Slide 1

Brain and Mind

•Mind<= /span> =3D cognition, emotion & behaviour

•= Brain includes structure & function – cells, synapses; neurotransmitters;

•All= mind functions reflect functions of the brain, autonomic nerv= ous system and some body sensations =

•Dif= ferent brain ar= eas involved in different mind functions, with multiple connec= tions

•= Mind effects of CAN well documented

•CAN effects on brain being studied with postulated explan= ations for mind effects

------=_NextPart_01C932A3.5A5B22F0 Content-Location: file:///C:/D4F25912/Day1Glaser_files/slide0035.htm Content-Transfer-Encoding: quoted-printable Content-Type: text/html; charset="us-ascii" Slide 1

Brain-mi= nd Equivalents

•Left frontal lobe activity associated with approach behaviour and positive emotion

•Right frontal lobe activity associated with withdrawal behaviour and negative emotion

•

•Right brain development do= minant in infancy – including attachment experiences

= •Right brain dominant for e= motion = processing (+ limbic system)

•

•Prefrontal cortex –

–<= /span>Executive function:

•Inhibition or response, set shift, se= lective attention, plann= ing

–<= /span>Emotion regulation

------=_NextPart_01C932A3.5A5B22F0 Content-Location: file:///C:/D4F25912/Day1Glaser_files/slide0038.htm Content-Transfer-Encoding: quoted-printable Content-Type: text/html; charset="us-ascii" Slide 1

Axon=

Cell=

Body=

Dend= rites

Neur= o-

Tran= smitters incl. dopamine, nora= drenaline, sero= tonin

N= ERVE CELL =3D NEURON

S= YNAPSE

Proc= ess

------=_NextPart_01C932A3.5A5B22F0 Content-Location: file:///C:/D4F25912/Day1Glaser_files/slide0038_image001.gif Content-Transfer-Encoding: base64 Content-Type: image/gif R0lGODlhHgD7AHcAMSH+GlNvZnR3YXJlOiBNaWNyb3NvZnQgT2ZmaWNlACH5BAEAAAAALAEAAAAb APoAgQAAAAAAAJnMAP///wL/hBGny23pGIwzIntq05ZnLG2gqHjj9ZwUqjpmm8KuPNOhvbyw3vKq fwKCAsKOQFDcHI/J3JJJCzyhu+kyKbVef9onMNulGsPeMbnsOls94CmxvXWuA4M6XIzQ0uv8OzKj xyfol0AoOKiXt3bY10XkyDhA+BB4OAm42HfHQfjmKKG2lhaKBxrq4yeKkYo2RIb1WaXaMytbKtuk lCuxS4Lz8QsczBLcezNsnDMcg7xM/Jtc4hwtXDx9vUzNbJ2N3dwN/i3OPQ7tTY5uHp6Oo/3cfq5e Dr8uz27jnh9PP4+/71+P370o/wgGBNjPYEIZ+g4qHMiwYESHExfukHiRYkaLjj0wdtT4keMPjyNB lhQZhGRKkytRjmjocojKlzNlsqR502bMVTV55vS5s0NPoT+JBl1RFOnRGkt9Qdz4NGTUk1NbVsXZ 9NhVnVuBdjX6VWlYpmOd2jsrEC3CslrVPnRbka2ypGThQrUrFS9VvVb5DtFWiFuyCsY07OIUV1pe xVjNiq0L2fFcrm29Tm4MoAAAOw== ------=_NextPart_01C932A3.5A5B22F0 Content-Location: file:///C:/D4F25912/Day1Glaser_files/slide0038_image002.gif Content-Transfer-Encoding: base64 Content-Type: image/gif R0lGODlhFQA+AXcAMSH+GlNvZnR3YXJlOiBNaWNyb3NvZnQgT2ZmaWNlACH5BAEAAAAALAAAAAAT ADwBgQAAAAAAAJnMAP///wL/hI8Zacv9mkMzglrthVrlvoGKOJLHB6KdagUC+7gvKQvzaud3VOts r9tRgsRPL4AMYnyDZjLnODanwIV0OqhelNjjSYn0Dom+GBnKO8OAQnM5habZYAykiXOnx+54k77O F5IX+FcyyFdIQbiIyHj46OcY2UgJSSN5WTlpKZJ4gtkJmiK6Qqrh2ZfJOaqpuvnqGhvaOrtaSstq e2rawsvju4d7q9srvGtcTPyLvKwc7AzI/AxbS51rPYx9DG2onezdDD4te02ebb4tHs2tKF3nGaX6 l6FnlN6+no8/Htjv/w8woMCBBAsKXBNunz47wxJZcdcN3TeJCTvBmyMHI5w3wy3IrFGT5kybLT6K jJkTIIsYklC6lKmCJYsSlnNcxqGZ0snML1Ce3GwgUqMCkT884th5iuNRhyPPVaPIr9zTqVKrOrV6 j+rVrVmxTtTaletXrxXJRhVbFu3ZsGzHqtUH1m3btHPXyr1LF6/dvHz3+oVrFvDbiHH7Cq57WG9i w4QDNx6ssPDfx4gpK7bMOLJjzZA/QeRcGfRl0Zk9szOtDvNk0qtRQ13cOpVk2LRV12Z92/Vs2x4G wZMdrl5iFAjPFgdQAAA7 ------=_NextPart_01C932A3.5A5B22F0 Content-Location: file:///C:/D4F25912/Day1Glaser_files/slide0038_image003.gif Content-Transfer-Encoding: base64 Content-Type: image/gif R0lGODlhCwANAHcAMSH+GlNvZnR3YXJlOiBNaWNyb3NvZnQgT2ZmaWNlACH5BAEAAAAALAAAAAAJ AAsAgwAAALzf4dbAus3My8XW1sDb3f5pHvtxPfh9WPGNc+mfjuCwpgECAwECAwECAwECAwQk0Mg5 j70X6b2T/58ijuNinqegruvgvi9AzPQMAEWe3zwQBLwIADs= ------=_NextPart_01C932A3.5A5B22F0 Content-Location: file:///C:/D4F25912/Day1Glaser_files/slide0038_image004.gif Content-Transfer-Encoding: base64 Content-Type: image/gif R0lGODlhCgBJAHcAMSH+GlNvZnR3YXJlOiBNaWNyb3NvZnQgT2ZmaWNlACH5BAEAAAAALAMAAAAF AEYAgAAAAAAAAAIqBGKGuZr3GmSx0uvwzHx7CVpdqJGj+KFmWqpuC58xK9f0TQb6viu6bykAADs= ------=_NextPart_01C932A3.5A5B22F0 Content-Location: file:///C:/D4F25912/Day1Glaser_files/slide0038_image005.gif Content-Transfer-Encoding: base64 Content-Type: image/gif R0lGODlhCgAxAHcAMSH+GlNvZnR3YXJlOiBNaWNyb3NvZnQgT2ZmaWNlACH5BAEAAAAALAIAAAAG AC8AgAAAAAAAAAInBGKJedy8lIuGPgmnzhz7un0X2JGihYbmOrZp6apxFdT2Tdc5REUFADs= ------=_NextPart_01C932A3.5A5B22F0 Content-Location: file:///C:/D4F25912/Day1Glaser_files/slide0039.htm Content-Transfer-Encoding: quoted-printable Content-Type: text/html; charset="us-ascii" Slide 1

Brain Development = (1)

•<= b>Most neurons formed / migrated in embryo/early post-natal life. •Brain growth greatest in 1st yr, spurt continuing into 4th year. •In 1st 2 yrs, serial overproduction of axons & dendrites, their myelination, glial cells and vasculature.

