like a ladder, with the base pairs forming the ladders rungs.
- Each strand of DNA can replicate itself – this is critical because when cells divide each new cell needs to have an
exact copy of the DNA present in the old cell.
Chromosome
- In the nucleus of each cell, the DNA is packaged into chromosomes. chromosome is made up of DNA.
- Humans should have 23 pairs of chromosomes (46 total). Chromosomes divide into 22 autosome pairs, and one
pair of sex hormones (X and Y).
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,Genetic mutation
Genetic mutation occurs during cell division when your cells divide and replicate. When your cells divide, your DNA gets
copied. During this process, there is a lot of room for error because your cells might skip a part. If you have an error in the
copy (= genetic mutation), your DNA gives your body the wrong directions. This might not change the function of your body,
but it might that a person isn’t able to function completely.
- Changes to a gene’s DNA sequence to produce something different
- Genetic mutations create permanent change to
the DNA-sequence Cel -> genen (allelen) -> DNA -> chromosomen
Lichaam is opgebouwd uit cellen.
Genotype: de erfelijke informatie van iemand noemen we
Cellen bevatten genen (opgebouwd uit DNA) die het erfelijk materiaal van
het genotype. Je genotype verandert niet. een persoon bevatten.
Fenotype: het fenotype is hoe je er van de buitenkant
uitziet, wat merkbaar is van je genotype. Je fenotype kan In een cel, heeft iedereen twee varianten van een gen (allelen) één van de
veranderen door omgeving (-- > haar blond verven). vader/moeder.
Some genes code for MRNA (proteins -- > decide the functions) others for
Voor elke eigenschap heb je een gen, bv. voor haarkleur.
RNA (no functions)
Een allel is een versie van het gen: bruin haar. Per gen heb
je twee allelen, omdat chromosomen in paren voorkomen. DNA is het genetische materiaal in een cel, in de celkern. DNA bestaat uit
Eén allel op het ene chromosoom (moeder) en een op het een code van basepairs (C&G - A&T). De volgorde waarin de paren
andere chromosoom (vader). voorkomen bepalen de erfelijke informatie in je lichaam.
Een allel kan dominant of recessief zijn. Als een allel dominant is, betekent dat dat slechts 1 van de 2 allelen dominant hoeft
te zijn om de dominante eigenschap in het fenotype te zien. Als een allel recessief is, betekent dat dat beide versies van het
allel recessief moeten zijn om zichtbaar te zijn in het fenotype.
Polymorphism
The presence of two or more variant forms of a specific DNA sequence that can occur among different individuals or
populations. Little differences between people in the sequence of nucleotides of a gen (-- > cause people to be different)
which are the consequence of SNPS.
SNP = single nucleotide polymorphism
SNPS are the most common type of genetic variation among people. Each SNP represents a difference single DNA building
block, called nucleotide (composed of base pairs). SNPS occur normally throughout a persons DNA.
- SNPS can act as biological markers helping scientists locate genes that are associated with disease.
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, Literature College 1.
A1: Child Maltreatment and Risk for Psychopathology in Childhood and Adulthood
• Meemaken van mishandeling/verwaarlozing vergroot de kans om betrokken te raken in MH of VW, maar dit is geen
garantie. De meerderheid wordt geen dader.
• Slachtoffers lopen grotere kans op mentale gezondheidsproblemen: depressie, angst, middelenmisbruik,
antisociaal gedrag, psychotische symptomen en persoonlijkheidsstoornis.
• Mishandeling vergroot de kans op psychopathologie via vergroten van dreiging-sensitiviteit, daling van
beloningsgevoeligheid en gebreken in de emotie-herkenning en begrip.
• Geen garantie: sociale support kan een buffer vormen, en sommige individuen hebben genen die hen minder
gevoelig maken voor mishandeling.
In dit artikel worden drie mogelijke mechanismen besproken die de relatie tussen mishandeling of verwaarlozing in de
jeugd en het risico op psychopathologie verklaren:
1. Hyperwaakzaamheid voor dreiging
2. Gebreken in emotieherkenning en begrip van emoties
3. Lage beloningsgevoeligheid
Prevalentie van MH/VW
- US, laatst gemeten in 2014: De prevalentie van mishandeling neemt af in US (9.4 per 1000 kids in 2014), kinderen
onder 3 jaar lopen het grootste risico om slachtoffer te worden.
- Vooral VW (75%), fysieke MH = 17%, 8% Seksueel misbruik en 6% EMH
- Risicofactoren: armoede, jonge moeder, antisociaal gedrag ouder, IGO.
- Vooral gemeten met retrospectieve self-report -- > gevoelig voor bias
Mishandeling en het risico op psychopathologie
Risico op externaliserende en internaliserende psychopathologie
- Externaliserend: ADHD, CD, ODD, delinquentie, antisociaal gedrag (middelen)-- > grotere kans.
o Deze problemen lopen door in de volwassenheid: criminaliteit
- Internaliserend: depressie, angststoornis, PTSS en internaliserende symptomen -- > meer risico. De gevolgen
hiervan lopen door in de volwassenheid.
o MH – groter risico PTSS via: a) mentale problemen -- > groter risico PTSS als adult. B) MH vergroot de
neurobiologische response op trauma -- > grotere kans op PTSS.
Ook groter risico op persoonlijkheidsstoornissen, psychotische symptomen en suïcide
- Psychotisch: psychotische stoornis, schizofrenie en psychotische symptomen.
Causaliteit van de relatie tussen MH – psychopathologie is lastig te achterhalen. Je kunt alleen corrigeren voor genetische
factoren als je adoptie- of tweelingstudies gebruikt. Het komt echter niet vaak voor dat één van de tweeling mishandeld
wordt, en adoptieouders mishandelen bijna nooit.
Mediatoren van Mishandeling effecten = mechanismen
1.Hypergevoeligheid/waakzaamheid voor dreiging
• Attention bias: neiging om disproportioneel veel aandacht te geven aan kleine dreiging.
o Methode: boos en neutraal gezicht -- > stip vervangt één van de twee.
- Meer gevoeligheid voor dreiging vergroot de aanwezigheid van angstklachten;
- Kinderen die, door een afwijkende opvoeding, extra gevoelig worden voor woede, dreiging en negatieve emoties,
lopen een groter risico op angstproblemen.
o Onduidelijk of het komt door de aandacht bias, maar sowieso grotere kans op angst.
- Biased attention naar bedreiging houdt verband met meer limbische en prefrontale corticale hersenactiviteit -- >
bv. amygdala activatie bij angst en woede cues.
- Niet alle studies vinden een attention bias richting bedreigende stimuli.
- Sociaal informatieverwerkingsmodel -- > hostile atrributions en agressieve reacties.
o Moeite om te reageren op sociale situaties -- > kans op externaliserende problematiek
• Attention bias, moeite met aandacht weghalen bij dreiging, minder informatie integratie bij het interpreteren en
daardoor agressiever reageren.
2.Gebreken in emotieherkenning
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