Samenvatting literatuur - Consequences of child abuse (6463)

THE BOY WHO WAS RAISED
AS A DOG
https://www.worldsupporter.org/nl/chapter/86171-summary-boy-who-was-raised-dog-perry

Peery & Szalavitz (2017)

TINA’S WORLD
Characteristics patient

 Tina
 7 year old girl
 African-american
 3ft tall
 Tiny and fragile

Case

 Tina lived with her mother (Sara) and 2 younger siblings.
 Behavior: aggressive and inappropriate
o She exposed herself, attacked other children, used sexual language
and tried to get them to engage in sex play.
 2-year abused
o Start when she was 4.
o Ended when she was 6.
 Perpetrator was 16-year old boy  babysitter’s son.
o Molested Tina and her younger brother Michael.
o Tied the children and rape them.
 Home situation
o Tina’s mom is a single parent.
o Poor  mom had a minimum wage job.
o The children are home alone until Sara comes home.
 Brain problems
o Brainstem
 Sleep & attention problems
o Diencephalon & cortex
 Difficulties with fine motor control & coordination
o Limbic & cortex
 Social and relational delays & deficits
o Cortex
 Speech & language problems
 Tina has a abnormal/poorly regulated stress-response-system(?)

, o In Tina’s case the repeated activation of her stress-response-systems
from a trauma endured at a young age, when her brain was still
developing, had probably caused a cascade of altered receptors,
sensitivity, and dysfunction throughout her brain.

Story

 Took place at University of Chicago
 After the door closed Tina sat on the psychiatric lap and moved her hand to
his crotch.
 Psychiatric suggest to color  Tina seems upset.
 Tina had only known men as sexual predators.
 The only adults males she’d met were her mother’s often inappropriate
boyfriends and her own abuser.
 For the next 40 minutes the psychiatric and Tina sat on the floor, side by side,
coloring quietly.
 The psychiatric presented Tina’s case to his first supervisor Dr. Stine.
 Dr. Stine think she has ADD, but the psychiatric is not so sure. He feels that
Tina was experiencing something more.
 Psychiatric has another supervisor: Dr. Dyrud.
 Dr Dyrud advice is to get to know Tina and not her symptoms  psychiatric
has to find out about her life.
 For the next few sessions the psychiatric and Tina spent time coloring or
playing simple games and talking about what she liked to do.
 Later that fall, however Tina was late to therapy for several weeks in a row.
 One day the psychiatric saw the family waiting for the bus in the cold and give
them a ride home.
 Later in the year Sara and her family moved to an apartment closer to the
medical center.
 The psychiatric labeled Tina: she has PTSD.
 Over 3 years the psychiatric has worked with Tina.
 Unfortunately 2 weeks before the psychiatric left the clinic, Tina was caught
performing fellatio on an older boy at school.

General information

History

 In 1987 child psychiatric had not embraced the neurosciences.
 The expansion of research on the brain and brain development exploded in
1990.

Brain

 Neurons

, o 86 billion neurons (brain cells) and for each neuron there are also
equally important support cells (galia)
o During development (from birth to early adulthood) all for these
complicated cells must be organized into specialized networks.
o This results in countless intricately interconnected and highly
specialized systems.
 4 major brain parts:
o Brainstem
 Simple
 Evolved first
 Function
 Body temperature
 Heart rate
 Respiration
 Blood pressure
o Diencephalon
 Central region  simple
 Evolved first
 Function
 Emotional responses that guide behavior, like fear,
hatred, love and joy.
o Limbic system
 More complex
 Completely internal
 Function
 Emotional responses that guide behavior.
o Cortex
 Function
 Speech & language
 Abstract thinking
 Planning
 Decision making
 Organized in a hierarchical fashion:
bottom to top, inside to outside.
 While interconnected, each of these 4
main areas controls a separate set of
functions.
 Stress and the brain
o The stress-response-system can, if poorly regulated or abnormal,
cause dysfunction in all 4 main eras of the brain.

Memory

,  Memory = a basic property of biological systems. The capacity to carry
forward in time some element of an experience.
o Memory is what the brain does, how it composes us and allows our
past to determine our future.
o It is through association that people weave all of our incoming sensory
signals together to create the whole person, place, thing, and action.
Association allows and underlies both language and memory.
o All of the previously stored experiences has laid down the neural
networks, the memory “template”, that you now use to make sense out
of any new incoming information.
o Early experiences will necessarily have a far greater impact than later
ones.

FOR YOUR OWN GOOD
Characteristics patient

 Sandy
 Girl
 3 years old
 Sleeping problems and pervasively anxious
 Episodic period of daydreaming  extremely difficult to snap her her out of it
 Aggressive, tantrum-like outbursts

Case

 Sandy had witnessed the rape & murder of her own mother.
 Sandy’s throat was cut twice and left for dead.
 She was alone with her dead mother’s body for eleven hours in their
apartment. Then she has been hospitalized due to injuries she’d received
during the crime.
 Sandy does not have a therapist
 Sandy is in foster care. For 9 months she’s moved from foster home to foster
gone with no counseling or psychiatric care.
 Sandy didn’t want to use silverware  especially knives. She refused to drink
milk or even look at a milk bottle. And when the doorbell rang she would hide.

Story

 Year: 1990
 Psychiatric is now an assistant professor at the University of Chicago.
 The case: homicide  story plays after almost a year later. Stan ask
psychiatric to help prepare her for court.
 Psychiatric ask Stan who the therapist is  there is no therapist.
 Sandy knew the murderer. There was other evidence  so does Sandy needs
to testify?