•Randomly connected synapses

•Genetically determined stepwise sequence of synaptogenesis in = brain areas & later pruning of synapses.<= /span>

------=_NextPart_01C932A3.5A5B22F0 Content-Location: file:///C:/D4F25912/Day1Glaser_files/slide0040.htm Content-Transfer-Encoding: quoted-printable Content-Type: text/html; charset="us-ascii" Slide 1

Brain Development= (2)

•= Experience determines = which synapses are pruned =

•(Cr= itical) sensitive periods for different brain= areas to remain open/receptive to no= rmal, expected & required experiences

•=3D Experience expectant development=

•If = no experience during (long) sensitive period, capacity for that function is lost

•= Nature of experience will determine wh= ich synapses will survive (e.g. = sounds in a particular language- ‘r’ & ‘l’ not in Japan)

------=_NextPart_01C932A3.5A5B22F0 Content-Location: file:///C:/D4F25912/Day1Glaser_files/slide0041.htm Content-Transfer-Encoding: quoted-printable Content-Type: text/html; charset="us-ascii" Slide 1

Brain Development= (3)

•Exp= erience dependent development =3D new learning =

•Not dependent on critical/sensitive period= s

•New synapses formed=

•Lifelong learning &= amp; neural plasticity

•BUT= - New learning/synapses do not replace previous synapses

•The longer the ‘old’ information continues, the longer later learning of ‘= replacement information’ takes

------=_NextPart_01C932A3.5A5B22F0 Content-Location: file:///C:/D4F25912/Day1Glaser_files/slide0037.htm Content-Transfer-Encoding: quoted-printable Content-Type: text/html; charset="us-ascii" Slide 1

Five issues

•<= /span>Effects on developing brain, of:- = ;

•

–<= /span>Prenatal exposure and experience =

–

–<= /span>Extreme deprivation

–

–<= /span>Adaptation to experiences =

–

–<= /span>Stress

•and

• &#= 13;

•<= /span>Gene-environment interactions

•

------=_NextPart_01C932A3.5A5B22F0 Content-Location: file:///C:/D4F25912/Day1Glaser_files/slide0036.htm Content-Transfer-Encoding: quoted-printable Content-Type: text/html; charset="us-ascii" Slide 1

Prenatal Factors<= /span>

•Alcohol abuse

•Drug abuse

•Maternal Stress

•

•No legal mandate to influence maternal behaviour & therefore <= /span>no legal protection of foetus=

------=_NextPart_01C932A3.5A5B22F0 Content-Location: file:///C:/D4F25912/Day1Glaser_files/slide0077.htm Content-Transfer-Encoding: quoted-printable Content-Type: text/html; charset="us-ascii" Slide 1

Prenatal factors

•<= /span>Opiates

–<= /span>Probably no damage to brain but stress of withdrawal

•<= /span>Cocaine

–<= /span> Coca= ine affects developing systems in the brain (dopamine, serotonin, noradrenaline (“Reward” neuro= transmitters) à executive function and regulation of level of emotional arousal

–<= /span>crucial to how brain forms structurally

–<= /span>Also critical to connectivity across brain regions, e.g., which impacts the gating of levels of stimulation to prefrontal cortex and hence, when “switch̶= 1; between predominantly exe= cutive and automatic responding occurs

•<= /span>Neurobehavioral effects including

–<= /span>increased emotional lability, distractibility, impulsivity, impaired attent= ion to novel, structured tasks, decreased inhibition & switching

–<= /span>Longer response times (disrupted connectivity in frontal brain regions)

------=_NextPart_01C932A3.5A5B22F0 Content-Location: file:///C:/D4F25912/Day1Glaser_files/slide0078.htm Content-Transfer-Encoding: quoted-printable Content-Type: text/html; charset="us-ascii" Slide 1

Prenatal effects

&#= 8226;Foetal alcohol syndrome

&#= 8226;Foetal alcohol effects

–Structural effects on total brain size, hippocampus, frontal lobes, corpus = callosum and basal ganglia

–= Neurobehavioural effects

•= Delayed motor and speech

•= Hearing impairments

•= Slower or less efficient information processing

•= Mathematical and short term memory deficits

•= Mental retardation

•= Behavioral problems

------=_NextPart_01C932A3.5A5B22F0 Content-Location: file:///C:/D4F25912/Day1Glaser_files/slide0042.htm Content-Transfer-Encoding: quoted-printable Content-Type: text/html; charset="us-ascii" Slide 1

Extreme deprivation/neglect

= 226;Probable sensitive period for developing stranger wariness < 3 yrs.

= 226;If no selective attachment formed by 3 years, children may become disinihibited in their approach to strangers

&#= 8226; ?Sensitive peri= ods for affect regulation

= 226;? Sensitive period for normal development of oxytocin – vasopressin system=

–No rise in TO & VP in ex-orphanage children following play with adopt. mothers

------=_NextPart_01C932A3.5A5B22F0 Content-Location: file:///C:/D4F25912/Day1Glaser_files/slide0080.htm Content-Transfer-Encoding: quoted-printable Content-Type: text/html; charset="us-ascii" Slide 1

Neglect

•Reduced brain size

•Reduced brain activity

•Reduced brain development

–Corpus callosum

•? Sensitive period or delayed maturation

•

------=_NextPart_01C932A3.5A5B22F0 Content-Location: file:///C:/D4F25912/Day1Glaser_files/slide0073.htm Content-Transfer-Encoding: quoted-printable Content-Type: text/html; charset="us-ascii" Slide 1

Adaptation to abusive experience

= 226;ERP response amplitudes elevated in physically abused children, when target is angry face (> happy face).

= 226;Physically abused children interpret ambiguous frightened/sad-angry

facial expressions as angry.

= 226;Neglected children had more difficulty in = distinguishing between different = emotions.

= 226;Normally reared children distinguished different emotions.

