Samenvatting ‘psychologologacag and neurobolooaologologacag colonsequroences olof chagd aourosei
Cologgege 1
Why shouldn’t we learn about the consequences of child abuse?
- Irrelevant for current well-being in adulthood
- New experiences can overwrite the old, negatve ones
- Focus on negatve feelings in the past will inhibit positve feelings in the present
- Personality/emotonal well-being is programmed in the brain and can’t be easily changed
Why we should learn about the consequences of child abuse:
- Freud early experiences form the base of problems later on in life
- Bowlby, Ainsworth and Harlow attachment and the consequences of unsafe attachment
DSM V classificaton system for psychological disorders, based on objectve descriptons. Less
focus on aetology (theoretcal framework/causes).
Gilbert et al., 2009 burden and consequences of child maltreatment in high-income countries.
Research queston : what are causes of mental health problems in adults? (recent stress, childhood
abuse/neglect, genetc vulnerability). Research queston 2: how can events that happened 25 years
ago have such a pervasive impact on a person’s emotonal, cognitve, and social well-being?
Definiton childhood maltreatment:
“Any act of commission or omission by a parent or other caregiver that results in harm, potental
harm, or threat of harm to a child. Harm does not need to be intended.”
Omission = failure to meet the child’s needs:
- physical neglect failure to meet basic physical needs, nutriton, medical/dental, hygiene,
shelter.
- emotonal neglect failure to meet emotonal needs and protect the child from violence.
- denial of access to educaton
Commission = actvely doing something harmful:
- physical abuse intentonal use of physical force to cause physical injury.
- emotonal abuse intentonal behavior to convince the child he is worthless, fawed,
unloved, unwanted, or valued only for meetng others needs.
- sexual abuse any attempted sexual act or contact to a child by a caregiver.
- shaken baby syndrome
- intmate-partner violence
Tronick stll face experiment babies get very upset when their mothers stop talking to them,
laughing at them, or following what they point at.
Dutch prevalence NPM-20 0 study 34 out of 000 children are abused.
SOM study (self report in 800 children 2- 6 years) 37% report abuse. Emotonal and physical
abuse most frequent.
NESDA study, 20 0 Netherlands Study of Depression and Anxiety. N = 298 . 8-year long controlled
longitudinal study. In the healthy control group (N = 498) 9% had sufered from emotonal neglect,
, % emotonal abuse, 6% physical abuse and 3% sexual abuse. In the group that had any disorder
(N = 2288) 45% had sufered from emotonal neglect, 29% emotonal abuse, 6% physical abuse and
2 % sexual abuse. The Odds Rato’s were 3,54 for emotonal neglect, 3,25 for emotonal abuse, 2,79
for physical abuse and ,79 for sexual abuse. They were all significant.
Emotonal neglect showed the highest connecton with disorders. The majority (>90%)of children
who were emotonally neglected or abused identfied their parents as perpetrator. Afer controlling
for demographics, comorbidity and clustering adversity emotonal neglect only related to chronic
depression, temporary depression, Social Anxiety Disorder and any disorder. Sexual abuse only
related to chronic depression and any disorder. Controlling for current psychopathology does not
efect the relatonship between the abuse and afect disorder.
Research methods:
- observatonal: epidemiological research, longitudinal research, cross-sectonal research.
Based on self-report, reports by parents and professionals (self reports 0x higher than
informants)
- Experimental: animal research and analogue ‘acute stress’ studies.
Research methods (Scott et al., 20 2):
- Prospectve objectve identficaton of abuse, no recall bias, no selectve inclusion based
on outcome. However, not intervening is unethical and there is selectve inclusion.
- Retrospectve practcal in the case of long-term consequences in adults. However, the
memory is prone to error, recall bias, because consequences and abuse are assessed at the
same moment the causality can be unclear.
A combinaton of methods is the best method.
