Unde rsta nding c hildhood tra uma with T he Child Atta c hme nt a nd Pla y Asse ssme nt: e vide nc e from psyc holog ic a l a nd physiolog ic a l pe rspe c tive s F a n Zha ng China, Unive r sity of Roe phampton, UK fanzhang0801@gmail.c om
T he Child Attac hme nt and Play Asse ssme nt (CAPA) • Use s na rra tive ste m sto rie s to a sse ss a tta c hme nt, pla y a nd me nta lising in c hildre n a g e d 3-11 ye a rs. • T he o ry b a sis: DDM, Winnic o tt’ s Po te ntia l Spa c e . • 6-8 sto rie s, pla y-b a se d pro c e dure with pro ps. • Vide o ta pe d, the n a na lyse d b y a re lia b le c o de r. Ob se rva tio n o f b e ha vio urs inste a d o f ve rb a l c o nte nt. • CAPA Co ding Ma nua l (F a rnfie ld, 2015) the inte rna tio na l a sso c ia tio n fo r the stud y o f a tta c hme nt
Re se ar c h que stions for today • Psyc ho lo g ic a l: • Physio lo g ic a l: - Ca n CAPA re lia b ly - Ca n b io c he mic a ls a sse ss unre so lve d pro vide e vide nc e tra uma in yo ung fo r a ro usa l le ve ls c hildre n? o b se rve d in CAPA? - Do diffe re nt - Diffe re nt pic ture s fo r o utc o me s o f CAPA diffe re nt stra te g ie s? indic a te diffe re nt risk o f psyc hia tric sympto ms? the inte rna tio na l a sso c ia tio n fo r the stud y o f a tta c hme nt
T he par tic ipants Contr ol (11 c hildr e n) T r auma (21/ 30 c hildr e n) • 3-8 ye a rs living • 3-8 ye a rs with a t le a st o ne re fe rre d b y b io lo g ic a l so c ia l se rvic e s, pa re nt, no no L D. invo lve me nt with me nta l he a lth o r so c ia l se rvic e . the inte rna tio na l a sso c ia tio n fo r the stud y o f a tta c hme nt
De sign: same for all! - Psyc ho me tric : T ra uma Sympto ms Che c klist fo r Yo ung Childre n (Brie re , 2001) RL - re spo nse le ve l AT R – a lle via te d tra uma re spo nse ANX – a nxie ty DE P – de pre ssio n ANG – a ng e r PT S-1 – po st tra uma stre ss-intrusio n PT S-AV – po st tra uma stre ss-a vo ida nc e PT S-AR – po st tra uma stre ss-a ro usa l PT S-T OT – po st tra uma stre ss-to ta l DI S – disso c ia tio n SC – se xua l c o nc e rns - L a ng ua g e : T e st fo r Audito ry Co mpre he nsio n o f L a ng ua g e -3 (Ca rro w-Wo o lfo lk, 1999) - De ve lo pme nta l a nd tra uma histo ry q ue stio nna ire - CAPA - Sa liva sa mple s: 5 thro ug ho ut a b a se line da y, the n 5 o n the da y o f CAPA (b e fo re &a fte r CAPA, a nd 3 mo re a t 30 minute inte rva ls. the inte rna tio na l a sso c ia tio n fo r the stud y o f a tta c hme nt
Pr e liminar y findings: Psyc hologic al - Utr mo difie r is a stro ng pre dic to r fo r hig he r T sc o re s in ANX, DE P, ANG, PT S-I , PT S-AV, PT S-AR, PT S-T OT , DI S a nd SC, a nd a lmo st AT R (sig =0.07) - Be ing in the tra uma g ro up o nly pre dic te d hig he r T sc o re s in ANX, PT S-I , PT S-AR, PT S-T OT , a nd a lmo st ANG (sig =0.051), DI S (sig =0.052) - Childre n who se stra te g ie s we re A&C5+ sc o re d sig nific a ntly hig he r o n ANX, ANG, PT S-I , PT S-AV, PT S-AR, PT S-T OT ,DI S a nd SC, c o mpa re d to B a nd A&C- - A&C3,4 sc o re d sig nific a ntly hig he r o n PT S-AR, PT S-T OT , DI S tha n B,A&C- - A&C5+ o nly ha d hig he r PT S-AR tha n A&C3,4 the inte rna tio na l a sso c ia tio n fo r the stud y o f a tta c hme nt
