Transcript Nature vs Nurture - YES! in Rock County

FAMILY’S
TRAUMA
PERSONAL
TRAUMA
PARENT’S
TRAUMA
ANCESTOR’S
TRAUMA
What’s in his backpack?
Nature and/or Nurture:
Trans-generational Transmission of Traumatic
Stress
Chris Dunning, Ph.D.
Professor Emerita
University of Wisconsin-Milwaukee
[email protected]
414/227-3399
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Why examine Trans-generational
Transmission of Trauma?
Children Bring Their Whole Lives into the Classroom
• Children spend 6-8 hours a day in school.
• If the school is trauma-informed, those could be hours in
which the children feel understood, accepted and validated,
all of which might g help them recover from trauma
• Teachers who function as secondary or alternative
attachment figures could provide some protection against
negative developmental outcomes
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• Education can help the children become part of society.
Trauma’s Legacies
YOUR STUDENT
PERSONAL
EXPERIENCES
PARENTAL/
CAREGIVER
EXPERIENCES
FAMILY
GRANDPARENTS’
& ANCESTORS’
EXPERIENCES
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Let’s Talk About the Elephant in the
Classroom
AFFECT
ATTITUDE
BEHAVIOR
LEARNING
COGNITION
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What Do You Have in the
Classroom?
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Personal Traumas
Family’s Traumas
Parent’s Childhood/Adult Traumas
Caregiver/Teacher’s/Staff Traumas
Ancestor’s Traumas
Community Traumas
NOT EVERY CHILD HAS THE SAME-SIZE
ELEPHANT IN THEIR BACKPACK
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Just Because a Person Has Been
in a Traumatic Event…
Doesn’t Mean They are TRAUMATIZED!!
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STUDENT
LEARNING
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Let’s Take out Personal Experience and
Look Only at Inherited/Transmitted Trauma
STUDENT
GENETIC MAKEUP
BIOLOGY
SCHEMAS/BELIEFS
VALUES
LEARNED
MODELED
BEHAVIORS
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What Makes Up a Student
BIOLOGY
SCHEMAS
BELIEFS
VALUES
LEARNED
BEHAVIOR
Abused Child>Abusive Parent
Domestic Violence>Domestic “Violentor”
Victim>Perpetrator (Role Reversal)
Vulnerability
Trust
Intent/Blame
Guilt
Empathy
Self-Esteem
Self-Worth
Futuring
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Key Developmental Capacities Affected By
Trauma
 Ability to modulate, tolerate, or recover from extreme
affect states
 Regulation of bodily functions
 Capacity to know emotions or bodily states
 Capacity to describe emotions or bodily states
 Capacity to perceive threat, including reading of safety
and danger cues
 Capacity for self-protection
 Capacity for self-soothing
 Ability to initiate or sustain goal-directed behavior
 Coherent self, Identity, sense of self-worth or esteem
 Capacity to regulate empathic arousal
 Capacity to trust
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Domains Impacted by Trauma That
Affect Learning
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Behavioral Control
Cognition
Attachment
Dissociation
Affect Regulation
Physiological and Psychological State
Self Concept
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Trans-generational Trauma
Attachment research shows a 75% correspondence
between a mother’s attachment and that of her
infant RESULTING IN…
• Repetition of disturbed interactions and patterns
of relationships
• Repetition of abuse and maltreatment
• Issues for abused parents - anxiety,
compensation and reparation, envy
• Re-enactment of unresolved attachment trauma
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Transmission of Trauma from
Parent to Child
• “Direct and specific" transmission (a
mental syndrome in the survivor parent
leads directly to the same specific
syndrome in the child)
• Indirect and general" transmission (a
disorder in the parent makes the parent
unable to function as a parent which
indirectly leads to a general sense of
deprivation in the child).
