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Developmental Trauma, Caregiver Support, and Emotion Regulation

Proposal Jala Jefferson

Background

Childhood trauma statistics reveal a distressing reality. Younger children are most vulnerable to maltreatment and trauma.

U.S. Department of Health & Human ServicesChild Maltreatment 2021 report

Background continued

Complex trauma: those who experience maltreatment are likely to be victims of chronic and repeated exposure. As complex trauma unfolds, it may intersect with critical developmental periods.What is developmental trauma?1. Early, repeated trauma, and loss that occurs within the child's significant relationships. 2. Examples include:- neglect - physical, sexual, emotional abuse - relinquished from caregivers - removed from home into a safe adoptive family -parent with mental illness -divorce - incarceration -witnessing domestic violence - lack of love from caregivers3. Very early, pre-cognitive and pre-verbal, 0 to 2/3 years old, "0-1000 days"

Background continued

Developmental trauma Debate

  • Currently, there is no Developmental trauma disorder in the DSM-5-TR. However, researchers debate the necessity over and importance of such a diagnosis.
    • PTSD does not elucidate the severity of interpersonal violence and the lack of inadequate caregiving systems within these children (van der Kolk et al., 2009).
    • Captures clinical manifestations of prolonged exposure to interpersonal trauma and aid in developing formidable interventions for children, adolescents, and adults.
    • Suggests symptoms such as: emotional and physiological dysregulation, poor self-other awareness, and cognitive processing and behavioral problems.
      • consists of symptoms that manifest following recurring traumatization (Schmid et al., 2013)
    • PTSD diagnosis as limited due to the need to verbally express symptoms, which poses challenges for children
      • In a study involving 1,699 children who experienced trauma, a significant proportion of the youth who had been exposed to multiple interpersonal traumas displayed posttraumatic effects that went beyond the symptoms typically associated with PTSD (van der Kolk et al., 2009; Spinazzola et al., 2005)

Reptillian Brain

Mammalian Brain

Rational Brain

Literature Review

Impact on Brain Development:1. Assault on the child's development. Develop maladaptive coping strategies, unable to manage impulse, solve problems or learn nearn new information.2. Constantly in fight, flight, freeze, collapse mode. Amygdala is hyper-actived Developmentally stuck in their primitive brain and unable to process rationally (Oh et al., 2022). 3. Limited resources for the cultivation of 'luxuries'. sharing with siblings, empathy, reasoning. - difficult to think clearly, focus, stay present and they may perceive non-threatening stimuli as dangerous.4. Hippocampus becomes under-activated causing memory difficulties and can relay inaccurate information to the anygdala. It can cause a person to feel afraid or triggered when no danger is present.5. Insula or Interoception can be under or hyper-activated or hyper-reactice to shifts in internal sensations causing emotional reactivity and outbursts or dissociation.

Literature Review

1. Prefrontal cortex. making it difficult to concentrate, make decisions, connect with others (Cross ey al., 2017). 2. Cingulate or Self-regulation center. responsible for regulation of emotion and thoughts. If underactive it can lead to emotion-regulation difficulties.

Literature Review

Emotion Regulation is a skill children learn in early childhood. 1. Dunn et al., 2018 defined ER as the ability to monitor and evaluate one's emotional experiences, modulate the intensity or duration of emotions, and adaptively manage emotional reactions to meet situational demands. 2. Babies learn to co-regulate through their parents. Caregiver reponds to the child's emotions which shows them how to respond to their emotions. They learn their emotions are copacetic and manangeable. Children will seek help from parents when confronted with heightened and negative emotional situations (Brumariu, 2015).3. Children with harmful, inconsistent or neglectful parents learn early on that their feelings are dangerous. The part of the brain responsibile for emotional regulation does not develop as it should and gets stuck.4. When in an constant state of trauma and poor caregiver support, children are not given strategies to help them modulate (Compas et al., 2017)- Adolescent or young adult may react like a young child over small things-Often described as naughty or attention seeking due to engaging in toddler-like behavior

Literature Review

1. Consitent and protective caregiving (Van der Kolk et al., 2009). Relationally enriched enviornements can mediate the effects of adverse life experiencces (Hambrick et al., 2018). 2. Bowlby explores attachment in terms of caregiver system failing to protect the child from the outside world, further traumatizing the child within the primary attachment relationship (1988).3. Parental support and emotion regulation have long been studied. However, it is uncertain if perceived caregiver support is a compelling factor of emotion regulation outcomes in adulthood when you factor their trauma hisotry.Caregiver Support: subjective understanding that caregiver is responsive to provide emotional guidance, facilitate emotional healing through disruptions, create a secure environment, remain attuned to the person's needs and experiences.

