HD_300 1stEdition Lecture 20 Outline of Last Lecture I. Levels of memoryII. Tools to enhance memoryIII. Types of MemoryIV. PTSDV. Trauma LearningOutline of Current LectureVI. PTSD SymptomsVII.PTSD in young childrenVIII. ObservationsIX. Parent alertX. Therapy XI. SymptomatologyCurrent LecturePTSD Symptoms- Re-experiencing the evento recurrent intrusive distressing images, thoughts, or perceptionso recurrent distressing dreams of the evento acting of feeling as if the event were recurring (reliving the event)o intense psychological distress or reactivity when exposed to cues resembling an aspect of the traumatic event Ex. cologne scent of abusero “Cell memory” Physical manifestations such as bruises may appear (bruises suddenly appear that happened in the event)- Avoidance/numbingo Avoidance of thoughts, feeling, or conversations associated with the trauma.o Avoidance of activities, places, or people that arouse recollections of the trauma,o inability to recall important aspects of the traumaThese notes represent a detailed interpretation of the professor’s lecture. GradeBuddy is best used as a supplement to your own notes, not as a substitute.o Diminished interest in significant activities (e.g. holidays)o Feeling estranged from otherso Restricted range of affect (“flat affect”)o Sense of foreshortened future (sense of doom)- Persistent symptoms of increased arousalo difficulty falling asleep and/or staying asleepo irritability or outbursts of angero difficulty concentratingo hypervigilanceo exaggerated startle responsePTSD in Young Children- Repetitive play in which themes or aspects of the trauma are expressed- recurrent and frightening dreams or night terrors- trauma-specific re-enactment- avoidance of stimuli associated with the trauma- Numbing of general responsiveness- re-enacted of the trauma: involving another child or a pet in the re-enactment- persistent symptoms of increased arousal- repeated visualizationOther observations:- A single traumatic event is less likely to lead to symptoms- delayed PTSD- may take time to become full blown, although victims are still hypervigilant- In both acute and delayed PTSD, the victim cannot remember that the trauma is part of the past, and he/she lives with it every day.Parent Alert:- A child who:o is experiencing repeated bad dreams and/or night terrorso displays major changes in personalityo has experiences more than one traumatic evento talks about things a child is not ordinarily knowledgeable about or that indicate that a child witnessed or was a participants in a traumatic eventSummary:- Memory is not exact and can be influenced and altered by:o age of the person at the time of the incidento events that surround the incident (interviews, etc.)o suggestibility issues- Child abuse can cause chemical and structural changes in the brain that altermemory encoding and recall that may influence later behavior.Therapy:- Provide a sense of safety (#1 goal)- connect memories and feelings- helps the child become more resilient- helps the child deal with guilt and shame- helps the child improve self-esteem- empowers the child- helps the child develop self-respect and assertivenesso Zipper metaphor (locus of control)- anyone can open or close ito internal zipper: the child controls it- helps the child gain a sense of futureSymptomatology:- What brings the child into therapy:o conduct disorderso drug/alcohol useo animal abuseo promiscuity or prostitutiono perpetrating on other childreno eating disorderso bedwetting (enuresis)o drop in academic achievemento depressiono suicidal ideation/attemptso anxiety (may look like ADHD)o borderline personality disorderso dissociative disorders (multiple personalities)o PTSD- Assessmento self-esteemo developmental issueso sense of guilt or shameo level of fear (what or who they are afraid of)o child’s concern for the perpetrator (esp. if it’s a family member)o child’s concern for other family memberso how intrusive are nightmares and what are the common themes?o what are the “triggers”?o what has the court process been