1. Trauma and the Adolescent Brain
Presented to: Tahal 2nd International Conference:
Shedding Light on the Darkness of Abuse
Wednesday, December 2, 2015
Sandi L. Isaacson, Ph.D.
Midwest Neuroeducational Services
Overland Park, KS

2. How Our Brains Develop Environment Parent – Child Interaction Genes
Epigenetics: the study of external or environmental factors that turn genes on and off and affect how cells read genes.
In Utero

3. How Our Brains Develop Brains develop from back to front,
from sensorimotor and emotion areas to thinking areas
“Feeling brain”
subcortical
late
early
prefronatal
cortex
sensorimotor
“Thinking brain”
“Acting brain”

4. Our “Thinking brains” are not fully developed until our 20’s!
How Our Brains Develop
Our “Thinking brains” are not fully developed until our 20’s!
Prefrontal
Cortex

5. Adolescent brains are in a period of tremendous reorganization!

6. Adolescent Brain
Rapid developmental shifts in brain structures and networks
Transition from “feeling” and “acting” brain to “thinking” brain
Affect/Action
Thinking/Planning
Limbic activation vs. dorsal (control) network – executive fx.
vs.

7. Trauma and the Brain
Many factors affect how trauma influences brain development:
Genetics
Gender
Age
Social Support
Trauma Characteristics
Type
Severity
Length
<5 worse than >5
Physical/sexual abuse > neglect/emotional abuse
Multiple forms of maltreatment
Severe sexual abuse
Interactions of gender x age x type of trauma

8. Trauma and Cognitive Functioning
Intelligence (IQ)
Language
Academic Achievement
Reading
Visual Attention
Memory
Learning
Executive Functioning
All adversely affected by trauma!

9. Multiple brain networks are affected by trauma:
Trauma and the Brain
Multiple brain networks are affected by trauma:
LHPA
LC-N/SNS-C
Serotonin
Oxytocin
Networks are interrelated and affect each other
Stress results in adverse brain development through aptosis (early neural death), delays in mylenation, abnormal pruning, inhibition of neurogenesis, decreased brain growth.
Immune

10. Brain Networks and Trauma

11. LHPA (Limbic-Hypothalamic-Pituitary-Adrenal Axis)
Controls release of cortisol
Affects immune functioning, learning, memory
Priming: hyper-response to later stress
Too HIGH: INTERNALIZING behaviors - depression, anxiety
Too LOW: EXTERNALIZING behaviors – antisocial, aggressive, disruptive
Increased anxiety, aggression, hypervigilance,
Decreased feeding and sexual behavior
Premature aging, chronic mental/physical health problems

12. LC-N/SNS-C Locus Coeruleus-Norepinepherine/Sympathetic Nervous System/Catecholamine
Norepinepherine (adrenaline) = “fight or flight”
Inhibits thinking
Increases survival/alertness
Increased activity – PTSD
Decreased activity – Antisocial behavior, DISSOCIATION

13. Serotonin Operates mainly in midbrain
Affects mood, behavior, cognitive functioning, motor functioning and appetite
Also affects body rhythms:
Cardiovascular
Circadian
Neuroendocrine
Respiratory
Sleep
Midbrain = prefrontal cortex, amygdala, hippocampus

14. Oxytocin Regulates interpersonal relationships:
Sexual response
Social cognition and memory
Emotional recognition
Empathy
Attachment
Particularly affected by emotional abuse
Affects girls more than boys --- promiscuity

15. Immune/NEI Network NEI = Neuroendocrine Immune Network
Stress a cytokines a inflammation a depression
Long term effects seen in adulthood:
Hypertension
Atherosclerosis
Metabolic Syndrome
Increased Body Mass Index (BMI)
Often manifests in adolescence and adulthood
Also bipolar disorder, schizophrenia, substance abuse

16. Is There Hope?
Only 22% of those abused as children determined to be “resilient”
BUT…
Enriched environment
Social support network
Are crucial in limiting damage.
Address sleep issues through medication/therapy
CBT effective in decreasing fear response
Supportive, enriching environments are crucial
Return to biological parents is NOT always the answer – maltreated kids in foster care showed less self-destructive behavior, substance abuse, total risk behavior and better academic grades at 6 yr follow up than kids reunited with bio parents