When a Traumatized Child Becomes an Adult

Difficulties modulating anger

Emotional reactivity

Co-regulate

Self-destruct

Self-soothing

hyper/hypomentalizing

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Adults with childhood trauma are impacted by profound difficulties Emotion dysregulation is a hallmark of childhood trauma

Purpose

1. Determine the effect of developmental trauma and perceived quality support on emotion regulation. Specifically, how, perceived support mitigates developmental trauma long term effects and promotes affect regulation. 2. Demonstrate the need for trauma informed care and support for caregivers.

Independent variables

Developmental traumaandPerceived support

Dependent variable

Emotion regulation

How does the presence of complex developmental trauma and perceived caregiver support during childhood impact emotion regulation in adulthood?

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Research Question

Happy

Sad

Angry

Scared

Surprised

Embarrassed

Ho is perceived quality of caregiver support does not influence emotion regulation in adults

Ha is that perceived quality caregiver support does predict emotion regulation/dysregulation in adults with a trauma history

Hypothesis

Research Methods

Design

  • Mixed-design: Measures will be administred first, and the qualitiative interview will follow
    • Convergent design: collect and analyze both quantitative and qualitative data independently and then merge the results
  • Within subject design: Each individual in the study will experience all levels of the independent variable

Research Methods

Population and Sample

  • Inclusion criteria
    • 21 years old
    • History of developmental trauma (not exceeding age 10)
  • N= 10

Recruitment Procedure

  • Screeening tool
    • Signage to QR code
    • Age, gender, ethnicity, type of trauma endured (interpersonal vs non-interpersonal) and at what age (start and end)
    • At least 3 tentative dates within 2 months of completing screening survey
    • Preferred method of contact
    • Wish to drop-out
  • Those eligible: notified of date and time, informed consent, and location
  • Those not eligible: will be sent appreciation for completing survey and a list of resources

Research Methods

Data Collection

  • Informed consent, overview of study
    • Participants will be notified that the study may cause distress
  • Measures: the Childhood Experience of Care and Abuse Questionnaire, Caregiver Support interview, and Difficulties Regulating emotions Questionnaire
    • Total time: Roughly 1 hour to 2 hours
    • Participants can take breaks if needed
  • Debrief and Resources

Statistics

  • Multiple regression
    • How one dependent variable is influenced by several independent variables
    • If those with a trauma history received more perceived support should lead to better affect regulation. And higher levels of developmental trauma should lead to pooper affect regulation—however multiple regulation would show if perceived support can mitigate that.
  • Explore overall themes in promoting emotion regulation and attunement

Instrumentation

Childhood Experience Care and Abuse Questionnaire

  • Examines early sever adverse childhood experiences
    • “loss of parents, neglect, antipathy from main caregivers and physical and sexual abuse” (Middlesex University London, 2019).
  • Self-report measure includes questionnaire and likert scale to exame any childhood neglect and trauma under 17.

Difficulties in Emotion Regulation Scale

  • 36-item self-report questionnaire that examines how participants relate to their emotions
  • 6 subscales:
    • nonacceptance of emotional responses
    • difficulty engaging in goal-directed behavior
    • impulse control difficulties
    • lack of emotional awareness
    • limited access to emotion regulation strategies
    • lack of emotional clarity

Instrumentation

Caregiver Support

  • Qualitative interview examining caregiver support that promote affect regulation skills
  • Open-ended to explore themes

  • 1. When faced with difficulties, how did your parents (caregivers) support you?
  • 2. How did your parents assist you in managing and expressing your emotions during your childhood?
  • 3. Describe the emotional support you received from your parents during your childhood.
  • 4. Can you provide examples of how frequently your parents actively participated in your activities and showed interest in your life during your childhood?
  • 5. Share instances that highlight how often your parents were responsive to your needs and concerns as a child.
  • 6. Reflect on your comfort level in seeking help or support from your parents when facing challenges or difficulties during childhood.
  • 7. In what ways did you feel your parents demonstrated love and affection towards you during your childhood?
  • 8. Share your experiences regarding the encouragement your parents provided for your personal growth and development during your childhood.
  • 9. How did your parents support you through your trauma?
  • 10. Describe the extent to which your parents created a nurturing and safe environment for you to express yourself and explore your individuality during your childhood.
  • 11. Considering your overall childhood experience, discuss the lasting impact of parental support in shaping your life on a scale of 1 to 5.

Sample questions:

Ethical Considerations

  • History of trauma
    • include sensitive nature of quesitons in informed consent process
    • Participants will have a right to drop out at any point
    • Support services
    • Debrief

Limitations

Assumptions

  • Participants may underreport
  • Little recollection of past experiences
  • Age of trauma
  • Time consuming

  • Truthful
  • Ethical guideliness are followed
  • Validity and reliability of assessment
  • Sample is representitive of population

Questions?Thank you!