The Silent Victims:

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29 Νοε 2013 (πριν από 3 χρόνια και 4 μήνες)

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The Silent Victims:

The Developmental Impact on
Children From Exposure to
Domestic Violence

Diane Zosky, Ph.D., ACSW, LCSW

Illinois State University

Prevalence

How Many Children Witness

Parental Domestic Violence?

30% of kids

3.3 Million

What do kids “witness”


Physical, verbal, threats, intimidation


May include overhearing from
somewhere else in the house


May not be present, but sense the signs
and tension of post
-
violence


May be used as tool of power and
control


Pet Abuse


May be used as tool of power and
control for human victims


May exert power and control directly


May threaten abuse of animal to coerce
silence from young victims


About 30% victims of family violence
experienced animal cruelty


About 60% of people who report animal
cruelty also report family violence


When children display animal cruelty,
very high rates of family violence or
child abuse

Children’s Awareness


One study found that children provide very detailed descriptions
of the violence when parents reported that the children were
unaware of the violence (Jaffe, Wolfe, and Wilson, 1990)



One study reported that 78% of children reported seeing
violence when their parents reported that there children did not
observe the domestic violence event (O’Brien, John, Margolin,
and Erel, 1994)



One study reported that 21% of children called someone for
help during the abuse, 23% of children became physically
involved in the violence trying to stop it, and 52% yelled from
another room for the violence to end (Edleson, Mbilinyi,
Beeman, Hagemeister, 2003)

Comparative Damage


Several studies have compared abused
children and children who have only
witnessed parental violence with
children from healthy environments


Children who have only witnessed
parental domestic violence appear to
suffer similar negative effects as
children who have been physically
abused

Danger to Children


O
bvious risks for children


Risk for child abuse

40%
-
60% of homes with DV


Risk for unintentional harm


children who witness may try to mediate






Danger to Children


Less obvious risks


Direct Path

trauma of witnessing violence





Danger to Children


Less Obvious Risks


Indirect Path
-

preoccupation of primary
caretakers render them unavailable as
auxiliary ego for developmental tasks


abused women more likely to be depressed


45%
-
85% of abused women/mothers
diagnosed with PTSD


In regression analysis of severity of
violence and maternal stress as predictors
of behavioral disorders and social
competence of kids, only maternal stress
remained as predictor


violence = maternal stress= kids’ problems


Related Issues


Home
-
life characterized by instability


Poor problem solving modeling


Models for aggression


Gender role modeling



male = aggressive



female = passive

What do these kids look like???


Impact on Social/Emotional
Development

Negative Effects


Externalizing Effects


Internalizing Effects


Social Competence Effects


Somatic Symptoms


Family
-
Interpersonal Relationship
Effects


Externalizing Effects


Aggression


Acting out


Delinquency


Hyperactivity


Post
-
Traumatic Play


Internalizing Effects


Low Self
-
Esteem


Depression


Isolation and Withdrawal


Guilt


Sense of Helplessness


Lack of efficacy


Lower frustration tolerance


Internalizing Effects


Emotional Constriction


Anxiety
-

generalized and specific fears


Regression in developmental
achievements


Social Competence Effects


Impaired school performance


Inappropriate social interaction


Less sensitive with interpersonal
interactions


Poor social problem solving skills


Fewer interests, activities

Somatic Symptoms


Nightmares and sleep disturbances


Bed wetting


Somatic complaints


Regression in developmental
achievements


Family, Interpersonal
Relationships


Separation anxiety with Mom


Mistrust/Anger towards Mom


Splitting with Dad


Role reversal, parentification of child


Inappropriate attempts to mediate
conflict


Enforced family secrets

So What causes these kids to
react this way????


Developmental (Attachment)
Needs of Children

What Do Kids Need?


Affirmed as loved, valued individual



Security, stability, consistency

Why do they need this?


Formation of self
-
identity


Formation of expectations of other

Neuro
-
physiological
development




* Bruce Perry’s work on trauma and the
neurobiology of brain development

3 important concepts of neuro
-
physiological development


Development is sequential


Development is characterized by
“sensitivity” or peak periods of
receptivity for optimal development


Use
-
dependent nature of development

Overview of Brain Development

As infants, born with only primitive brain
function from ANS

Followed by rapid brain development from less
to more complex

Brain development is sequential and dependent
on periods of “sensitivity”

Major working unit of brain is neurons, neurons
form into networks, then into systems which
mediate various functions


Levels of Brain Development


Brain develops from
most primitive areas
to more complex


From autonomic
functions to
purposeful thought


From brainstem, to
midbrain, to limbic,
to cortical

Brainstem Functions:

most primitive functions


Regulates autonomic
functions for life
sustaining activity


Body temperature


Heart rate


Blood pressure


respiration

brainstem

Midbrain

continues from the brainstem


Arousal


Sleep


Appetite


Motor regulation

midbrain

Limbic system:

much that makes us human


Emotional reactivity


Sexual behavior


Attachment


affiliation

Limbic system

Cortex:

“Our Computer”


Higher level thought


Concrete thinking


Abstract thinking

cortex

Sequential development


Brainstem, midbrain, limbic system
more primitive areas develop first


Higher functioning of cortical areas
develop later


As the higher functions of brain
develop, they modulate, mediate, or
control lower more primitive, reactive
functions of the brain


Higher level cortical functioning
mediates impulsivity of lower areas


A 2 year old will tantrum and act out
impulses from more primitive brain


A 12 year old will
FEEL

like throwing a
tantrum but will over
-
ride this impulse
with higher level cortical reasoning.

Impulse
-
mediating capacity


Ratio between excitatory activity of
lower brain and modulating activity of
higher brain


Increase activity or reactivity of
brainstem, or decrease in moderating
capacity of higher brain =


Increase impulsivity, aggression,
violence


“So What” of all this


Since brain development is sequential,


Higher level development will be
impaired if lower level development is
impaired.


Earliest experiences have
disproportionate importance in
developing mature brain


“How” The brain developments


Undeveloped brain comprised of
undifferentiated neural systems
(translation: It’s a blob)


Dependent on neurochemical and
neurtrophic factors (cues, chemicals) to
develop



cues are dependent on input from the
senses from child’s total experiences


Lack of or disruption in cues contribute
to disrupted brain development



2
nd

principle of brain
development: Sensitivity


Critical periods for specific development


Brain is sensitive to “organizing
experiences” because it is “primed” for
the neurochemical signals triggered by
the sensory input from the “organizing
experiences”


Child has experience


Leads to input information through the
senses


Leads to triggers for neurochemical
activity


Leads to neuronal development, “brain
development”

Use
-
dependent neuronal
development


Exposure to repeated experiences are
used to create “shortcuts” for increased
efficiency of brain response

The Miracle of Our Brain

Brain system is designed to sense,
perceive, process, store, and act on
information received from the
External
and
Internal

environments


Survival of the Species


As evolved animals, we still are
instinctual


Humans, due to instinct, are pre
-
adapted for :


Survival


Adaptive Nature of Brain


In order to survive:


brain designed to change in response to
signals


change permits storage of information
so it can respond to environmental
demand = SURVIVAL


Use
-
Dependent Neuronal
Change


All experiences are filtered by the
senses


Sensory signals stimulates processes in
brain that alters brain chemistry and
structure

“State” vs “Trait”


The more “use” of a response, the more
it becomes an indelible template for
automatic response


What would be a “state” response
memory in adults becomes a “trait” for
children since it becomes incorporated
into brain structuralization

2 ANS Paths for Child
response to Threat


The Hyper
-
arousal Continuum


Defensive or Fight/Flight Response



The Dissociative Continuum


Freeze or Surrender Response

Hyper
-
arousal Response


Threat perceived, SNS activated


Instinctual fight or flight response


Release of stress hormones from the
endocrine system, neurotransmitters
(brain chemicals) in the brain system


System flooded with cortisol,
norepinephrin



Increase in heart rate


Increase in BP


Increase respirations


Increase in pupil dilation


Decrease in digestion, release of stored sugar


Increase in muscle tone


Increase in perspiration



Increase in hyper
-
vigilance


Increase in “tunnel focus” or tune out
non
-
critical information


Dissociative Continuum


First response is vocalization, cry


As threat escalates, freeze response


Advance to dissociation, or disengage
from external world to internal world

Neuro
-
chemistry


Still regulated from the PNS and
primitive areas of the brain


Stimulate activity from dopaminergic
systems and endogenous opioids


Decrease in heart rate


Decrease in BP


Insensitivity to pain

The “So What” of these 2
threat response paths


“The Resilience Myth”


Children are NOT resilient, they are
ADAPTIVE!!!!


However, in adapting to threatening
environment for survival, they adopt
maladaptive methods for engaging the
rest of their experiences

Intergenerational Transmission


“God don’t make junk”


If we don’t invest in our children, the
problem doesn’t go away, it just gets
bigger and continues for the next
generation

Intergenerational
Transmission

What We Know About Batterers


82% of men convicted of DV were
either abused as children or witnessed
their parents domestic violence


Low self
-
esteem


Inability to regulate affect, self
-
soothe


Intense abandonment anxiety


Boundary diffusion


High correlation with personality
disorders of borderline, narcissistic,
antisocial


Ambivalence over dependency needs


Rigid gender roles


Need for control


Defenses of minimization and denial