------=_NextPart_01C932A3.5A5B22F0 Content-Location: file:///C:/D4F25912/Day1Glaser_files/slide0044.htm Content-Transfer-Encoding: quoted-printable Content-Type: text/html; charset="us-ascii" Slide 1

Stress in CAN

&#= 8226;Direct effect of physical violence

&= #8211;Fear, pain

&#= 8226;Effect of observing domestic violence

&= #8211;Fear

&#= 8226;Sexual abuse

–Fear, powerlessness, psychological discomfort – trauma

&#= 8226;Neglect

= 211;Fear of abandonment, discomfort/pain not alleviated, hunger or other deprivation

•

------=_NextPart_01C932A3.5A5B22F0 Content-Location: file:///C:/D4F25912/Day1Glaser_files/slide0045.htm Content-Transfer-Encoding: quoted-printable Content-Type: text/html; charset="us-ascii" Slide 1

Stress Response

•Physiological & psychological coping = mechanism

•

•Necessary for survival

•

•Enduring individual variations in stress = response, based on differences in temperament = and on prior experience

------=_NextPart_01C932A3.5A5B22F0 Content-Location: file:///C:/D4F25912/Day1Glaser_files/slide0046.htm Content-Transfer-Encoding: quoted-printable Content-Type: text/html; charset="us-ascii" Slide 1

Stress Response

= 226;Sympathetic nervous system (immediate)

- adrena= line & noradrenaline

fight or flight response

• elevated hea= rt rate & blood pressure

• elevated blo= od glucose

&#= 8226;Decreased vasopressin & oxytocin =

&#= 8226;Neurotransmitter system

= 226;Hypothalamic-pituitary-adrenal axis (HPA)

------=_NextPart_01C932A3.5A5B22F0 Content-Location: file:///C:/D4F25912/Day1Glaser_files/slide0075.htm Content-Transfer-Encoding: quoted-printable Content-Type: text/html; charset="us-ascii" Slide 1

Oxytocin & vasopressin

•Associated with

–Reduced stress

–

–Affiliative love

–Maternal caregiving

–

------=_NextPart_01C932A3.5A5B22F0 Content-Location: file:///C:/D4F25912/Day1Glaser_files/slide0048.htm Content-Transfer-Encoding: quoted-printable Content-Type: text/html; charset="us-ascii" Slide 1

