Brianna C. Delker

The Neurobiology of Intervention and Prevention in Early Adversity

Early adverse experiences are well understood to affect development and well-being, placing individuals at risk for negative physical and mental health outcomes. A growing literature documents the effects of adversity on developing neurobiological systems. Fewer studies have examined stress neurobiology to understand how to mitigate the effects of early adversity. This review summarizes the research on three neurobiological systems relevant to interventions for populations experiencing high levels of early adversity: the hypothalamic-adrenal-pituitary axis, the prefrontal cortex regions involved in executive functioning, and the system involved in threat detection and response, particularly the amygdala. Also discussed is the emerging field of epigenetics and related interventions to mitigate early adversity. Further emphasized is the need for intervention research to integrate knowledge about the neurobiological effects of prenatal stressors (e.g., drug use, alcohol exposure) and early adversity. The review concludes with a discussion of the implications of this research topic for clinical psychology practice and public policy.

Maternal abuse history and self-regulation difficulties in preadolescence ☆

Although poor parenting is known to be closely linked to self-regulation difficulties in early childhood, comparatively little is understood about the role of other risk factors in the early caregiving environment (such as a parents own experiences of childhood abuse) in developmental pathways of self-regulation into adolescence. Using a longitudinal design, this study aimed to examine how a mothers history of abuse in childhood relates to her offsprings self-regulation difficulties in preadolescence. Maternal controlling parenting and exposure to intimate partner aggression in the childs first 24-36 months were examined as important early social and environmental influences that may explain the proposed connection between maternal abuse history and preadolescent self-regulation. An ethnically diverse sample of mothers (N=488) who were identified as at-risk for child maltreatment was recruited at the time of their childrens birth. Mothers and their children were assessed annually from the childs birth through 36 months, and at age 9-11 years. Structural equation modeling and bootstrap tests of indirect effects were conducted to address the study aims. Findings indicated that maternal abuse history indirectly predicted their childrens self-regulation difficulties in preadolescence mainly through maternal controlling parenting in early childhood, but not through maternal exposure to aggression by an intimate partner. Maternal history of childhood abuse and maternal controlling parenting in her childs early life may have long-term developmental implications for child self-regulation.

Hypervigilance in college students: associations with betrayal and dissociation and psychometric properties in a brief hypervigilance scale

Betrayal trauma theory (Freyd, 1994, 1996) proposes that traumas high in social betrayal are expected to lead to psychological outcomes of dissociation, amnesia, and/or shame because these responses are adaptive to a survivor trying to preserve a necessary relationship in the face of mistreatment. Within the field of trauma studies more generally, there is substantial support for the proposition that traumas that cause intense fear should lead to posttraumatic anxiety and hypervigilance. Despite ample evidence for both theorized causal pathways, very few studies have tested associations between betrayal exposure, hypervigilance, and dissociation. The current study had 2 aims: first, as no self-report measure of hypervigilance had been developed for nonveteran populations, we sought to identify a subset of Hypervigilance Questionnaire (Knight, 1993) items that validly and reliably measure hypervigilance within college undergraduates (n = 489; 62.6% female, 69.9% Caucasian) with and without elevated levels of posttraumatic stress. Second, we tested the associations among trauma history, hypervigilance, and dissociation. Psychometric analyses revealed 5 hypervigilance items we introduce as the Brief Hypervigilance Scale. Partial correlations revealed that each posttraumatic response was not related to a history of low betrayal trauma (i.e. non-interpersonal trauma) controlling for betrayal trauma (i.e. interpersonal trauma), but was related to betrayal trauma controlling for low betrayal trauma. These associations remained significant after controlling for the other posttraumatic response (i.e. hypervigilance or dissociation). Follow-up analyses revealed that hypervigilance was independently associated with adult, but not child high betrayal trauma, and the opposite was true for dissociation. Implications for theory, research, and clinical practice are discussed.