Scott et al., 20 2 Childhood maltreatment and DSM-IV adult mental disorders: comparison of
prospectve and retrospectve findings. In 2-month disorders, it seems that prospectve studies
show higher results in odds rato’s. in lifetme disorders, it seems that retrospectve studies show
higher odds rato’s.
Some of the consequences of child abuse depression, low self esteem, fear, addicton to alcohol
or drugs, sleeping problems, concentraton difcultes, dissociaton, problems with intmate
relatonships, suicidality.
Comorbidity = having two or more disorders at the same tme. 60% overlap between depression and
anxiety. Comorbidity also means co-occurrence of multple forms of abuse and neglect. About 50% of
abused children are exposed to more than one form of abuse or neglect.
There are 2.000 depressive adolescents between 2- 8 years. LSDV 50% of students report
psychological complaints, mainly depression. /3 of depressive adolescents reports parental
emotonal maltreatment. The symptoms of depression are more severe in adolescents reportng
emotonal maltreatment.
Importance of good enough parentng and attachment establish sense of safety and security,
learn to regulate own emotons, understand emotonal states of others, learn to trust others, learn
empathy.
Schierholz et al., 20 6 what mediates the link between childhood maltreatment and depression?
The role of emoton dysregulaton, attachment, and attributonal style. (ARTIKEL LEZEN)
, Resilience why do some people develop psychopathology and others don’t?
Childhood and abuse and neglect are important transdiagnostc risk factors to developing
psychological problems, including depression, anxiety, aggression and addicton. Also related to
underlying psychological processes, like negatve self-esteem, suicidality, emoton regulaton
difcultes and executve problems. Consequences of emotonal abuse and neglect are at least as
pervasive as physical and sexual abuse.
Depressed patents with a history of abuse have more severe problems, more chronic, more
suicidality and more comorbidity.
Cologgege 2
How can abuse have such a pervasive efect on a person’s emotonal, cognitve and social well-being?
Maltreatment can chronically increase stress-sensitvity.
On cognitve/emotonal level parents hand the child negatve attudes and working
models, which become incorporated in their self-image. This leads to a social sensitvity that
may be evoked in new stressful situatons (Beck, 2008).
On neurobiological level by altering brain functons in networks that are important for
emotonal reactvity, emotonal memory, and emoton regulaton. And by chronically altering
the sensitvity of hormonal stress reactons, such as the HPA axis and adrenergic system.
Beck, 967, 2008 heredity + early life adversites = cognitve vulnerability. This leads to negatve
self-inferences, dysfunctonal attudes, and low self-worth. A current life stressor can enforce these
three aspects, leading to symptoms of depression and anxiety. These symptoms have an efect on
the cognitve vulnerability and current life stressors.
Negatve cognitons and associatons can be made explicit by the abuser: “you are worthless” or
“you’re stupid”. Negatve self-associatons can also be implicit. Van Harmelen et al. emotonal
maltreatment was the strongest predictor of negatve implicit self-associatons. Tested with the IAT
for implicit associatons: people with a history of abuse could faster organize negatve words, so
these schema’s were for them easier to access.
The brain is full development during childhood. In early childhood, the limbic system is developing
(threat and safety learning). This involves the amygdala (face recogniton, emotonal memories) and
hippocampus. In puberty, it’s more about emoton regulatono prefrontal brain.
Stressful events especially have an impact on the amygdala (threats, fear, memory for emotons or
fear). Hippocampus is for memory in general.
Van Harmelen 300 adult people looked at faces. Children who sufered emotonal maltreatment
had an enhanced amygdala sensitvity while processing faces. Not only did they respond more to
angry faces, they also responded more to fear, sad, happy and even neutral faces. Explanaton: even
happy faces can be ambivalent if you have issues trustng people. Or maybe they are more sensitve
to friendly faces because it is a rare thing for them. (people who show no symptoms of abuse, but
were abused, also have a higher actvaton of the amygdala).
Pollak children in environments of abuse looked at blurred pictures. Abused children were much
better at identfying angry faces, but not happy faces. This serves a purpose: they can antcipate on