Stress pathway= s

STRESS

Prefrontal cortex =

&nb= sp; Dopamine<= /span> à

Inattention, hypervigilance, emotional dysregulation

Amygdala

noradrenaline

Locus <= /b>coeruleus

Hypothalamus

HPA Axis<= /div>

------=_NextPart_01C932A3.5A5B22F0 Content-Location: file:///C:/D4F25912/Day1Glaser_files/slide0048_image006.gif Content-Transfer-Encoding: base64 Content-Type: image/gif R0lGODlhbQAhAHcAMSH+GlNvZnR3YXJlOiBNaWNyb3NvZnQgT2ZmaWNlACH5BAEAAAAALAAAAABr AB8AgAAAAAAAAAJshI+py+0PowRh2ouzprv7b1XgSJJiiabXqbbuwr6yG892Wd+6l+8+1vsJI8Gh kVE8Kg/JpbLpNEKjwinVZ73qslobtyv7gmnjqLicOqNx62f7qH5/4vIOva6544GBvv8PGCg4SFho eIiY2FcAADs= ------=_NextPart_01C932A3.5A5B22F0 Content-Location: file:///C:/D4F25912/Day1Glaser_files/slide0048_image007.gif Content-Transfer-Encoding: base64 Content-Type: image/gif R0lGODlhtAChAHcAMSH+GlNvZnR3YXJlOiBNaWNyb3NvZnQgT2ZmaWNlACH5BAEAAAAALAAAAACz AJ8AgAAAAAAAAAL/jI+py+0Po5y02gay3rz7D4biSJbmiaadobbuC8cyzM72jec6V+/+DwzyAsKi 8UgjIpfM5krpjEqFvan1aqtit1yUtgsOe77icphsTmPR6naU7Y4j4fJ6kG7P6/D6/ozvF+gCKFh4 QmiYKIKo2PjkCJnCGOk4SaloeWmYqSnI2en3CaonOmpXaiqHmuq2yqrm+moWKytGWwt2i8ulu7sG 5dvYGzw1TPwGfFxorMzE3DyXDN33PF1UbX0nnV2Hze3j/b23Ld4WXn5zjv5Hvl6m7p4UHwc/31Jv L9mev4XPb+LvH4mAAhftKyiFIMIPChc+csjrIMQlDSdmqGgR40SN4xA5OvS4ECRCkQVJCjT5DyU/ lflY2nM5D2Y8me5orrOJDmc5neJ4fvPJDWg2odaITjMKDWkzpcqYHnNKDGowqb6o7rKKC2strbK4 vvLKCmwqsabIjjILCm0ntZrYXnJLCW4kuZDoVpJo0YhdYXjzUunrF8heTIADgytseFxiZIudDE70 eBPixlkmU5YReZnly/I4H8nsabPne6JH6zN9rTRqgKpXD2zt2mDsH6AD1Q4FezbD3Lof9sZxmxrv 3xqCkxpOHIDxPMtPISfevNvz39FVTe9dnd513Re6e/8OPrz48QUAADs= ------=_NextPart_01C932A3.5A5B22F0 Content-Location: file:///C:/D4F25912/Day1Glaser_files/slide0048_image008.gif Content-Transfer-Encoding: base64 Content-Type: image/gif R0lGODlhMQHnAHcAMSH+GlNvZnR3YXJlOiBNaWNyb3NvZnQgT2ZmaWNlACH5BAEAAAAALAAAAQAv AeUAgAAAAAAAAAL/hI+py+0Wnpy02ouz3rz7DypRSJbmiabqyo3sC8fyTIdujef6zoN3DwwKh7Uf 8YhMKi/GpfMJJTaj1Kr1Nb1qt1xNtgsOiw/fsflMLaPXbGn7DUeq4/T6am7P6z/4vf9f0Qc4SJgg WIgIeJjImLfYCAn3GEmJNlmJGXaZyam12Qka9RlKqjRaijp0msrKs9oKWxQ7W/VKe6tii7tbosv7 6+ELPJwhTHxMYYy83KDM/IzgDA0tPc1cbY2MnU28zQ3s/c0bLo5LXk57jh6rvt7a7p4KH186Tx9q f9+Zr5/J31/pH8BIAgc2KmgwEcKEhRYyHOTw4Z+IEvdQrOgIo7uL/xrpcOwoCWS5jyLZkCxpCSW3 kyrHsGypCea0lzAC2LyJM6fOnTx7+vwJNKjQoUR3JqGJZeRRgkrlMBVHESkLqWKiPv1mFRLVmE61 Nj2yNUXYLlkPfnXjFerStFjXmlXb9W3buIzGcilb96yqqyvd5oULlm82vAr1CrFrArEnv4UBo5Xb l27juYHZRq4MeTBjRIqvEOZsOEhnG6GBjPZRusdpPqldCbb2uWHrHauDzdZRu0PuJ7EJFf0NPLjw 4cRvbpbZDfmz3cpFN1/G/Llr6cmpD4tuHQf27DS2c5fh/XtN8bvCk79z/pb59CjWs0/8nl18WO7n o7YvD39+/fX49//3jw+AAQq4D4EFGugPggkqGBCDDTr4GoSySZgZhb5Z+BeGE2p4IYeK5OShHziF KKJxJFpU34k2nchiiy6+CGOMMs5IY4023ohjjjruyGOPPv64QXFCDklkkb89lOJjBiW5F0NMHoYk PU86MaVpUcZTpSlSGslll0PGkOV0qHgTJm2skCnlmWCmuV9SWKo53pttTsXmmGvKaWecG8Hp5p5z oofnf32uU2Ygd/qZ56DoFJrMoYTySWegpKAp6YCK3kYJpYgKGummkzq6KKSAemrpVF6eimqqQYkK pBWMQviqg7EyOKuCtSJ4q4G5ErirgL0C+Kt/wfI3rH7F4nesfck0zrdsfM2+9yx70aY37XnVknet eNl+ty133Wb3rXXhUjeudOU+d25z6Sq3rhSqvgvviPMVAAA7 ------=_NextPart_01C932A3.5A5B22F0 Content-Location: file:///C:/D4F25912/Day1Glaser_files/slide0048_image009.gif Content-Transfer-Encoding: base64 Content-Type: image/gif R0lGODlhdABaAHcAMSH+GlNvZnR3YXJlOiBNaWNyb3NvZnQgT2ZmaWNlACH5BAEAAAAALAEABQBv AFQAgAAAAAAAAALmhI+py+0PozShhomz3txWDoYi6I3miSJlyrba97nyzFz0jVN2zrtxD0TtgsTQ r4h8DZPMyLIJrT2j1MOxigVMs9ArN+r9NrdiZLhsJqOD6nXv7AbC47w2/Ta/4+16Wb7vB0j0J8hC WCiE+ManaHLYKMIIaSQ52VFp+ZI587iZ0ek5gRnqNEr6AHqKqipkyrqQ+grrKqtSG0l7q5V7y1sb q6sT3DG8ARx8rOsrm9y7/PrM2vwbrVp9Os18Tbodmg3d7fktXaxU/hm+mZ45br1u+T7Zjh0PWd84 z32vuI+Y792vUEBEBQAAOw== ------=_NextPart_01C932A3.5A5B22F0 Content-Location: file:///C:/D4F25912/Day1Glaser_files/slide0048_image010.gif Content-Transfer-Encoding: base64 Content-Type: image/gif R0lGODlhMgBIAHcAMSH+GlNvZnR3YXJlOiBNaWNyb3NvZnQgT2ZmaWNlACH5BAEAAAAALAEABQAs AEIAgAAAAAAAAAJ9hI+pyxrRopQPznvrw5zWDi5aSB6WVYJoGm4sub5cLGd0TeHdrTNuP+EBE8Kh qWgEII3L4S8pgjaawKcUQe1lddarYYsD17pescz8Il/RLHbK/fY65ER63f7F5/VKPhzG16f31xJI qOJnmDioyOj4aHe404gnOUMZuQhpVwAAOw== ------=_NextPart_01C932A3.5A5B22F0 Content-Location: file:///C:/D4F25912/Day1Glaser_files/slide0048_image011.gif Content-Transfer-Encoding: base64 Content-Type: image/gif R0lGODlhCgAVAHcAMSH+GlNvZnR3YXJlOiBNaWNyb3NvZnQgT2ZmaWNlACH5BAEAAAAALAIAAgAF ABMAgAAAAAAAAAITBGKGGtv44lPp1EUTtvr6DmZZAQA7 ------=_NextPart_01C932A3.5A5B22F0 Content-Location: file:///C:/D4F25912/Day1Glaser_files/slide0048_image012.gif Content-Transfer-Encoding: base64 Content-Type: image/gif R0lGODlhqwB2AHcAMSH+GlNvZnR3YXJlOiBNaWNyb3NvZnQgT2ZmaWNlACH5BAEAAAAALAAAAACq AHUAgAAAAAAAAAL/jI+py+0Po5y0WoCz3rz7D4biSJbmWRroyrbuC7dqTNf2jWNzzvf+D9gBh8Ri KmBMKpc6JPMJ5Qmj1Cpras1qQdit99v9iq3hsflZPquN6bX7137LcfG5PVa/66/Ovb+W9ycYEjho yFF4qBjUt+jI1fgouZE46VdpqYeZabfJKef56RYqqkZaanaKKqa66tXqqgUbSxZJ+zd7G5Wri2bb e8cLrCQ8zPZr/FacPLTMDIf8fOYsLRVdzXqN/aq9LdvtXRu+Rj2OB24OVZ7uss7O954dD4Y+f2y/ 5Y5Por8v0u8PUsAqAAd2KGiQUr2EORAybPKQicOHExlWTHjRYMaBaxsDdvT3cV9IfCPtlZx3Ml7K dyvZtUz30lzMcTPD1fR2c1tObDur9ZT281lQZkOTFTV2dFhSYEt7NdX19FZUWlNjVXV1dVVWVFtL dRX19VNYTmMzlbV0dlJaSWsftXX0dpGFuXTr2r2LF28BADs= ------=_NextPart_01C932A3.5A5B22F0 Content-Location: file:///C:/D4F25912/Day1Glaser_files/slide0048_image013.gif Content-Transfer-Encoding: base64 Content-Type: image/gif R0lGODlhCgAiAHcAMSH+GlNvZnR3YXJlOiBNaWNyb3NvZnQgT2ZmaWNlACH5BAEAAAAALAIAAQAG AB4AgAAAAAAAAAIehGOJCavcoDuyshmvfbrzT3khmJFLgKaNuqLK5AIFADs= ------=_NextPart_01C932A3.5A5B22F0 Content-Location: file:///C:/D4F25912/Day1Glaser_files/slide0048_image014.gif Content-Transfer-Encoding: base64 Content-Type: image/gif R0lGODlhKgAXAHcAMSH+GlNvZnR3YXJlOiBNaWNyb3NvZnQgT2ZmaWNlACH5BAEAAAAALAEAAQAl ABEAgAAAAAAAAAIvTICpy+1gnpwt0jvNwbzuDiJWCI4kp53lp15mm7GwlM4xK9viUeuL9vJBesIh sAAAOw== ------=_NextPart_01C932A3.5A5B22F0 Content-Location: file:///C:/D4F25912/Day1Glaser_files/slide0049.htm Content-Transfer-Encoding: quoted-printable Content-Type: text/html; charset="us-ascii" Slide 1

