Given recent attention to emotion regulation as a potentially unifying function of diverse symptom presentations, there is a need for comprehensive measures that adequately assess difficulties in emotion regulation among adults. This paper (a) proposes an integrative conceptualization of emotion regulation as involving not just the modulation of emotional arousal, but also the awareness, understanding, and acceptance of emotions, and the ability to act in desired ways regardless of emotional state; and (b) begins to explore the factor structure and psychometric properties of a new measure, the Difficulties in Emotion Regulation Scale (DERS). Two samples of undergraduate students completed questionnaire packets. Preliminary findings suggest that the DERS has high internal consistency, good test–retest reliability, and adequate construct and predictive validity.

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Multidimensional Assessment of Emotion Regulation and Dysregulation: Development, Factor Structure, and Initial Validation of the Difficulties in Emotion Regulation Scale

Erik Eriksen is a remarkable individual. He has no college degrees yet is Professor of Human Development at Harvard University. He came to psychology via art, which explains why the reader will find him painting contexts and backgrounds rather than stating dull facts and concepts. He has been a training psychoanalyst for many years as well as a perceptive observer of cultural and social settings and their effect on growing up. This is not just a book on childhood. It is a panorama of our society. Anxiety in young children, apathy in American Indians, confusion in veterans of war, and arrogance in young Nazis are scrutinized under the psychoanalytic magnifying glass. The material is well written and devoid of technical jargon. The theme of the volume is that it is human to have a long childhood which will leave a lifelong residue of emotional immaturity in man. Primitive groups and

Childhood and Society.

Brains, it has recently been argued, are essentially prediction machines. They are bundles of cells that support perception and action by constantly attempting to match incoming sensory inputs with top-down expectations or predictions. This is achieved using a hierarchical generative model that aims to minimize prediction error within a bidirectional cascade of cortical processing. Such accounts offer a unifying model of perception and action, illuminate the functional role of attention, and may neatly capture the special contribution of cortical processing to adaptive success. This target article critically examines this "hierarchical prediction machine" approach, concluding that it offers the best clue yet to the shape of a unified science of mind and action. Sections 1 and 2 lay out the key elements and implications of the approach. Section 3 explores a variety of pitfalls and challenges, spanning the evidential, the methodological, and the more properly conceptual. The paper ends (sections 4 and 5) by asking how such approaches might impact our more general vision of mind, experience, and agency.

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Whatever next? Predictive brains, situated agents, and the future of cognitive science

Childhood maltreatment has been linked to a variety of changes in brain structure and function and stress–responsive neurobiological systems. Epidemiological studies have documented the impact of childhood maltreatment on health and emotional well–being. After a brief review of the neurobiology of childhood trauma, we use the Adverse Childhood Experiences (ACE) Study as an epidemiological “case example” of the convergence between epidemiologic and neurobiological evidence of the effects of childhood trauma. The ACE Study included 17,337 adult HMO members and assessed 8 adverse childhood experiences (ACEs) including abuse, witnessing domestic violence, and serious household dysfunction. We used the number of ACEs (ACE score) as a measure of cumulative childhood stress and hypothesized a "doseresponse" relationship of the ACE score to 18 selected outcomes and to the total number of these outcomes (comorbidity). Based upon logistic regression analysis, the risk of every outcome in the affective, somatic, substance abuse, memory, sexual,and aggressionrelated domains increased in a graded fashion as the ACE score increased (P <0.001). The mean number of comorbid outcomes tripled across the range of the ACE score. The graded relationship of the ACE score to 18 different outcomes in multiple domains theoretically parallels the cumulative exposure of the developing brain to the stress response with resulting impairment in multiple brain structures and functions.

https://traumasensitiveschools.org/wp-content/uploads/2013/06/Anda-Article-Enduring-Effects-of-Abuse.pdf

The enduring effects of abuse and related adverse experiences in childhood: A convergence of evidence from neurobiology and epidemiology

Risky families are characterized by conflict and aggression and by relationships that are cold, unsupportive, and neglectful. These family characteristics create vulnerabilities and/or interact with genetically based vulnerabilities in offspring that produce disruptions in psychosocial functioning (specifically emotion processing and social competence), disruptions in stress-responsive biological regulatory systems, including sympathetic-adrenomedullary and hypothalamic-pituitary-adrenocortical functioning, and poor health behaviors, especially substance abuse. This integrated biobehavioral profile leads to consequent accumulating risk for mental health disorders, major chronic diseases, and early mortality. We conclude that childhood family environments represent vital links for understanding mental and physical health across the life span.

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Risky Families: Family Social Environments and the Mental and Physical Health of Offspring

Childhood trauma has profound impact on the emotional, behavioral, cognitive, social, and physical functioning of children. Developmental experiences determine the organizational and functional status of the mature brain. The impact of rruumufic experiences on the development and function of the brain are discussed in context of basic principles of neurodevelopment. There are various adaptive mental and physical responses to trauma, including physiological hyperarousal and dissociation. Because the developing brain organizes and internalizes new information in a use-dependent fashion, the more a child is in a state of hyperarousal or dissociation, the more likely they are to have neuropsychiatric symptoms following trauma. The acute adaptive states, when they persist, can become maladaptive traits. The clinical implications of this new neurodevelopmental conceptualization of childhood trauma are discussed.

