Our Agenda - nic.unlv.edu

Our Agenda

• Review the brain structures involved in trauma response

• Review neurochemicals involved in brain response

• Discuss impact of trauma on the child’s brain

Structural Response to Stress

• Amygdala – Hyper-responsive

– Continued neuron growth

• Medial Prefrontal Cortex – Hypo-responsive

– Loss of neural connections

• Hippocampus – Reduced volume

– Loss of neural connections

– Overall Brain Changes -

What’s really happening?

What’s really happening?

Traumatic event

What’s really happening?

Traumatic event

Prolonged exposure

What’s really happening?

Traumatic event

Prolonged exposure

Altered neural circuits

Areas of the brain ‘talk’

Thalamus

Areas of the brain ‘talk’

Amygdala

Thalamus

Areas of the brain ‘talk’

Amygdala

Medial Prefrontal

Cortex

Thalamus Hippocampus

Areas of the brain ‘talk’

Amygdala

Medial Prefrontal

Cortex

Thalamus Hippocampus

Different brain response to ‘aggressor’

Brain Chemicals and Stress

• Cortisol – A steroid hormone, also known as the stress

hormone, produced in response to low blood glucose and stress. It serves to maintain homeostasis and can cause release of norepinephrine in response to stress.

• Norepinephrine (NE) – A neurotransmitter released in response to stress.

NE affects areas of the brain for attention and response to actions. The fight or flight hormone.

Traumatic stimuli/responses can change…

• Physiology

– Increased heart rate and respirations, dilated pupils, dry mouth

• Affective responses

– Helplessness, fear, horror

• Cognitive processing

– Memory can become fragmented, time distorted

Impact of the traumatic event

Amygdala

Medial Prefrontal

Cortex

Hippocampus Thalamus

Impact of the traumatic event

Amygdala

Medial Prefrontal

Cortex

Hippocampus Thalamus

Impact of the traumatic event

Amygdala

Medial Prefrontal

Cortex

Hippocampus Thalamus

Impact of the traumatic event

Amygdala

Medial Prefrontal

Cortex

Hippocampus Thalamus

Impact of Cortisol

• Released by kidney in response to stress

• Cortisol (glucocorticoid) is released into the limbic system

• Cortisol triggers the release of stress hormones (norepinephrine)

• Norepinephrine causes increased alertness and vigilance

Cortisol / norepinephrine in action

• Alert

• Energy shunted to large muscles for escape/run

• Pupils dilated to let in maximum light

• Secretions dried

• Vigilant

Trauma and the Child’s Brain

• We have the most neurons at birth

• Pruning occurs throughout early childhood

• Stress impacts brain structure and chemical function

• Changes to the brain early in development have long-lasting effects

• HOWEVER, some of these changes are reversible

Structural Changes and Childhood Trauma: Problems

• Hippocampus – Learning and memory (school)

• Corpus Callosum – Complex information processing

• Cerebellum – Behavior, motor and executive function

• Medial Prefrontal Cortex – Emotional regulation, cognition and behavior

• Amygdala – Most stimuli are perceived as threats

Severe Neglect Causes…

• Decreased electrical activity

• Decreased metabolism

• Poor connections between key information processing areas

• Abnormal norepinephrine patterns persist

Structural Change due to Abuse

Functional Change due to Abuse

Behaviors Result from Brain 'Injury'

• Persistent fear response

• Hyperarousal

• Increased internalization

• Decreased executive function

• Delayed milestones

What to Expect

• Frequent outbursts, can't seem to control emotions

• Quiet and submissive

• Difficulty learning

• Difficulty with peer relationships

• Unresponsive to affection

EARLY INTERVENTION, WHEN THE BRAIN IS MOST PLASTIC, IS MORE EFFECTIVE THAN REACTIVE TREATMENT AS THE CHILD AGES. PERRY, 2009

Summary

• Traumatic stimuli are received by the brain in a multisensory fashion.

• Traumatic stimuli trigger response from the brain and body.

• The developing brain is hypersensitive to the effect of trauma and stress

• Through rapid and early intervention the impact of trauma and stress can be reversed

1. All of the following are true about smell-based (olfactory) memory except • 1. The stimuli effects the amygdala

• 2. The stimuli effects the thalamus

• 3. In response to stress, the thalamus triggers release of hormones through the kidney

• 4. Olfactory memories and visual memories are created through the same pathway

• 5. Olfactory memories and auditory memories are created through different pathways

2. All of the following parts of the brain are involved in trauma response

• 1. Brainstem

• 2. Medulla oblongata

• 3. Thalamus

• 4. Amygdala

• 5. Medial prefrontal cortex

3. A child has suffered physical neglect for two years. Which of the following are true

• 1. Neglect effects the amygdala less than physical abuse

• 2. Neglect effects the thalamus the same as sexual abuse

• 3. Physical abuse leads to changed brain structure; Neglect does not.

• 4. Physical abuse leads to changed brain structure; Neglect does.

• 5. Neglect does not impact cortisol release.