Hypothal= amic-pituitary-adrenal Axis

= 226;Physiological hormonal pathway, connecting brain to adrenal cortex

&#= 8226;Corticotropin Releasing Factor (CRF)

•

•ACTH   adre= nal cortex    cortisol
•=3D Negative feedback loop&= #13;

&#= 8226;Diurnal cortisol level variation

R= 11; – up morning,   down afternoo= n

&#= 8226;CRF à vasopressin & oxytocin

R= 11; =

------=_NextPart_01C932A3.5A5B22F0 Content-Location: file:///C:/D4F25912/Day1Glaser_files/slide0049_image015.gif Content-Transfer-Encoding: base64 Content-Type: image/gif R0lGODlhDgAKAHcAMSH+GlNvZnR3YXJlOiBNaWNyb3NvZnQgT2ZmaWNlACH5BAEAAAAALAAAAgAL AAYAgAAAAAAAAAIOhB+nGAkNY1svUkiNMwUAOw== ------=_NextPart_01C932A3.5A5B22F0 Content-Location: file:///C:/D4F25912/Day1Glaser_files/slide0049_image016.gif Content-Transfer-Encoding: base64 Content-Type: image/gif R0lGODlhFQAKAHcAMSH+GlNvZnR3YXJlOiBNaWNyb3NvZnQgT2ZmaWNlACH5BAEAAAAALAEAAwAS AAUAgAAAAAAAAAIPhI8WkZ27FJyUugdvi6cAADs= ------=_NextPart_01C932A3.5A5B22F0 Content-Location: file:///C:/D4F25912/Day1Glaser_files/slide0049_image017.gif Content-Transfer-Encoding: base64 Content-Type: image/gif R0lGODlhLQApAHcAMSH+GlNvZnR3YXJlOiBNaWNyb3NvZnQgT2ZmaWNlACH5BAEAAAAALAUAAAAo ACQAgAAAAAAAAAJShI+pyxcNI3uySmqzClh7wH1iKHpkmXVopa5R6zZwvM00ct6TrYO8/gP2IEFa bogrxo5IA7P5RCqXzcV0FR1me1vgFdV1hb6j8JJjxqLTJbarAAA7 ------=_NextPart_01C932A3.5A5B22F0 Content-Location: file:///C:/D4F25912/Day1Glaser_files/slide0049_image018.gif Content-Transfer-Encoding: base64 Content-Type: image/gif R0lGODlhLQAlAHcAMSH+GlNvZnR3YXJlOiBNaWNyb3NvZnQgT2ZmaWNlACH5BAEAAAAALAUABQAo ACAAgAAAAAAAAAJLDI6py40Bo5tURVPzvLo37oUHBpDiaZ4hpKJpq71wxc5dbcf5vcdyb/kBE8Lh qDjEGRnI5NKhfD6aQGovKi1Zd9tc14aVhsXZRaAAADs= ------=_NextPart_01C932A3.5A5B22F0 Content-Location: file:///C:/D4F25912/Day1Glaser_files/slide0050.htm Content-Transfer-Encoding: quoted-printable Content-Type: text/html; charset="us-ascii" Slide 1

Costs of stress re= sponse

&#= 8226;Cortisol à   glial cell division = à

= 226;      myelination

= 226;Cortisol à reduced immune & inflammatory response

= 226;Hippocampus & vermis harmed by    cortisol

&= #8211;High concentration of GC receptors. <= /div>
&#= 8226;Hippocampus concerned with memory
&#= 8226;In 1 year old infants,

= 226; -ve correlation between ERPs recording hippocampal activity & salivary cortisol

------=_NextPart_01C932A3.5A5B22F0 Content-Location: file:///C:/D4F25912/Day1Glaser_files/slide0050_image019.gif Content-Transfer-Encoding: base64 Content-Type: image/gif R0lGODlhCgAQAHcAMSH+GlNvZnR3YXJlOiBNaWNyb3NvZnQgT2ZmaWNlACH5BAEAAAAALAIAAQAG AAwAgAAAAAAAAAIQBGKJedy8lIuh2nNxVRGbAgA7 ------=_NextPart_01C932A3.5A5B22F0 Content-Location: file:///C:/D4F25912/Day1Glaser_files/slide0050_image020.gif Content-Transfer-Encoding: base64 Content-Type: image/gif R0lGODlhCgAQAHcAMSH+GlNvZnR3YXJlOiBNaWNyb3NvZnQgT2ZmaWNlACH5BAEAAAAALAIAAQAG AA0AgAAAAAAAAAIRhGOJCavcoDsnWNsu0gpXaRQAOx== ------=_NextPart_01C932A3.5A5B22F0 Content-Location: file:///C:/D4F25912/Day1Glaser_files/slide0051.htm Content-Transfer-Encoding: quoted-printable Content-Type: text/html; charset="us-ascii" Slide 1

Effects of stress = of CAN (1)

•HPA = axis dysregulation – elevated cortis= ol, altered diurnal variation, blunted cortisol stress response

•<= /span>

•Low morning cortisol level associated with externalising behaviour problems (? Gene= tic or 2º to early stress)=

•<= /span>

•

------=_NextPart_01C932A3.5A5B22F0 Content-Location: file:///C:/D4F25912/Day1Glaser_files/slide0052.htm Content-Transfer-Encoding: quoted-printable Content-Type: text/html; charset="us-ascii" Slide 1

= Effects of stress of CAN (2)

= 226;Children with PTSD, sexually abused at 2-6, & phys. abused at 1-3, +DV à

&#= 8226;Reduced brain volume on MRI

= 226;Reduced middle portion of corpus callosum à

&= #8211;decd. hemispheric integration

&= #8211;incd. hemispheric laterality

= 211;R frontal and temporal EEG dominance (=3Dreversal)

= 226;Abnormalities correlated +vely with duration of abuse

------=_NextPart_01C932A3.5A5B22F0 Content-Location: file:///C:/D4F25912/Day1Glaser_files/slide0052_image021.gif Content-Transfer-Encoding: base64 Content-Type: image/gif R0lGODlhCgAaAHcAMSH+GlNvZnR3YXJlOiBNaWNyb3NvZnQgT2ZmaWNlACH5BAEAAAAALAMAAQAF ABYAgAAAAAAAAAIUBGKGuZr3GmSx0uvwzDn4/ymeaBUAOx== ------=_NextPart_01C932A3.5A5B22F0 Content-Location: file:///C:/D4F25912/Day1Glaser_files/slide0055.htm Content-Transfer-Encoding: quoted-printable Content-Type: text/html; charset="us-ascii" Slide 1

Genetic vulnerabi= lity

•<= /span>Children vulnerable to the effects of maltreatment

–<= /span>? Higher genetic stress reactivity&#= 13;