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Trauma Symptoms that Impact Parenting:
PTSD Avoidant
D. Negative alterations in cognitions and mood associated with
the traumatic event(s), beginning or worsening after the
traumatic event(s) occurred), as evidenced by two or more of
the following:
1. Inability to remember an important aspect of the traumatic event(s)
(typically due to dissociative amnesia that is not due to head injury,
alcohol, or drugs)
2. Persistent and exaggerated negative beliefs or expectations about
oneself, others, or the world (e.g., “I am bad,” “No one can be
trusted,” "The world is completely dangerous"). (Alternatively, this
might be expressed as, e.g., “I’ve lost my soul forever,” or “My whole
nervous system is permanently ruined”).
3. Persistent, distorted blame of self or others about the cause or
consequences of the traumatic event(s)
4. Persistent negative emotional state (e.g., fear, horror, anger, guilt, or
shame)
5. Markedly diminished interest or participation in significant activities
6. Feelings of detachment or estrangement from others
7. Persistent inability to experience positive emotions (e.g., unable to
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have loving feelings, psychic numbing)
Parent’s PTSD Arousal Symptoms
E. Marked alterations in arousal and reactivity associated
with the traumatic event(s), beginning or worsening after
the traumatic event(s) occurred, as evidenced by two or
more of the following:
1. irritable or aggressive behavior
2. reckless or self-destructive behavior (alcohol, drug,
eating, self-harm, high risk, promiscuity…)
3. hypervigilance
4. exaggerated startle response
5. problems with concentration
6. sleep disturbance (e.g., difficulty falling or staying
asleep or restless sleep)
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Empathic damage done to student by parent
1.
2.
3.
4.
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6.
7.
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9.
10.
Sense of Self-esteem
Sense of Safety
Affect Regulation Ability
Fear of Abandonment
Fear of Rejection
Trust Level Questioned
Fear of Betrayal
Fear of Blame
Sense of Control
Loss of Sense of Self In Larger
Picture/Context
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Let’s Look at Traumatized Families:
Adaptational Styles (Danieli)
• General family types are associated with
traumatic psychological responses:
– “Families of fighters,“
• Children had to adopt a “Fighter/Hero” identity to saty in
family and achieve parents’ goals for recognition and
redress
• Contempt and intolerance for dependency, weakness, or
failure
• Outside world seen as oppositional so aggressive
interaction the norm
• Children programmed to seek validation for parents’
suffering and to make their parents’ whole
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Adaptational Family Styles
– "the Numb family,"
• Pervasive silence and depletion of all emotions
• Parents capable of tolerating only minimal amount of
stimulation
• Children’s inner spontaneity and fantasy life severely
limited
• Parents protect each other and children protect the
parents
• Children adapt by numbing themselves or are
perpetually angry
• In attempt to please parents, try to excel in social
standard of achievements
• Children frequently accept outside role models over
parents to know how to live
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Adaptational Family Styles
– “Those who made it.“ families
• Motivated by magical fantasies during trauma
• Desire to “make it big”, regain power and control
– “Victim families”
• Pervasive depression, fear, worry, and distrust of
outside world
• Symbiotic clinging within the family
• Catastrophic reactions to everyday problems and
situations
• Guilt used as a form of control
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Two new categories to add to Danieli's
typology–
5. “Life goes on" families
Conspiracy of Silence
Advocacy for present and future gains
Children expected to achieve
6. “Split families."
– Ready acceptance of new members (“aunties”,
“uncles”, “daddies”, “siblings”…)
– Fluid membership-transfer between families
– Toleration of independence, parentification
– Creation of “new families” (eg. affiliation with gangs,
cults, groups, social institutions [churches]…
– Little parental oversight
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Holocaust Link:
Jewish and Native American
Holocaust
Survivors’ child complex
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Fixation to trauma
attempts to resolve past
1. Effects
• Nightmares
• Perceived
obligation to
ancestors
2. Coping strategies
• Memory Candles
(Living testaments)
Disenfranchised grief
•
Transposition
Loss cannot be openly •Living in the Past & Present
mourned
1. Individual
• Inhibited with
shame
1. 1st Generation
•Post Traumatic Stress
Disorder
2. Society
2. Subsequent Generations
• Loss of ancestral
•Historical Unresolved
tradition
Trauma
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Neurobiology of Trans-generational
Transmission of Trauma
Caveat: The genetic model of transmission may evoke
resistance because of its similarity with the Nazi ideology
of purifying the gene pool of the German race, it provides
a clear theoretical basis for future research.
