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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

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SLIDE 1

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

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SLIDE 2

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

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SLIDE 3

Re se ar c h que stions for today

  • Psyc ho lo g ic a l:
  • Ca n CAPA re lia b ly

a sse ss unre so lve d tra uma in yo ung c hildre n?

  • Do diffe re nt
  • utc o me s o f CAPA

indic a te diffe re nt risk

  • f psyc hia tric

sympto ms?

  • Physio lo g ic a l:
  • Ca n b io c he mic a ls

pro vide e vide nc e fo r a ro usa l le ve ls

  • b se rve d in CAPA?
  • Diffe re nt pic ture s fo r

diffe re nt stra te g ie 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

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SLIDE 4

T he par tic ipants

Contr

  • l (11 c hildr

e n)

  • 3-8 ye a rs living

with a t le a st o ne b io lo g ic a l pa re nt, no invo lve me nt with me nta l he a lth o r so c ia l se rvic e .

T r auma (21/ 30 c hildr e n)

  • 3-8 ye a rs

re fe rre d b y so c ia l se rvic e s, no L D.

the inte rna tio na l a sso c ia tio n fo r the stud y o f a tta c hme nt

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SLIDE 5

De sign: same for all!

the inte rna tio na l a sso c ia tio n fo r the stud y o f a tta c hme nt

  • 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
  • f CAPA (b e fo re &a fte r CAPA, a nd 3 mo re a t 30 minute inte rva ls.
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SLIDE 6

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
  • 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

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SLIDE 7

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 .

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SLIDE 8

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).

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SLIDE 9

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

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SLIDE 10

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

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SLIDE 11

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.

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SLIDE 12

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

  • e hampton.ac .uk
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SLIDE 13

F rankfurt, 2012 Camb ridg e , 2010 Be rtino ro , 2008 Miami, 2015

T

  • download pr
  • gr

am mate r ials, c lic k he r e

https:/ / www.ia sa - dmm.org / ia sa - c onfe re nc e /