–<= /span>Low levels of a gene encoding neurotransmitter-metabolising enzyme MAOA + maltreatment à antisocial behaviour

–<= /span>Genetic variant (short allele) of serotonin transporter gene + = maltreatment &agrav= e; depression in late adolescence

------=_NextPart_01C932A3.5A5B22F0 Content-Location: file:///C:/D4F25912/Day1Glaser_files/slide0079.htm Content-Transfer-Encoding: quoted-printable Content-Type: text/html; charset="us-ascii" Slide 1

Epigenet= ics –
developmental programming

&#= 8226;Environment influences gene expression
&#= 8226;Experience adaptive programming

•

&#= 8226;Rat experiments Michael Meaney et al

= 211;Genetically-determined high maternal grooming transmitted to genetically low offspring with enduring effects on offsprings’ <= /span>maternal behaviour

–Mechanism of this lasting response =3D effects = on gene expression in offsprings’ brain      (but not heritable)

------=_NextPart_01C932A3.5A5B22F0 Content-Location: file:///C:/D4F25912/Day1Glaser_files/slide0058.htm Content-Transfer-Encoding: quoted-printable Content-Type: text/html; charset="us-ascii" Slide 1

Effects= of attachment security on brain functioni= ng

•

•Security of attachment in human infants <= span style=3D'position:absolute;top:35.75%;left:10.29%;width:83.14%;height:6.75= %'>is equivalent buffer of the HPA axis =

•<= /span>

•Str= ong association between salivary cortis= ol & distress during SST- in infants classified as disorganised/disorientated

•<= /span>

•Rai= sed cortisol levels in young children with disorganised attachment

•<= /span>

------=_NextPart_01C932A3.5A5B22F0 Content-Location: file:///C:/D4F25912/Day1Glaser_files/slide0057.htm Content-Transfer-Encoding: quoted-printable Content-Type: text/html; charset="us-ascii" Slide 1

Conclusions

R= 26;Experience determines pattern of brain development <= /span>

&#= 8226;Effect of serious deprivation

&#= 8226;Most harm by

= 211;early experiences incorporated into neural networks

&= #8211;Effects of stress

= 226;Established connections not erasable but new learning (synapses) possible

&#= 8226;Parental patterns often enduring

= 226;Secure attachment is protective of stress response

------=_NextPart_01C932A3.5A5B22F0 Content-Location: file:///C:/D4F25912/Day1Glaser_files/slide0071.htm Content-Transfer-Encoding: quoted-printable Content-Type: text/html; charset="us-ascii" Slide 1

Conclusions

•Differential genetic vulnerability - ? Early identification of vulnerable <= /span>children

•Intervene early to

–Maximise potential to compensate for irreversible damage

–Minimise negative experiences affecting brain development =

–Minimise stress

------=_NextPart_01C932A3.5A5B22F0 Content-Location: file:///C:/D4F25912/Day1Glaser_files/master01.htm Content-Transfer-Encoding: quoted-printable Content-Type: text/html; charset="us-ascii"

Click to edit Master text styles

Second level

Third level

Fourth level

Fifth level

‹#›

1&#= 13;

Ambitious and only very partial exposition

Environment specifically maltreatment &#= 8211; abuse and neglect

2&#= 13;

3&#= 13;

Context for talk is the relationship between mind and brain. Crudely – b= iology and psychology. Kandel’s review in Am J of psychiatry traces = the development of the divergence between the two.

4&#= 13;

5&#= 13;

6&#= 13;

Although dentate gyrus of Hippocampus continues to generate new neurons postnatally

7&#= 13;

Pruning in order to minimise ‘noise’, reduce redundancy, reduce energy= need in brain, = although reduces plasticity.

8&#= 13;

9&#= 13;

10&= #13;

13&= #13;

15&= #13;

16&= #13;

17&= #13;

Early stress greater fearfulness, and therefore greater stress response. =

18&= #13;

19&= #13;

20&= #13;

21&= #13;

22&= #13;

23&= #13;

24&= #13;

25&= #13;

26&= #13;

27&= #13;

28&= #13;

29&= #13;

