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Complextrauma EU
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CE at the Dutch Trauma center Assen-Drenthe NL - also Veteran Care. A lonely walker - Ora et Labora - Traumatized - Born Autistic HFA + CPTSD-TSD(DID)
CE at the Dutch Trauma center Assen-Drenthe NL - also Veteran Care. A lonely walker - Ora et Labora - Traumatized - Born Autistic HFA + CPTSD-TSD(DID)

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"We live in a culture that emphasizes therapy, but trauma often has to be overcome morally, through rigorous philosophical autobiography, nuanced judgment, case by case."

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Whether intelligence is emotional or social, the idea that being “smart” means more than scoring high on standard IQ test remains a valid psychological finding...

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Mit dem #Stress führt das #Gedächtnis eine komplizierte Beziehung: Eigentlich ist er schädlich; tatsächlich stellen die Neurone im #Hippocampus bei einem Übermaß an dauerhaftem Stress ihre Aktivitäten schlicht ein. 

Auf der anderen Seite bleibt uns eher im Gedächtnis, was uns kurzfristig unter Stress gesetzt hat. Das ist sinnvoll, denn wir müssen uns merken, wo der Fressfeind wohnt oder andere Gefahren lauern. 

Hanna Drimalla beschreibt im Lesetipp des Tages das ...

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Seeing is not remembering
Researchers find that memory isn't always 'on.'

January 21, 2015
UNIVERSITY PARK, Pa. -- People may have to "turn on" their memories in order to remember even the simplest details of an experience, according to Penn State psychologists. This finding, which has been named "attribute amnesia," indicates that memory is far more selective than previously thought.

"It is commonly believed that you will remember specific details about the things you're attending to, but our experiments show that this is not necessarily true," said Brad Wyble, assistant professor of psychology. "We found that in some cases, people have trouble remembering even very simple pieces of information when they do not expect to have to remember them."

Wyble and Hui Chen, postdoctoral fellow in psychology, tested the memories of 100 undergraduate students, divided into several groups. Each group performed a variation of the experiment in order to replicate the results for different kinds of information, such as numbers, letters or colors.

In each trial participants were shown four characters on a screen arranged in a square -- for example three numbers and one letter -- and were told that they would need to report which corner the letter was in. After a set amount of time, the characters disappeared from the screen and the participants reported where they remembered the letter had been. This part of the task was expected to be easy -- participants rarely made an error.

After repeating this simple task numerous times, the participant was asked an unexpected question in order to probe the memory for the very information used to find the letter's location. Four letters appeared on the screen and the participant was asked to identify which one had appeared on the previous screen. Only 25 percent of the participants identified the correct letter -- the same percentage as would be expected to randomly guess it.

Similar results were obtained when participants were asked to locate odd numbers, even numbers and colors.

"This result is surprising because traditional theories of attention assume that when a specific piece of information is attended, that information is also stored in memory and therefore participants should have done better on the surprise memory test," said Wyble.

Chen and Wyble have called the phenomenon they observed attribute amnesia, as they reported in an article recently published online in the journal Psychological Science. Attribute amnesia occurs when a person uses a piece of information to perform a task, but is then unable to report specifically what that information was as little as one second later.

"The information we asked them about in the surprise question was important, because we had just asked them to use it," said Chen. "It was not irrelevant to the task they were given."

After the surprise trial, the same question was repeated on the next trial, however it was no longer a surprise. Participants did dramatically better with the average of correct answers between 65 and 95 percent across the different experiments.

The researchers point out that this result suggests that people's expectations play an important role in determining what they remember, even for information they are specifically using.

"It seems like memory is sort of like a camcorder," said Wyble. "If you don't hit the 'record' button on the camcorder, it's not going to 'remember' what the lens is pointed at. But if you do hit the 'record' button -- in this case, you know what you're going to be asked to remember -- then the information is stored."

Wyble and Chen argue that this selective memory storage might be a useful adaptation because it prevents the brain from remembering information that is probably not important. The researchers plan to continue this line of research as they study whether people are aware of their own lack of memory.

The National Science Foundation supported this research.

