COSIG CONFERENCE BROCHURE.pdf - Drexel University College ...

COSIG Co-Occurring Disorders Conference, Hershey PA, May 15-17, 2006
PART II: TRAUMA AND SUBSTANCE
ABUSE USE: THE
NEUROPHYSIOLOGY
• HYPERAROUSAL RESPONSES:
1. Include both “flight” and “flight” responses,
enabling individual to take emergency action
in response to fear, terror, and danger.
a. “Fight” = self-defense.
b. “Flight” = removing self from danger.
2. Mediating processes: Catecholamines –
adrenaline and noradrenalin – and
hypothalamic pituitary axis.
PART II: TRAUMA AND SUBSTANCE
ABUSE USE: THE
NEUROPHYSIOLOGY
• HYPERAROUSAL RESPONSES:
3. Physiological responses of hyperarousal:
a. Increased heart rate.
b. Increased blood pressure.
c. Increased energy availability in skeletal muscles.
4. Observable manifestations of hyperarousal:
a. Highly focused attention
b. Sweating
c. Erect posture
PART II: TRAUMA AND SUBSTANCE
ABUSE USE: THE NEUROPHYSIOLOGY
• DISSOCIATION RESPONSES:
1. Dissociation involves “disengaging from stimuli in
the external world and attending to an internal
world” (Perry et al, 1995), in order to
“camouflage” oneself and child and buy time.
2. A dissociation continuum, depending on trauma
severity and circumstances. Dissociation
involves emotional numbing and withdrawal.
3. Mediating processes: Increase in vagal tone,
chemical activations, and feedback loops.
4. Physiological responses of dissociation:
a. Decrease in heart rate.
b. Decrease in blood pressure.
PART II: TRAUMA AND SUBSTANCE
ABUSE USE: THE NEUROPHYSIOLOGY
• DISSOCIATION RESPONSES (cont.):
5. Observable manifestations of dissociation:
a. Decreased movement
b. Compliance
c. Avoidance
d. Restrictive affect
PART II: TRAUMA AND SUBSTANCE
ABUSE USE: THE NEUROPHYSIOLOGY
• VARIABILITY OF PREFERENTIAL RESPONSES TO
DANGER AND THREAT:
1. Young children and females tend to dissociate.
2. Older children and adolescents tend to become
hyperaroused.
3. Child and adolescent may use combinations of
responses; responses may change over time.
PART II: TRAUMA AND SUBSTANCE
ABUSE USE: THE NEUROPHYSIOLOGY
• UNDERLYING BASIS OF NEUROBIOLOGICAL
DYSREGULATION CAUSED BY TRAUMA:
1. Hyperarousal system as the primary source of
dysregulation:
a. An adaptive response becomes maladaptive: problem
with turn-off, baseline, and reactivation.
b. Adaptive emergency “state” becomes maladaptive
“trait” (consistent pattern).
c. Impaired capacity for self-regulation.
d. Impact global: internal discomfort, impaired learning,
problem solving, daily functioning, and lack of
empathy.
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