------=_NextPart_01C932A3.5A5B22F0 Content-Location: file:///C:/D4F25912/Day1Glaser_files/master05_stylesheet.css Content-Transfer-Encoding: base64 Content-Type: text/css Ym9keQ0KCXt3aWR0aDo1MzRweDsNCgloZWlnaHQ6NDAwcHg7fQ0KLlRCDQoJe21zby1zcGVjaWFs LWZvcm1hdDpub2J1bGxldFwyMDIyO30NCi5UDQoJe3RleHQtYWxpZ246Y2VudGVyOw0KCWZvbnQt ZmFtaWx5OkFyaWFsOw0KCWNvbG9yOmJsYWNrOw0KCW1zby1jb2xvci1pbmRleDozOw0KCWZvbnQt c2l6ZToyMDklOw0KCW1zby1jaGFyLXdyYXA6MTsNCgltc28ta2luc29rdS1vdmVyZmxvdzoxO30N Ci5CQg0KCXttc28tc3BlY2lhbC1mb3JtYXQ6YnVsbGV0XDIwMjI7fQ0KLkINCgl7dGV4dC1hbGln bjpsZWZ0Ow0KCWZvbnQtZmFtaWx5OkFyaWFsOw0KCWNvbG9yOmJsYWNrOw0KCW1zby1jb2xvci1p bmRleDoxOw0KCWZvbnQtc2l6ZToxNTIlOw0KCW1zby1jaGFyLXdyYXA6MTsNCgltc28ta2luc29r dS1vdmVyZmxvdzoxO30NCi5CMUINCgl7bXNvLXNwZWNpYWwtZm9ybWF0OmJ1bGxldFwyMDEzO30N Ci5CMQ0KCXt0ZXh0LWFsaWduOmxlZnQ7DQoJZm9udC1mYW1pbHk6QXJpYWw7DQoJY29sb3I6Ymxh Y2s7DQoJbXNvLWNvbG9yLWluZGV4OjE7DQoJZm9udC1zaXplOjEzMyU7DQoJbXNvLWNoYXItd3Jh cDoxOw0KCW1zby1raW5zb2t1LW92ZXJmbG93OjE7fQ0KLkIyQg0KCXttc28tc3BlY2lhbC1mb3Jt YXQ6YnVsbGV0XDIwMjI7fQ0KLkIyDQoJe3RleHQtYWxpZ246bGVmdDsNCglmb250LWZhbWlseTpB cmlhbDsNCgljb2xvcjpibGFjazsNCgltc28tY29sb3ItaW5kZXg6MTsNCglmb250LXNpemU6MTE0 JTsNCgltc28tY2hhci13cmFwOjE7DQoJbXNvLWtpbnNva3Utb3ZlcmZsb3c6MTt9DQouQjNCDQoJ e21zby1zcGVjaWFsLWZvcm1hdDpidWxsZXRcMjAxMzt9DQouQjMNCgl7dGV4dC1hbGlnbjpsZWZ0 Ow0KCWZvbnQtZmFtaWx5OkFyaWFsOw0KCWNvbG9yOmJsYWNrOw0KCW1zby1jb2xvci1pbmRleDox Ow0KCWZvbnQtc2l6ZTo5NSU7DQoJbXNvLWNoYXItd3JhcDoxOw0KCW1zby1raW5zb2t1LW92ZXJm bG93OjE7fQ0KLkI0Qg0KCXttc28tc3BlY2lhbC1mb3JtYXQ6YnVsbGV0XDAwQkI7fQ0KLkI0DQoJ e3RleHQtYWxpZ246bGVmdDsNCglmb250LWZhbWlseTpBcmlhbDsNCgljb2xvcjpibGFjazsNCglt c28tY29sb3ItaW5kZXg6MTsNCglmb250LXNpemU6OTUlOw0KCW1zby1jaGFyLXdyYXA6MTsNCglt c28ta2luc29rdS1vdmVyZmxvdzoxO30NCi5OQg0KCXttc28tc3BlY2lhbC1mb3JtYXQ6bm9idWxs ZXRcMjAyMjt9DQouTg0KCXt0ZXh0LWFsaWduOmxlZnQ7DQoJZm9udC1mYW1pbHk6QXJpYWw7DQoJ bXNvLWhhbnNpLWZvbnQtZmFtaWx5OkFyaWFsOw0KCWNvbG9yOmJsYWNrOw0KCW1zby1jb2xvci1p bmRleDoxOw0KCWZvbnQtc2l6ZTo1NyU7fQ0KLk4xQg0KCXttc28tc3BlY2lhbC1mb3JtYXQ6bm9i dWxsZXRcMjAyMjt9DQouTjENCgl7dGV4dC1hbGlnbjpsZWZ0Ow0KCWZvbnQtZmFtaWx5OkFyaWFs Ow0KCW1zby1oYW5zaS1mb250LWZhbWlseTpBcmlhbDsNCgljb2xvcjpibGFjazsNCgltc28tY29s b3ItaW5kZXg6MTsNCglmb250LXNpemU6NTclO30NCi5OMkINCgl7bXNvLXNwZWNpYWwtZm9ybWF0 Om5vYnVsbGV0XDIwMjI7fQ0KLk4yDQoJe3RleHQtYWxpZ246bGVmdDsNCglmb250LWZhbWlseTpB cmlhbDsNCgltc28taGFuc2ktZm9udC1mYW1pbHk6QXJpYWw7DQoJY29sb3I6YmxhY2s7DQoJbXNv LWNvbG9yLWluZGV4OjE7DQoJZm9udC1zaXplOjU3JTt9DQouTjNCDQoJe21zby1zcGVjaWFsLWZv cm1hdDpub2J1bGxldFwyMDIyO30NCi5OMw0KCXt0ZXh0LWFsaWduOmxlZnQ7DQoJZm9udC1mYW1p bHk6QXJpYWw7DQoJbXNvLWhhbnNpLWZvbnQtZmFtaWx5OkFyaWFsOw0KCWNvbG9yOmJsYWNrOw0K CW1zby1jb2xvci1pbmRleDoxOw0KCWZvbnQtc2l6ZTo1NyU7fQ0KLk40Tg0KCXttc28tc3BlY2lh bC1mb3JtYXQ6bm9idWxsZXRcMjAyMjt9DQouTjQNCgl7dGV4dC1hbGlnbjpsZWZ0Ow0KCWZvbnQt ZmFtaWx5OkFyaWFsOw0KCW1zby1oYW5zaS1mb250LWZhbWlseTpBcmlhbDsNCgljb2xvcjpibGFj azsNCgltc28tY29sb3ItaW5kZXg6MTsNCglmb250LXNpemU6NTclO30NCi5PQg0KCXttc28tc3Bl Y2lhbC1mb3JtYXQ6bm9idWxsZXRcMjAyMjt9DQouTw0KCXt0ZXh0LWFsaWduOmxlZnQ7DQoJZm9u dC1mYW1pbHk6QXJpYWw7DQoJbXNvLWhhbnNpLWZvbnQtZmFtaWx5OkFyaWFsOw0KCWNvbG9yOmJs YWNrOw0KCW1zby1jb2xvci1pbmRleDoxOw0KCWZvbnQtc2l6ZTo4NSU7DQoJbXNvLWNoYXItd3Jh cDoxOw0KCW1zby1raW5zb2t1LW92ZXJmbG93OjE7fQ0KLk8xDQoJe21zby1oYW5zaS1mb250LWZh bWlseTpBcmlhbDsNCgltc28tY2hhci13cmFwOjE7DQoJbXNvLWtpbnNva3Utb3ZlcmZsb3c6MTt9 DQouTzINCgl7bXNvLWhhbnNpLWZvbnQtZmFtaWx5OkFyaWFsOw0KCW1zby1jaGFyLXdyYXA6MTsN Cgltc28ta2luc29rdS1vdmVyZmxvdzoxO30NCi5PMw0KCXttc28taGFuc2ktZm9udC1mYW1pbHk6 QXJpYWw7DQoJbXNvLWNoYXItd3JhcDoxOw0KCW1zby1raW5zb2t1LW92ZXJmbG93OjE7fQ0KLk80 DQoJe21zby1oYW5zaS1mb250LWZhbWlseTpBcmlhbDsNCgltc28tY2hhci13cmFwOjE7DQoJbXNv LWtpbnNva3Utb3ZlcmZsb3c6MTt9DQouQ0JCDQoJe21zby1zcGVjaWFsLWZvcm1hdDpub2J1bGxl