..///

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re-shared by Nique, www.complex-trauma.eu & dissociatie.wordpress.com 
SHAME ON U.S.
January 2015
Failings by All Three Branches of Our Federal Government
LEAVE ABUSED AND NEGLECTED CHILDREN VULNERABLE TO FURTHER HARM

The Scope and Impact of Abuse and Neglect on the Child Victims
During 2012, at least 686,000 American children were the victims of maltreatment (abuse or neglect).
1 A conservative estimate of the number of those children who were killed that year by abuse or neglect is 1,6402 meaning that abuse or neglect leads to the death of at least 4–5 children every day in the U.S. Sadly, the real numbers of both child abuse/neglect victims and fatalities are much higher, due in part to unreported abuse. 3 According to the U.S. Department of Health and Human Services (HHS), “abuse and neglect can have consequences for children, families, and society that last lifetimes, if not generations.”4 Such long-term consequences may be 
• physical (e.g., impaired brain development, poor physical health);
• psychological (e.g., low self-esteem, depression, anxiety, relationship difficulties);
• behavioral (e.g., juvenile delinquency, adult criminality, teen pregnancy, low academic achievement, alcohol and drug use, mental health problems, abusive behavior); and
• societal (e.g., direct costs associated with maintaining a child welfare system to investigate and respond to allegations of child abuse and neglect, as well as expenditures by the judicial, law enforcement, health, and mental health systems, and indirect costs associated with juvenile and adult criminal activity, mental illness, substance abuse, domestic violence, loss of productivity due to unemployment and underemployment, the cost of special education services, and increased use of the health care system).5 During 2012, states served about 638,000 foster children, including 252,000 abused or neglected children who entered into the foster care system that year.6 In order to serve those children, state courts became their legal parents, assuming the authority to determine where they should live, where they will attend school, who they may see, and countless other details of their lives. This extraordinary governmental intervention into family affairs is intended not to punish parents or other caretakers — but to protect children from abuse and neglect, and to temper negative consequences.
End quote..//

CHILDHOOD TRAUMA LEADS TO BRAINS WIRED FOR FEAR
Last week, a report by the University of San Diego School of Law found that about 686,000 children were victims of abuse and neglect in 2013. Traumatic childhood events can lead to mental health and behavioral problems later in life, explains psychiatrist and traumatic stress expert Bessel van der Kolk, author of the recently published book, The Body Keeps the Score: Brain, Mind, and Body in the Healing of Trauma. Children’s brains are literally shaped by traumatic experiences, which can lead to problems with anger, addiction, and even criminal activity in adulthood, says van der Kolk. Sound Medicine’s Barbara Lewis spoke with him about his book. 
src: http://soundmedicine.org/post/childhood-trauma-leads-brains-wired-fear


quote//..
Shame on U.S., a report by the Children’s Advocacy Institute of the University of San Diego School of Law, in collaboration with First Star, discusses how the federal government is failing to properly enact, monitor, interpret, and enforce federal child welfare laws — and in so doing is allowing states to fall below minimum floors with regard to appropriately detecting and protecting children from child abuse and neglect and complying with minimum federal child welfare requirements and outcomes.   
Each branch of our federal government plays an integral role in the child welfare system, and when even one fails to perform its role in an appropriate manner, children are put at risk of harm.  Because all three branches must be performing optimally to ensure a well-functioning child welfare system, this report discusses the performance of each branch in this arena.  Specifically, the report:
• provides an overview of the scope and purpose of major child welfare laws as enacted by Congress, and to what extent current laws meet the needs of children;
• examines how the judicial branch has interpreted those laws;
• discusses to what extent the executive branch implements and enforces those laws;
• comments on the potential efficacy of each branch’s scope and reach;
• provides examples of shortcomings in all three branches with regard to their respective roles vis-à-vis the child welfare system;
• discusses issues where the purpose or intent of child welfare laws are being openly violated by some states;
• calls for more robust activity from all three branches — and particularly enforcement by the executive branch charged with enforcing Congressional intent and, when necessary, withholding federal funding or imposing penalties where states are clearly not meeting minimum standards; and
• makes several recommendations for all three branches of federal government, all of which are necessary in order to ensure a well-functioning child welfare system.
..//End quote
src:
http://www.caichildlaw.org/Shame_on_US.htm