– Parental traumatization may be transmitted in
the same manner as some hereditary
diseases are passed on from one generation
to another.
– Genetic memory code of a traumatized parent
may thus be transmitted to the child through
some electro-chemical processes in the brain.
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Genetic transmission
The neural organization of various memory systems in
the parent (e.g. hyperalertness) would lead to a
similar organization and constitution in the child.
Since psychic trauma is assumed to have long-term
effects on the neurochemical responses to stress in
traumatized parents it may also lead to the same
enduring characterological deficiencies and to a kind
of biological vulnerability in the child.
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Gene Environment Interaction
• New research helps answer the puzzling
question of why post-traumatic stress
doesn't happen to everyone who endures
horrible trauma.
• Researchers found that survivors of child
abuse were particularly likely to have
symptoms of post-traumatic stress as
adults if they also had specific variations in
a stress-related gene.
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We are concerned with the gene
for stress hormone systems
•Norepinephrine – “revving up” hormone
•Cortisol – “quieting down” hormone
Both hormones are released in response
to stress. They are normally in balance.
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Stress Response
• Designed to help mobilize ourselves to
cope with danger by responding in one or
more of the following behaviors:
Withdrawal –FLIGHT
Immobility-FREEZING
Aggression-FIGHT
Appeasement-SUBMISSION
Typically, our first reaction to danger is to freeze, to stop
all movement.
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A Threat Occurs: Human Stress
Response
Fight/flee/freeze
􀂆 State of high alert, hypervigilance
􀂆 Action, not thought
􀂆 Decreased ability to think clearly or completely
􀂆 Extremist thinking
􀂆 Attention to threat – tagged for mental priority
􀂆 Increased aggression – loss of impulse control
􀂆 Dissociation buffers CNS but fragments mental functioning
􀂆 Speechless terror – loss of words
􀂆 Action is successful or not=helplessness
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The Culprit-FKBP5
The FKBP5 gene is active in the biochemical
make-up of the body's stress-response
system.
• Early-life abuse can result in particularly potent
changes to this system as it develops — depending
partly on whether or not the variations are present in
the gene.
• The combination of the gene variations and past child
abuse were the key ingredients for the doubled PTSD
symptoms when a subsequent trauma occurred
• This finding suggests a gene/childhood environment
interaction for adult PTSD.
• Inherited variations in multiple genes, which have yet
to be identified, are estimated to account for 30 to 40
percent of the risk of developing PTSD.
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Research on Ancestral PTSD
• Found that low cortisol levels were significantly
associated with both PTSD in parents and
lifetime PTSD in offspring, whereas having a
current psychiatric diagnosis other than PTSD
was relatively, but non-significantly, associated
with higher cortisol levels.
– “Ancestral PTSD, a putative risk factor for PTSD, appears to
be associated with low cortisol level in offspring, even in the
absence of lifetime PTSD in the offspring. The findings
suggest that low cortisol levels in PTSD may constitute a
vulnerability marker related to parental PTSD as well as a
state-related characteristic associated with acute or chronic
PTSD symptoms”
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PHYSIOLOGIC DIFFERENCE
Depression, Stress, or Trauma
CRF
Gluco
Corticoid
Receptors
----HYPOTHALMUS
PITUATARY
ADRENAL
Gluco
Corticoid
Receptors
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Research Findings-FKBP5
• Research examines polymorphisms (variants of a
gene among a population) of a gene called FKBP5.
– Protein in this gene encodes is involved in mediating the
actions of the glucocorticoid receptor, which upon
activation moves into the nucleus of the cell and regulates
gene expression.
• Researchers discovered polymorphisms of FKBP5
were correlated with increased rates of PTSD in
adults who experienced traumatic stress, but only in
subjects who had experienced trauma previously or
who had inherited the morphism of their FKBP5
gene.
