Test 2

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characteristics of neglectful parents: maternal depression, intellectual impairments, substance abus, social isolation, domestic abuse
steps of divorce transition: individual cognition: the decision, family meta-cognition: the announcement, systemic separation: dismantling the nuclear family systemic reorganization: the binuclear family, family redefinition: the aftermath
sexual abuse: sexual harassment, rape, assault with intent to commit sexual abuse
hippocampus: involved in recording, filinng and remembering traumatic events
aids to diagnose abuse, history: conflicting history of cause of illness, repeated injuries, inconsistent with severity of injuries, delay in seeking care, another child blamed
right hemisphere activity: increases with chronic/sever stress and trauma. Assigns emotional significance to stimuli and attaches physiological responses to emotional information, sensitive to emotional nuances
high risk factors for divorce: <20 yrs when married, low income and education or womeon with 5+ yrs college, western part of US, african americans,
'cooperative colleagues': need a more structured agreement outlining children's living schedules, holidays, who goes to what meetings
differentiation of self (bowen theory): universal and is used to categorize people on a single continuum according to the degree of fusion between emotional and intellectual functioning.
psychodynamic/multigenerational model: capacity to function as a spouse or parent is a consequence of early relations
dependent adult abuse: any knowing, intentional, or negligent act by caretaker causing harm or serious risk of harm
images stored in memory: the internal pictures or recollections the brain creates, stores and uses to identify similar objects in the future. they are automatically tagged with emotional labels
types of neglect: physical, educational, emotional,
four types of abusive caregivers: well-intentioned (overwhelmed), well-intentioned (ignorant), unwilling/disinterested, abusive or sadistic personality features
coercive behaviors: actual or threatened physical injury, sexual assault, psychological abuse, economic abuse, economic control, social isolation, destruction of person's property or personal possessions, abuse of animals/pets
emotional process of transition: joining of families: commtment to new system
emotional process of transition: families with young children: accepting new members into the system
adolescent dating violence: adolescents often confuse jealousy with love, lack of perspective about behaviors constituting a healthy relationship, striving for independence,
risk factors for abusive caregiver: unrealistic expectations for child's developmental ability, substance abuse/mental health disorder, environmental stress, domestic violence, history of abuse in own childhood
common responses to unbearable emotional states: withdraw, move against self (self harm, substance abuse), move against others (rage, agression)
the brain's interpretation of images: all are treated the same regardless of the source (real, remembered, imagined). interpretationo of an image is communicated to the whole body and the body responds to it in some way.
effects of early traumatic experiences on the amygdala: over activity or amygdala, decreased activity of prefrontal cortex (generates positive feelings)
steps to improve illness experience: recognize importance of doctor-pt relationship, identify who else is involved in his/her illness, offer essential information and learn about pt's and family's views of illness, provide emotional supporty, stay involved overe time, be aware of your reactions, recognize your limtis
emotional process of transition: launching: accepting a multitude of exits from and entries into the family system
characteristics of amygdala: mature at birth, operates at implicit level, center of negative emotions that inform the brain of dread and fear.
reasoning pathway of emotional stimulus: cognitive, thinking brain. sensory thalamus --->sensory cortex---> amygdala.
emotional process of transition: leaving home: emotional and financial responsibility for self
chronic illness oriented genogram: focuses on how a family adapted around previous illnesses and unexpected crises in current and previous generations, used widely in family medicine and family therapy
neocortex: oriented to the outside world, problem solving, learning, and discrimination of complex stimuli, weighing options, predicting outcomes
'angry associates': need very structured agreement, stating specifics about what a parent can and cannot do with children
imagination: brain/mind's capacity to make changes in images and organize them into stories to interpret the world in meaningful and helpful ways
family systems theory: family is more than a collection of individuals, families have repeating interaction patterns that regulate members' behavior, individual symptoms may have a function within the family, the ability to adapt to change is the hallmark of healthy family functioning, family members share responsibility for their problems
traumatic recall: sensory imprints of an experience are stored in memory but not organized into a whole. these memories are laid down and retrieved as isolated images, bodily sensations, smells, sounds,
location of implicit memory: occipital cortex, stratum, cerbellum
emotional reaction of adapting to illness: shock, anxiety, fear, denial, anger, frustration, regression, powerlessness, depression
second leading cause of death from abusive injuries: abdominal trauma. 50% mortality rate. delayed onset of symptoms,large organs, small blood volume contribute to mortality
the limbic system: plays role in functions needed for self-preservation and procreation. Regulation of survival behaviors, evaluating situations (signal ANS). regulates emotional expression, controls pitutitary gland
Bowen Theory: model of optimal functioning based on differentiation
characteristics of hippocampus: matures between 2-3 yrs, contextualizes an event by giving it time and space,
functions of amygdala: facilitates remembering by re-creating the emotional state of the original experience, responsible fo the 'take-over' of consciousness by emotion,
denial of critical care by caretaker: deprivation of minimum food, shelter, clothing, supervision, physical or mental healthcare.