Full rapport 
http://www.caichildlaw.org/Misc/Shame%20on%20U.S._FINAL.pdf



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PSYCHOPHYSIOLOGICAL CHARACTERISTICS OF PEDIATRIC POSTTRAUMATIC STRESS DISORDER DURING SCRIPT-DRIVEN TRAUMATIC IMAGERY
Published: 5 February 2015

DISCUSSION
This study investigated self-reported anxiety and psychophysiological functioning of children and adolescents with a trauma history during exposure to an idiosyncratic trauma script. We found significant differences between children and adolescents with and without PTSD in self-reported anxiety and in the script contrast of the facial EMG, but not in the autonomic psychophysiological responding during the trauma script experiment. Thus, our expectation that children and adolescents with PTSD would show specific baseline levels or a characteristic psychophysiological reactivity to trauma reminders could not be confirmed, with the exception of facial EMG. During the experiment, study participants with PTSD reported more anxiety already at baseline, that is, without exposure to their trauma script, compared to traumatized children and adolescents without PTSD. As expected, children and adolescents with PTSD then reacted to their trauma script with greater anxiety than their non-PTSD counterparts, evident in both reactivity and script contrast measures.

Concerning psychophysiological variables, we found higher script contrast of the activity of the corrugator supercilii muscle in children and adolescents with PTSD compared to controls without PTSD. The muscle is involved in frowning and is regarded as the principal muscle in the facial expression of unpleasant affects, varying as a function of intensity and sociality of emotional stimuli. It is also interpreted as an indicator of emotional information processing (Wilhelm, Schneider, & Friedman, 2006; Tassinary & Cacioppo, 1992). It corresponds to the diagnostic criterion of emotional burden at exposure to trauma reminders (American Psychiatric Association, 2000) and mirrors the intersection between overt behavior and psychophysiological reactions. Corrugator supercilii EMG has previously been described as specific to adults with PTSD during exposure with idiosyncratic trauma reminders (Pole, 2007). Our study groups did not differ in EMG reactivity to the trauma script referenced to baseline. This indicates that the direct script contrast (trauma script referenced to neutral script) is more sensitive for detecting characteristic facial affective response to the trauma script as it controls for individual differences in facial EMG reactivity when listening to a story and producing mental imagery.

In contrast to results from adults, no psychophysiological group differences were found in HR, RSA, SCL and NSF, although study groups differed considerably both in diagnosis and the amount of PTSD symptoms. HR is considered to be a particularly strong putative peripheral marker for anxiety (Wilhelm & Orr, 1998), but PTSD was not associated with HR in our study group, or in previous studies with pediatric populations. Thus, higher HR at exposure seems to be specific to adults, but not to children or adolescents with PTSD. It is not associated with current symptoms but with individual trauma history (Kirsch, Wilhelm, & Goldbeck, 2011; Buckley & Kaloupek, 2001). RSA is often interpreted as an index of affect regulation capacity therefore suggesting a strong relation with PTSD (Wilhelm, Schneider, & Friedman, 2006). In contrast to this suggestion, and consistent with a study of Scheeringa et al. (2004), our study did not find differences in RSA dependent on PTSD, either at baseline or in response to trauma reminders.

Developmental and clinical differences might contribute to the obvious discordance between marked psychophysiological alterations in adult patients with PTSD and absent or only low psychophysiological reactions in children and adolescents with PTSD. Age-dependent characteristics, such as a higher resting HR and less sympathetic reactivity in children and adolescents compared to adults may cause divergent findings of autonomic reactions (Quigley & Stifter, 2006). Another explanation might be that the severity of psychophysiological alterations may depend on trauma history, for example, amount and diversity of experienced trauma types, amount of symptoms, or duration of PTSD (D’Andrea et al., 2013; Langeland & Olff, 2008). Possibly, psychophysiological alterations show differential patterns according to time since trauma and trauma history. The experimental setting of having the psychologist nearby the children and adolescents during the investigation might be another explanation for low psychophysiological reactions, as studies found that the presence of another human decreased the perceived threat (Coan, Schaefer, & Davidson, 2006).