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Childhood trauma, the neurobiology of adaptation, and "use-dependent" development of the brain: How "states" become "traits."

THE current diathesis-stress model of schizophrenia proposes that a genetic deficit creates a predisposing vulnerability in the form of oversenstivity to stress. This model positions all psychosocial events on the stress side of the diathesis-stress equation. As an example of hypotheses that emerge when consideration is given to repositioning adverse life events as potential contributors to the diathesis, this article examines one possible explanation for the high prevalence of child abuse found in adults diagnosed schizophrenic. A traumagenic neurodevelopmental (TN) model of schizophrenia is presented, documenting the similarities between the effects of traumatic events on the developing brain and the biological abnormalities found in persons diagnosed with schizophrenia, including overreactivity of the hypothalamic–pituitary–adrenal (HPA) axis; dopamine, norepinephrine, and serotonin abnormalities; and structural changes to the brain such as hippocampal damage, cerebral atrophy, ventricular enlargement, and reversed cerebral asymmetry. The TN model offers potential explanations for other findings in schizophrenia research beyond oversensitivity to stress, including cognitive impairment, pathways to positive and negative symptoms, and the relationship between psychotic and dissociative symptomatology. It is recommended that clinicians and researchers explore the presence of early adverse life events in adults with psychotic symptoms in order to ensure comprehensive formulations and appropriate treatment plans, and to further investigate the hypotheses generated by the TN model.

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The contribution of early traumatic events to schizophrenia in some patients: a traumagenic neurodevelopmental model

This article provides the theoretical rationale and overview of a neurodevelopmentally-informed approach to therapeutic work with maltreated and traumatized children and youth. Rather than focusing on any specific therapeutic technique, the Neurosequential Model of Therapeutics (NMT) allows identification of the key systems and areas in the brain which have been impacted by adverse developmental experiences and helps target the selection and sequence of therapeutic, enrichment, and educational activities. In the preliminary applications of this approach in a variety of clinical settings, the outcomes have been positive. More in depth evaluation of this approach is warranted, and is underway. Over the last 30 years, key findings in developmental neurobiology have informed and influenced practice in several clinical disciplines, including pediatrics, psychology, social work, and psychiatry. Despite this influence, the capacity of these large clinical fields to incorporate and translate key neurobiological principles into practice, program, and policy has been inefficient and inconsistent. The purpose of this article is to present preliminary efforts to integrate core concepts of neurodevelopment into a practical clinical approach with maltreated children. This neurosequential model of therapeutics (NMT) has been utilized in a variety of clinical settings such as therapeutic preschools, outpatient mental health clinics, and residential treatment centers with promising results (Perry, 2006; Barfield et al., 2009).

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Examining Child Maltreatment Through a Neurodevelopmental Lens: Clinical Applications of the Neurosequential Model of Therapeutics

Studies of childhood abuse and neglect have important lessons for considerations of nature and nurture. While each child has unique genetic potentials, both human and animal studies point to important needs that every child has, and severe long-term consequences for brain function if those needs are not met. The effects of the childhood environment, favorable or unfavorable, interact with all the processes of neurodevelopment (neurogenesis, migration, differentiation, apop- tosis, arborization, synaptogenesis, synaptic sculpting, and myelination). The time courses of all these neural processes are reviewed here along with statements of core principles for both genetic and environmental influences on all of these processes. Evidence is presented that development of synaptic pathways tends to be a "use it or lose it" proposition. Abuse studies from the author's laboratory, studies of children in orphanages who lacked emotional contact, and a large number of animal deprivation and enrichment studies point to the need for children and young nonhuman mammals to have both stable emotional attachments with and touch from primary adult caregivers, and spontaneous interactions with peers. If these connections are lacking, brain development both of caring behavior and cognitive capacities is damaged in a lasting fashion. These effects of experience on the brain imply that effects of modern technology can be positive but need to be monitored. While technology has raised opportunities for children to become economically secure and literate, more recent inadvertent impacts of technology have spawned declines in extended families, family meals, and spontaneous peer interactions. The latter changes have deprived many children of experiences that promote positive growth of the cognitive and caring potentials of their developing brains.

http://centerforchildwelfare.fmhi.usf.edu/kb/ChronicNeglect/ChildExperience.pdf

Bruce D. Perry

Papers

Childhood trauma, the neurobiology of adaptation, and "use-dependent" development of the brain: How "states" become "traits."

The contribution of early traumatic events to schizophrenia in some patients: a traumagenic neurodevelopmental model

Examining Child Maltreatment Through a Neurodevelopmental Lens: Clinical Applications of the Neurosequential Model of Therapeutics

Childhood Experience and the Expression of Genetic Potential: What Childhood Neglect Tells Us About Nature and Nurture

Incubated in terror: Neurodevelopmental factors in the "cycle of violence."