Branches of ANS: sypmathetic, parasympathetic. they work in tandem, one activated and the other suppressed
caretaker: related or unrelated person who has responsibility for protection, care, or custody of dependent adult.
neocortex: the thinking area of the brain
sexual exploitation: only applies to dependent adults residing in healthcare facility. consensual or non consensual sexual conduct
dependent adult: person 18 and older, unable to protect own interests due to physical or mental vulnerability
short term effects of sexual assault: direct trauma from rape, vaginal or anal bleeding, bruises, and scratches
signs of sensitized nervous system: reacting to minor stressor as if it were a traumatic one, increased reaction to the last stressor in a series of stressors.
child neglect: failure to provide adequate food, shelter, and protection, including lack of clothing, healthcare and educational needs of children
PNS: aroused in states of rest and relaxation
dysfunctional family systems: tend to maintain or reinforce the symptoms in ongoing interactional processes
examination signs of abuse: multiple injuries at various stages of healing, recognizable patterns (hand prints, belt marks, etc), location on sites not involved in accidental falls, signs of neglect, ano-genital trauma, recurrent acute life threatening events in the presense of a single caregiver,
sensitization of nervous system: under repeated stress becomes more sensitized. the threshold of tolerance decreases and the frequency of episodes and triggering of traumatic responses increases. can lead to spontaneously erupting episodes of traumatic stress
pathway for fear from emotional stimulus: sensory thalamus-->amygdala --> hypothalamus --->stress hormones to blood stream
domestic violence don'ts: "domestic violence" "abused" "battered." inquire about abuse in presence of partner, friend, or family members. ask pt what she/he did to bring on violence, ask why hasn't left,
enmeshment: from structural model of family systems. characterized by diffuse boundaries
family life cycle stages: leaving home (single young adult), joining of families through marriage, families with young children, families with adolescents, launching children and moving on, families in later life
attachment trauma: significant disruptions in relationships with caregivers who provide the comfort needed to manage and regulate stress.
perception: psychological and neurological processes by which we take in information about an object in the environment and identify or recognize it
disengaged: from structural model of family systems. the other extreme from enmeshment
most important determinant in assesing risk for partner violence: pt's level of fear and appraisal of both immediate and future safety needs
effects of traumatic stress: activation of amygdala (fear level is amplified and implicit memory formation is strengthened). Impaired prefrontal cortex (reduced ability to reason and think to regulate fear, bad decisions made) and hippocampus (processing and storage of event hindered, reduced ability to conceptualize experience, reduced ability to form explicit memories)
left hemisphere: categorizes and labels internal states and finds words to describe and express an experience, organizes problem solving tasks into a set of operations and processes information sequentially
factors affecting responses to illness: nature and severity of physical symptoms, cultural and family contex, affect on daily/future functioning, past experiences, sociocultural values/beliefs
diease: using biomedical model, symptoms in light of biological or disease related
obstacles to leaving, why victims stay: fear, economic and logistical constraints, social isolation, feelings of failure, promises of change, prior lack of intervention,
emotional process of transition: families with adolescents: increasing flexibility of familiy boundaries to permit children's independence and grandparent's frailties
examples of physical abuse: unreasonable confinement or punishment, assault, willful or negligent acts or omissions of a caretaker
differences between emotional and cognitive systems in response to emotional stimulus: emotioal ( rapid, general ideas about avoid/approach; flee/fight, instictive) cognitive (takes more time, is more precise and discriminating)
increased prevelance of partner violence: women who are single, separated, or divorced. individuals who have recently sought restraining/vacate order, teens and young adults, poor women, alcohol or substance abuse, pregnant women that have previously been abused, excessively jealous or possessive partners
long term effects of sexual assault: chronic abdominal pain, headaches, changes in eating and sleeping, purging, depression, PTSD, suicidal ideation or attempts
most serious form of child abuse: abusive head trauma-unexplained loss of consciousness, anea, seizures, resp. distress, recurrent vomiting, irritablity, coma,
denial of critical care by self: self neglect
SNS: aroused in states of effor and stress
areas of assesment for adult dependency: physical factors, mental factors, social factors, financial factors
remembering: each recollection of a specific memory is different from the one preceding it, it is a new reation
implicit memory: unconscious. non-verbal sensory level. the level where traumatic events and early attachments are typically encoded.