Although little is known about response coherence between different emotional systems, results of recent studies suggest a certain concordance between physiology and experience, affected by some parameters like age of the study population, amount and valence of elicited emotion (Lench, Flores, & Bench, 2011; Mauss, Levenson, McCarter, Wilhelm, & Gross, 2005). The obvious discordance between increased self-reported anxiety and mostly absent physiological reactivity in our study group may therefore be explained by the mentioned parameters. Another interesting explanation is suggested by findings of subgroups in adult PTSD, reporting subjective distress without any observable psychophysiological responses (Pineles et al., 2013). This is worth of further investigations as there may exist groups with different needs in psychotherapy.

There are some limitations to the interpretation of our results: We powered the study for large effect sizes, as reported in adult studies. Therefore, the sample size was small and statistical power was not sufficient to detect small or moderate effects. Effect sizes suggest that there may be a rather weak or moderate association between psychophysiological parameters and PTSD. The variability of trauma types or time since trauma was large. Moreover, a control group without a history of traumatic events was not included, although in previous trauma script studies, the most significant differences were reported for comparisons of children and adolescents with vs. without a trauma history, regardless of PTSD. Therefore, we cannot answer the question whether just experiencing a traumatic event might explain the variance in psychophysiological reactions, instead of developing PTSD.

CONCLUSIONS
Our finding of a more negative emotional reaction to idiosyncratic trauma script exposure indicated by a higher script contrast of the facial EMG should be further evaluated in longitudinal studies with a larger sample. The assessment of facial EMG is a non-invasive method, which is easy to realize, even during a treatment session (Wilhelm & Grossman, 2010). Future studies should utilize larger samples to allow for subgroup analyses regarding the effects of trauma type, sex or age groups on psychophysiology, as there remain open questions regarding the relationship of psychophysiological alterations and diagnostic criteria in pediatric PTSD.

http://www.ejpt.net/index.php/ejpt/article/view/25471/pdf_10


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#dissociatie #complex_trauma  #CPTSD  #CPTSS  #GGz  #Dissociation  #PTSD  #PTSS  #celevt  #TRTC, #structural_dissociation #structurele_dissociatie #dissociatieve_identiteitsstoornis #DIS #DID #dissociative_identity_disorder #post_traumatic_stress_disorder #complex-trauma.eu
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PSYCHOPHYSIOLOGICAL CHARACTERISTICS OF PEDIATRIC POSTTRAUMATIC STRESS DISORDER DURING SCRIPT-DRIVEN TRAUMATIC IMAGERY
Published: 5 February 2015

DISCUSSION
This study investigated self-reported anxiety and psychophysiological functioning of children and adolescents with a trauma history during exposure to an idiosyncratic trauma script. We found significant differences between children and adolescents with and without PTSD in self-reported anxiety and in the script contrast of the facial EMG, but not in the autonomic psychophysiological responding during the trauma script experiment. Thus, our expectation that children and adolescents with PTSD would show specific baseline levels or a characteristic psychophysiological reactivity to trauma reminders could not be confirmed, with the exception of facial EMG. During the experiment, study participants with PTSD reported more anxiety already at baseline, that is, without exposure to their trauma script, compared to traumatized children and adolescents without PTSD. As expected, children and adolescents with PTSD then reacted to their trauma script with greater anxiety than their non-PTSD counterparts, evident in both reactivity and script contrast measures.

Concerning psychophysiological variables, we found higher script contrast of the activity of the corrugator supercilii muscle in children and adolescents with PTSD compared to controls without PTSD. The muscle is involved in frowning and is regarded as the principal muscle in the facial expression of unpleasant affects, varying as a function of intensity and sociality of emotional stimuli. It is also interpreted as an indicator of emotional information processing (Wilhelm, Schneider, & Friedman, 2006; Tassinary & Cacioppo, 1992). It corresponds to the diagnostic criterion of emotional burden at exposure to trauma reminders (American Psychiatric Association, 2000) and mirrors the intersection between overt behavior and psychophysiological reactions. Corrugator supercilii EMG has previously been described as specific to adults with PTSD during exposure with idiosyncratic trauma reminders (Pole, 2007). Our study groups did not differ in EMG reactivity to the trauma script referenced to baseline. This indicates that the direct script contrast (trauma script referenced to neutral script) is more sensitive for detecting characteristic facial affective response to the trauma script as it controls for individual differences in facial EMG reactivity when listening to a story and producing mental imagery.