Betrayed? That’s Me: Implicit and Explicit Betrayed Self-Concept in Young Adults Abused as Children

ABSTRACT Attenuated awareness of betrayal, or “betrayal blindness,” is a proposed survival mechanism in relationships where awareness of betrayal will mobilize confront-or-withdraw responses that jeopardize a needed relationship. Empirical tests of betrayal blindness and its effects are hampered by the methodological conundrum of how to measure an absence of awareness. The purpose of this study was to evaluate the validity of a novel empirical method to measure implicit betrayed self-concept, the first step in a long-term research aim to operationalize “betrayal blindness.” Informed by betrayal trauma theory, we hypothesized that a history of betrayal within close childhood relationships (but not recent close relationships or “not-close” relationships) would predict implicit betrayed-self associations in young adulthood. An adaptation of the Implicit Association Test (IAT) and measured implicit and explicit betrayed-self associations and self-reported history of physical, sexual, and psychological abuse in 529 university undergraduates was designed. Internal consistency reliability of the betrayed self IAT was low but adequate. Hierarchical regression modeling revealed that history of abuse within close childhood relationships (but not recent close relationships or “not-close” relationships) predicted betrayed-self IAT scores. The effect size was small, β = .12, p < .05, 95% CI [.01, .07], R2 = .12. In addition, history of betrayal by someone close (but not someone “not close”) at any age predicted increased explicit evaluations of the self as betrayed versus respected, a small effect size, R2 = .16. Findings indicate that implicit betrayed self-concept can be measured empirically.

Polyvictimization in childhood and its adverse impacts across the lifespan: Introduction to the special issue

ABSTRACT Although much empirical work has focused on the adverse impact of specific types of childhood victimization (e.g., sexual, physical, or emotional abuse), researchers and clinicians increasingly are recognizing the prevalence of polyvictimization, or exposure to multiple types of victimization. Polyvictimization during formative developmental periods may have detrimental and potentially lifelong biopsychosocial impacts over and above the effects of exposure to specific types of adversity. In this guest editorial, we summarize the key questions and findings for six empirical studies on polyvictimization included in this Special Issue of the Journal of Trauma & Dissociation. These empirical studies further our understanding of the nature, consequences, and assessment of polyvictimization. We conclude with recommendations for continued scientific research and clinical inquiry on polyvictimization.

When Home Is Where the Harm Is: Family Betrayal and Posttraumatic Outcomes in Young Adulthood

ABSTRACT Research on institutional betrayal has found that institutional wrongdoing that fails to prevent or respond supportively to victims of abuse adds to the burden of trauma. In this two-study investigation with young adult university students, we demonstrated parallels between institutional betrayal and ways that families can fail to prevent or respond supportively to child abuse perpetrated by a trusted other, a phenomenon we call family betrayal (FB). In Study 1, psychometric analysis of a new FB questionnaire provided evidence of its internal consistency, unidimensionality, and convergent and discriminant validity. The majority (approximately 72%) of young adults abused in childhood reported a history of FB, with an average of 4.26 FB events (SD = 4.45, range 0–14). Consistent with betrayal trauma theory, Study 2 revealed that FB was 4× more likely to occur in relation to childhood abuse by someone very close to the victim (vs. non-interpersonal victimization), with a particularly strong effect for female participants. FB history predicted significant delay to disclosure of a self-identified worst traumatic event (ηp2 = .017) and significant increases in dissociation (∆R2 = .05) and posttraumatic stress (∆R2 = .07) symptoms in young adulthood. Moreover, with FB in the regression models, only FB—not child abuse nor recent interpersonal victimization—predicted dissociation and clinically significant elevations in posttraumatic stress. Findings suggest that FB is a prevalent phenomenon among young adults abused as children and that it explains unique, clinically significant variance in posttraumatic distress, warranting increased attention from trauma researchers and clinicians.

Out of harm's way: Secure versus insecure–disorganized attachment predicts less adolescent risk taking related to childhood poverty

Although some risk taking in adolescence is normative, evidence suggests that adolescents raised in conditions of socioeconomic disadvantage are disproportionately burdened with risk taking and its negative consequences. Using longitudinal data from the NICHD Study of Early Child Care and Youth Development, we investigated quality of the early caregiving environment as a potential prospective buffer against the long-term association between childhood poverty and adolescent risk taking. Multicategorical moderation model results indicated that if raised in poverty across age 1-54 months (average family income to needs ratio ≤ 1.02), relative to affluence (income to needs ratio ≥ 6.16), adolescents with histories of secure attachment to caregivers exhibited two times the number of risk behaviors at age 15, whereas adolescents with insecure-disorganized histories exhibited nearly five times the number of risk behaviors. Both early family economic hardship and history of insecure-disorganized attachment remained significant predictors of increased adolescent risk taking, alongside the interactive effect. Probing the interactions region of significance revealed that history of secure (vs. insecure-disorganized) attachment is associated with protective reductions in risk taking below a family income to needs ratio of 2.24, or about 220% poverty level. Findings support a diathesis-stress model in which children with secure attachment histories are less deleteriously impacted by early socioeconomic adversity than their insecure-disorganized peers.