common threats/losses experienced by people with illness: self-efficacy, love, functioning, control and rationality, pain and suffering
types of memory: explicit, implicit
traumatic: a disordered psychic state or behavioral state resulting from mental or emotional stress or physical injury. to wound or pierce-a break in the body tissue due to some external action.
common experiences associated with illness: dependence, low energy, limited mobility, inability to depend on body, physical pain, withdrawal from others, frequent contact with healthcare system, pessimism and passivity, focus on self and symptoms
explicit memory: autobiographical, mediated by words and cognitions, has time and place dimension
'perfect pals': very flexible and unwritten type of contract b/c they negotiate easily
sexual abuse: involvement of children or adolescents in a sexual activity, which they do not understand, to which they cannot give informed consent, and that which violates social taboos
why abuse is not reported: family secrecy, self-blam, isolation, fear, embarrassment. victims will put up with anything to prevent being institutionalized.
factors affecting a perosn's response to illness: nature/severity of illness, cultural and family context, hwo it affects daily routine and future functioning, past experiences with health care, sociocultural values and beliefs
amygdala: involved in recording, filing, and remembering traumatic events
mandatory reporters: in course of employment treats a dependent adult and resonably believes the adult has suffered dependednt adult abuse
emotional abuse: inflicting mental pain or distress through verbal or non verbal acts
characteristics of the worst traumas: repetitive, human initiated, fight/flight response not possible, lack of emotional support following.
emotional process of transition: later life: accepting shifting generational roles.
explanatory model of illness: illness is the human experience of suffering. disease and illness are not the same.
impersonal trauma: natural and human related disasters, accidents
indicators of escalating risk: increase in frequency or severity of assaults, increasing or new threats of homicide or suicide by partner, presence or availability of firearm, new or increasingly violent behavior by perpetrator outside the relationship
financial exploitation: takin unfair advantage of resources for personal profit, theft, coercion into signing or changing documents
left hemisphere activity: decreases when there is incread emotionality and sensitivity
risk factors for child abuse: age 0-5, boys physically abused more, girls sexually abused more, medical conditions,
emotional cut off: isolation, withdrawal, running away, denyin the importance of the parental family.
important brain areas of explicit memory: hippocampus, thalamus, and frontal cortex
contextual theory: fairness leads to trustworthiness, which leads to autonomy
'fiery foes': usually have everything possible written in legal, contractual form, but likely to violate contracts
categories of trauma: impersonal, interpersonal, attachment
thalamus: receives input from the senses and transmits stimuli to the neocortex and the limbic system
permissive reporters: any person whoe believed dependent adult has suffered abuse.
illness: human experiennce of suffering, attachems meaning or significance to sickness
effects of chronic/severe stress and truama on hippocampus: changes shape, size and number of neurons within, kills hippocampal cells and supresses ability to renew nerve cells, results in cognitive decline, decreased ability to process and integrate information and form declarative memory
domestic violence, spousal abuse, battering, and other terms: intentionally violent or controlling behavior by a person who is currently or was previously in a dating or intimate relationship with victim
foundation of memory: mental representations of something perceived, world and ourselves
interpersonal trauma: designed and initiated by humans (assault, rape, etc)

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