In contrast to results from adults, no psychophysiological group differences were found in HR, RSA, SCL and NSF, although study groups differed considerably both in diagnosis and the amount of PTSD symptoms. HR is considered to be a particularly strong putative peripheral marker for anxiety (Wilhelm & Orr, 1998), but PTSD was not associated with HR in our study group, or in previous studies with pediatric populations. Thus, higher HR at exposure seems to be specific to adults, but not to children or adolescents with PTSD. It is not associated with current symptoms but with individual trauma history (Kirsch, Wilhelm, & Goldbeck, 2011; Buckley & Kaloupek, 2001). RSA is often interpreted as an index of affect regulation capacity therefore suggesting a strong relation with PTSD (Wilhelm, Schneider, & Friedman, 2006). In contrast to this suggestion, and consistent with a study of Scheeringa et al. (2004), our study did not find differences in RSA dependent on PTSD, either at baseline or in response to trauma reminders.

Developmental and clinical differences might contribute to the obvious discordance between marked psychophysiological alterations in adult patients with PTSD and absent or only low psychophysiological reactions in children and adolescents with PTSD. Age-dependent characteristics, such as a higher resting HR and less sympathetic reactivity in children and adolescents compared to adults may cause divergent findings of autonomic reactions (Quigley & Stifter, 2006). Another explanation might be that the severity of psychophysiological alterations may depend on trauma history, for example, amount and diversity of experienced trauma types, amount of symptoms, or duration of PTSD (D’Andrea et al., 2013; Langeland & Olff, 2008). Possibly, psychophysiological alterations show differential patterns according to time since trauma and trauma history. The experimental setting of having the psychologist nearby the children and adolescents during the investigation might be another explanation for low psychophysiological reactions, as studies found that the presence of another human decreased the perceived threat (Coan, Schaefer, & Davidson, 2006).

Although little is known about response coherence between different emotional systems, results of recent studies suggest a certain concordance between physiology and experience, affected by some parameters like age of the study population, amount and valence of elicited emotion (Lench, Flores, & Bench, 2011; Mauss, Levenson, McCarter, Wilhelm, & Gross, 2005). The obvious discordance between increased self-reported anxiety and mostly absent physiological reactivity in our study group may therefore be explained by the mentioned parameters. Another interesting explanation is suggested by findings of subgroups in adult PTSD, reporting subjective distress without any observable psychophysiological responses (Pineles et al., 2013). This is worth of further investigations as there may exist groups with different needs in psychotherapy.

There are some limitations to the interpretation of our results: We powered the study for large effect sizes, as reported in adult studies. Therefore, the sample size was small and statistical power was not sufficient to detect small or moderate effects. Effect sizes suggest that there may be a rather weak or moderate association between psychophysiological parameters and PTSD. The variability of trauma types or time since trauma was large. Moreover, a control group without a history of traumatic events was not included, although in previous trauma script studies, the most significant differences were reported for comparisons of children and adolescents with vs. without a trauma history, regardless of PTSD. Therefore, we cannot answer the question whether just experiencing a traumatic event might explain the variance in psychophysiological reactions, instead of developing PTSD.

CONCLUSIONS
Our finding of a more negative emotional reaction to idiosyncratic trauma script exposure indicated by a higher script contrast of the facial EMG should be further evaluated in longitudinal studies with a larger sample. The assessment of facial EMG is a non-invasive method, which is easy to realize, even during a treatment session (Wilhelm & Grossman, 2010). Future studies should utilize larger samples to allow for subgroup analyses regarding the effects of trauma type, sex or age groups on psychophysiology, as there remain open questions regarding the relationship of psychophysiological alterations and diagnostic criteria in pediatric PTSD.

http://www.ejpt.net/index.php/ejpt/article/view/25471/pdf_10


re-shared by Nique
www.complex-trauma.eu
#dissociatie #complex_trauma  #CPTSD  #CPTSS  #GGz  #Dissociation  #PTSD  #PTSS  #celevt  #TRTC, #structural_dissociation #structurele_dissociatie #dissociatieve_identiteitsstoornis #DIS #DID #dissociative_identity_disorder #post_traumatic_stress_disorder #complex-trauma.eu
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