Psych 3290 1nd EditionExam # 3 Study Guide I. Cultural CompetencyRace: Social categories based on biological characteristicsEthnicity: Group you identify withNationality: Country of originCultural competence: Ability of systems to provide care to patients with diverse values, beliefs, & behaviors.Barriers: Lack of diversity, poorly designed systems, bad communicationBenefit: Quality improvement, eliminates racial/ethnic disparities.Acculturation: Stress immigrant/refugee kids have when navigating between new and old cultures.Issues: Conflicts w/parents over cultural values, cultural misunderstandings w/peers, haveto translate for family.4 stages of acculturation1. Euphoria-excitement over newness2. Culture Shock-New culture resentment b/c they don’t understand.3. Anomie-Gradual recovery, accept differences, feel homeless.Culture stress-some problems are solved, others continue4. Assimilation/Adaptation-accept new culture, self-confidenceII. ResilienceResiliency: Good outcomes despite threat.Goal: Learn how to promote positive adaptation and development for people at riskCore findings: all are vulnerable, depends on behavior of surrounding adults, doesn’t require anything special, at risk when adaptive systems are disrupted. 2 judgments-1. Demonstrable risk-Individuals are not considered resilient if there has not been a significant threat to their development2. Good adaptation2 ModelsPerson-focused: Comparing people to determine differences in resilient vs. non-resilient kids.Pros-keeps variables together, can look for common problems.Cons-info is lumped together, hinders explanationVariable-focused: using data to look for patterns among measures. Best for statisticsFactors supporting resiliencyConnections to competent and caring adultsCognitive and self-regulation skillsPositive views of selfMotivation to be effective in environmentWays to increase resiliencyAdults-secure base, helps kids growSchools- nurtures human capital, peer activitiesMission-State goals positively, Promote health, positivity, conflict resolution, etcMeasures: Evaluate positives and negativesMethodsRisk-focused: Eliminating risk (parent substance abuse classes)Asset-focused: Goods and services (WIC, TANF)Process-focused: Restoring human power (therapy, coping skills)III. VictimizationAbuse occurs if perp has care, custody, and control. Psychological maltreatment 1. neglect (medical, physical, mental, educational) 2. emotional abuse3. emotional neglectMedical neglect: Kids “clear” medical need not met by delay (condition which any reasonable person would recognize) or refusal of health care (as directed by competent physician). Consider-actual vs potential harm, severity, frequency/chronicityEmotional maltreatment: Injury to psychological capacity or emotional stability demonstrated by observable or substantial change in behavior, emotional response, or cognition. Types:1. Emotional abuse: Intentional and aggression 2. Emotional neglect: Unresponsive to needs or checked out & don’t know kid has needs.Problems: All abuse has emotional component.Overlooked b/c of other abuse.No physical signsAssumed minimal consequences-impacts kids brain!Legal issue: Ambiguity of mental injury-“observable and substantial”, Injurious actions, Harm to child emphasized over parents actionsParent profile: Don’t understand emotional complexity, Less empathy, Global thinking, Depressed, Poor impulse control, Previous trauma historyEffectsShort-interpersonal maladjustment, intellectual deficits, affective-behavioral problems (ODD, Anxiety)Long-delinquency, aggression, low esteem, SI, depressionPhysical abuse: Non accidental injury from adult responsible for kid.National Center on Child Abuse and Neglect set 2 standards-1. Harm standard: CPA if observable injuries last 48 hours.2. Endangerment standard: kid at substantial risk for injury.Risk: Young parents, Low control, Chronic, stressful events Triggers: Crying, Noncompliance, Effort to discipline kidProtective factorsSocial supportsFinancial stabilityStable grandparentsEfficacyPA explanations 1. Difficult Child Model2. Parent-Child Interaction Model-personality conflict3. Social learning theory-parent has own abuse history4. Situational and societal-poor, isolated5. Stress-military families6. Cultural factorsCharacteristicsParent-young, male, problems controlling anger, attributional biases, only sees wrong behaviors, stronger stress response.Victim- First year of life = more fatality, low SES, black, disabledImpact1/3 get PTSDArray of external and internal behaviors.Criminal behavior, interpersonal violence, socioemotional difficulty, cognitive problems. Sexual AbuseOral sex, sodomy, intercourse, touching, rubbing, kissing body above or under clothes, exposure to or taking nude photographs with child under age of consent (14yo).MO-penetrate “however slight”Bodily contact, intentionality, control, 2 year age discrepancy, cultural context. Risk factors:Gender-Girls higherAge-12 and upDisabilities-blindness, deafness, mental retardationSES-lowRace & Ethnicity-influence symptom expressionFamily-Single w/partner worseOutcomes: DSM disorders (PTSD, depression, personality, etc). Psychiatric disorders, dysfunctional behaviors, neurobiological dysregulation. IV. School, Community, and Domestic ViolenceDomestic violence: occurs between intimate partners with aim of exerting control over the other. Impact of in home DV 1. Kids-15X likely to be victims.a. Early childhoodSleep/eating disturbances, separation anxiety, insolable crying, regression, b. Middle childhoodNightmares, aggression, lower concentration, withdrawal, numbing, truancyc. AdolescenceAntisosical behavior, failing school, impulsive/reckless, depression, anxiety2. ParentsSadness/anxiety=less responsiveInconsistent and unpredictable = anxiety in kidsHypervigilance and overprotectiveFrustration & anger at situation = more aggression towards kidMay put kid at riskInfluencing factors:Age-Worse under 6yo. Exposure frequency-ChronicThreat proximity-witnessing worse than hearing laterThreat degree-kids threatened worse that other feeling unsafe.Familiarity of perpHelpful adultMandated reportingpros: medical documentation of injuriesremoves responsibility from victimcollects incidence & prevalence dataincreases training in areaabuse wont be condonedcons: victim cant make own decisionsstrain patient-dr relationshipretaliatory violence on victimless may admit abuse or seek careTeen DVFemales 16-24 most at