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FKBP5 Gene
• On its own FKBP5 polymporphism was not correlated with
adult PTSD-Mutation only happens in early childhood under
traumatic circumstances.
FOR EXAMPLE
A.
B.
A.
B.
Normal FKBP5 parent traumatized while serving in Iraq=no mutation
Parent abused repeatedly in first 5 years of life= possibility of
FKPB5 mutation which could then be passed on
Child inherits mutated FKBP5 gene and never experiences a
trauma=no PTSD (may have some symptoms)
Child inherits mutated FKBP5 gene and experiences a
trauma=substantially greater possibility of PTSD if no buffering
factors
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FKBP5 and HPA axis
• Identified genes were generally involved in
hypothalamic-pituitary-adrenal (HPA) axis,
signal transduction, or brain and immune cell
function.
– FKBP5, a modulator of glucocorticoid receptor (GR)
sensitivity, showed reduced expression in PTSD,
consistent with enhanced GR responsiveness.
– FKBP5 expression was predicted by cortisol when
entered with PTSD severity in regression
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HPA Axis Alterations
PTSD
Cortisol levels
Glucocorticoid receptors
Low
Increased
Negative feedback
Stronger
CSF CRF levels
Increased
Major Depression
High
Decreased
Weaker
Increased
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What does this biological state
do to the student’s body?
CRH
Short-term effect of cortisol
Glucose release from liver and
muscles
ACTH
cortisol
Long-term effects
Immune changes
Loss of muscle and bone mass
Loss of insulin sensitivity
Hippocampus neuronal death
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STRESS
Targets for Cortisol
•
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•
•
•
•
•
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Acute - enhances immune,
Memory, energy replenishment,
Cardiovascular function
Chronic suppresses immune,
impairs memory and attention via
effects on hippocampus and PFC;
Heightens fear via altering
amygdala;
Promotes bone & mineral
loss; induces metabolic
syndrome
Stress induced cortisol release
causes declarative memory
impairment
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Hippocampal Volume Reduction in PTSD
NORMAL
PTSD
MRI scan of the hippocampus in a normal control and
patient with PTSD secondary to childhood abuse. The
hippocampus, outlined in blue, is visibly smaller in PTSD.
Overall there was a 12% reduction in volume in PTSD.
Bremner et al., Am. J. Psychiatry 1995; 152:973-981;
Bremner et al., Biol. Psychiatry 1997; 41:23-32;
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Effects of Increased Cortisol
Effect on Child’s Brain:
Loss of neurons- pruning
Decreased myelination- as neurons are fired,
they strengthen the myelin by using proteins, hence the
brain is stronger
Decreased neurogenesis- growth of new brain
cells
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STAT5B
• Also less expressed in PTSD were STAT5B, a
direct inhibitor of GR (glucocorticoid receptor),
and major histocompatibility complex (MHC)
Class II.
• The Major Histocompatibility Complex (MHC) is
a set of molecules displayed on cell surfaces
that are responsible for lymphocyte recognition
and "antigen presentation". The MHC molecules
control the immune response through
recognition of "self" and "non-self"
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Early Stress and Stress
Reactivity: Gene Environment
Interaction
• Disrupt pre-programmed, gene transcription related to
stress reactivity during critical developmental period
– Disrupts developmental stress circuit integration
– Permanent behavioral and neurobiologic changes
• Gene variants can make individual more susceptible to
impact of trauma
– Polymorphisms of monoamine oxidase A and alcoholism
– Polymorphisms of serotonin transporter and depression
– Increased risk for psychiatric disorder
Caspi et al., 2003; Ducci et al., 2008
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Implications for Educators
• Safe, successful learning must maintain stress
hormone levels low enough to keep the
hippocampus functioning.
• That's why it's so crucial for both student and
teacher to know how to "apply the brakes" in class to keep the hippocampus in commission and return
it to action as promptly as possible when the system
goes on overload.
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The last thing we want to happen is that we
as educators add to that backpack!
QUESTIONS?
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