Bioc he mic als - Co rtiso l is a ho rmo ne , indic a to r o f e le va te d psyc ho lo g ic a l stre ss. Sa liva ry le ve l e le va tio n de te c te d with a time de la y o f 10-30 minute s. Diurna l pa tte rn, de c re a sing thro ug h the da y. No rma tive le ve ls diffe r with g e nde r a nd a g e . - Alpha -a myla se is a n e nzyme , indic a to r o f Sympa the tic Ne rvo us Syste m do mina nc e . Sa liva ry le ve l e le va tio n de te c te d insta ntly. Diurna l pa tte rn, inc re a sing thro ug h the da y. No rma tive le ve ls diffe r with g e nde r a nd a g e . the inte rna tio na l a sso c ia tio n fo r the stud y o f a tta c hme nt
Pr e liminar y findings: 3 c hildr e n - L is a n 8 ye a r o ld g irl, who se stra te g y is A1. - E is a 5 ye a r o ld g irl, B5 a nd L ’ s siste r. - G is a 5 ye a r o ld b o y, who se stra te g y is C1,2. De spite b e ing the yo ung e st, G ha d the hig he st c o rtiso l da ily b a se line me a sure me a ns. Ho we ve r, this diffe re nc e wa s no t sig nific a nt. G’ s da ily c o rtiso l me a n wa s a lmo st sig nific a ntly hig he r tha n E , so me o ne ne a r his o wn a g e (sig =.052). T he re wa s sig nific a nt diffe re nc e in me a n da ily a lpha - a myla se le ve ls o n b a se line da y. G still the hig he st. (Sig =.003) No sig nific a nt diffe re nc e b e twe e n L a nd E , b ut G’ s a lpha - a myla se me a n wa s sig nific a ntly hig he r tha n b o th L a nd E (Sig =.005 a nd .003 re spe c tive ly). the inte rna tio na l a sso c ia tio n fo r the stud y o f a tta c hme nt
Cortisol Clinic a l Da y Sa mple s the inte rna tio na l a sso c ia tio n fo r the stud y o f a tta c hme nt
Alpha- amylase Clinic al Day Sample s the inte rna tio na l a sso c ia tio n fo r the stud y o f a tta c hme nt
E ar ly Conc lusions - CAPA is a re lia b le a nd va lid a sse ssme nt fo r sympto ms o f tra uma a nd o the r psyc hia tric diso rde rs in yo ung c hildre n. - Childre n who se CAPA o utc o me s indic a te d hig h A&C stra te g ie s do e xpe rie nc e mo re se ve re me nta l he a lth issue s. - T he impo rta nc e o f tra uma a ro usa l ne e d to b e furthe r e xplo re d. - Amo ng no rma tive c hildre n, C stra te g y c o uld b e pro ve n to ha ve hig he r a ro usa l le ve l tha n A a nd B, b ut le ss fluc tua tio n. - Alpha -a myla se ma y b e a b e tte r stre ss le ve l indic a to r tha n c o rtiso l fo r sho rt a sse ssme nts. the inte rna tio na l a sso c ia tio n fo r the stud y o f a tta c hme nt
T hank you! zhangf@r oe hampton.ac .uk the inte rna tio na l a sso c ia tio n fo r the stud y o f a tta c hme nt
Be rtino ro , 2008 Camb ridg e , 2010 T o download pr ogr am mate r ials, c lic k he r e https:/ / www.ia sa - dmm.org / ia sa - c onfe re nc e / F rankfurt, 2012 Miami, 2015
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