dFwyMDIyO30NCi5DQg0KCXt0ZXh0LWFsaWduOmNlbnRlcjsNCglmb250LWZhbWlseTpBcmlhbDsN Cgljb2xvcjpibGFjazsNCgltc28tY29sb3ItaW5kZXg6MTsNCglmb250LXNpemU6MTUyJTsNCglt c28tY2hhci13cmFwOjE7DQoJbXNvLWtpbnNva3Utb3ZlcmZsb3c6MTt9DQouQ0IxDQoJe21zby1j aGFyLXdyYXA6MTsNCgltc28ta2luc29rdS1vdmVyZmxvdzoxO30NCi5DQjINCgl7bXNvLWNoYXIt d3JhcDoxOw0KCW1zby1raW5zb2t1LW92ZXJmbG93OjE7fQ0KLkNCMw0KCXttc28tY2hhci13cmFw OjE7DQoJbXNvLWtpbnNva3Utb3ZlcmZsb3c6MTt9DQouQ0I0DQoJe21zby1jaGFyLXdyYXA6MTsN Cgltc28ta2luc29rdS1vdmVyZmxvdzoxO30NCi5DVEINCgl7bXNvLXNwZWNpYWwtZm9ybWF0Om5v YnVsbGV0XDIwMjI7fQ0KLkNUDQoJe3RleHQtYWxpZ246Y2VudGVyOw0KCWZvbnQtZmFtaWx5OkFy aWFsOw0KCWNvbG9yOmJsYWNrOw0KCW1zby1jb2xvci1pbmRleDozOw0KCWZvbnQtc2l6ZToyMDkl Ow0KCW1zby1jaGFyLXdyYXA6MTsNCgltc28ta2luc29rdS1vdmVyZmxvdzoxO30NCi5IQg0KCXtt c28tY2hhci13cmFwOjE7DQoJbXNvLWtpbnNva3Utb3ZlcmZsb3c6MTt9DQouSEIxDQoJe21zby1j aGFyLXdyYXA6MTsNCgltc28ta2luc29rdS1vdmVyZmxvdzoxO30NCi5IQjINCgl7bXNvLWNoYXIt d3JhcDoxOw0KCW1zby1raW5zb2t1LW92ZXJmbG93OjE7fQ0KLkhCMw0KCXttc28tY2hhci13cmFw OjE7DQoJbXNvLWtpbnNva3Utb3ZlcmZsb3c6MTt9DQouSEI0DQoJe21zby1jaGFyLXdyYXA6MTsN Cgltc28ta2luc29rdS1vdmVyZmxvdzoxO30NCi5RQg0KCXttc28tY2hhci13cmFwOjE7DQoJbXNv LWtpbnNva3Utb3ZlcmZsb3c6MTt9DQouUUIxDQoJe21zby1jaGFyLXdyYXA6MTsNCgltc28ta2lu c29rdS1vdmVyZmxvdzoxO30NCi5RQjINCgl7bXNvLWNoYXItd3JhcDoxOw0KCW1zby1raW5zb2t1 LW92ZXJmbG93OjE7fQ0KLlFCMw0KCXttc28tY2hhci13cmFwOjE7DQoJbXNvLWtpbnNva3Utb3Zl cmZsb3c6MTt9DQouUUI0DQoJe21zby1jaGFyLXdyYXA6MTsNCgltc28ta2luc29rdS1vdmVyZmxv dzoxO30NCi5UYmwNCgl7bXNvLWNoYXItd3JhcDoxOw0KCW1zby1raW5zb2t1LW92ZXJmbG93OjE7 fQ0KLlRibDENCgl7bXNvLWNoYXItd3JhcDoxOw0KCW1zby1raW5zb2t1LW92ZXJmbG93OjE7fQ0K LlRibDINCgl7bXNvLWNoYXItd3JhcDoxOw0KCW1zby1raW5zb2t1LW92ZXJmbG93OjE7fQ0KLlRi bDMNCgl7bXNvLWNoYXItd3JhcDoxOw0KCW1zby1raW5zb2t1LW92ZXJmbG93OjE7fQ0KLlRibDQN Cgl7bXNvLWNoYXItd3JhcDoxOw0KCW1zby1raW5zb2t1LW92ZXJmbG93OjE7fQ0KLmRlZmF1bHRC DQoJe21zby1zcGVjaWFsLWZvcm1hdDpub2J1bGxldFwyMDIyO30NCi5kZWZhdWx0DQoJe3RleHQt YWxpZ246bGVmdDsNCglmb250LWZhbWlseTpBcmlhbDsNCglmb250LXdlaWdodDpub3JtYWw7DQoJ Zm9udC1zdHlsZTpub3JtYWw7DQoJdGV4dC1kZWNvcmF0aW9uOm5vbmU7DQoJdGV4dC1zaGFkb3c6 bm9uZTsNCgl0ZXh0LWVmZmVjdDpub25lOw0KCW1zby1mYXJlYXN0LWhpbnQ6bm87DQoJbGF5b3V0 LWZsb3c6aG9yaXpvbnRhbDsNCgljb2xvcjpibGFjazsNCgltc28tY29sb3ItaW5kZXg6MTsNCglm b250LXNpemU6ODUlOw0KCW1zby10ZXh0LXJhaXNlOjAlOw0KCW1zby1saW5lLXNwYWNpbmc6IjEw MCAwIDAiOw0KCW1zby1tYXJnaW4tbGVmdC1hbHQ6MDsNCgltc28tdGV4dC1pbmRlbnQtYWx0OjA7 DQoJbXNvLWNoYXItd3JhcDoxOw0KCW1zby1raW5zb2t1LW92ZXJmbG93OjE7DQoJZGlyZWN0aW9u Omx0cjsNCgltc28td29yZC13cmFwOjE7DQoJbXNvLXZlcnRpY2FsLWFsaWduLXNwZWNpYWw6YmFz ZWxpbmU7DQoJbXNvLWFuc2ktbGFuZ3VhZ2U6RU4tVVM7fQ0KYTpsaW5rDQoJe2NvbG9yOiMwMDk5 OTkgIWltcG9ydGFudDt9DQphOmFjdGl2ZQ0KCXtjb2xvcjojMzMzMzk5ICFpbXBvcnRhbnQ7fQ0K YTp2aXNpdGVkDQoJe2NvbG9yOiM5OUNDMDAgIWltcG9ydGFudDt9DQp= ------=_NextPart_01C932A3.5A5B22F0 Content-Location: file:///C:/D4F25912/Day1Glaser_files/script.js Content-Transfer-Encoding: quoted-printable Content-Type: application/javascript; charset="us-ascii" function LoadSld() { var sld=3DGetObj("SlideObj") if( !g_supportsPPTHTML ) { =09 sld.style.visibility=3D"visible" return } if( MakeNotesVis() ) return runAnimations =3D _InitAnimations(); =09 if( IsWin("PPTSld") ) parent.SldUpdated(GetSldId()) g_origSz=3DparseInt(SlideObj.style.fontSize) g_origH=3Dsld.style.posHeight g_origW=3Dsld.style.posWidth g_scaleHyperlinks=3D(document.all.tags("AREA").length>0) if( g_scaleHyperlinks ) InitHLinkArray() if( g_scaleInFrame||(IsWin("PPTSld") && parent.IsFullScrMode() ) ) document.body.scroll=3D"no" _RSW() if( IsWin("PPTSld") && parent.IsFullScrMode() ) FullScrInit(); =09 MakeSldVis(); ChkAutoAdv() if( runAnimations ) { if( document.all("NSPlay") ) document.all("NSPlay").autoStart =3D false; if( sld.filters && sld.filters.revealtrans ) setTimeout( "document.body.start()", sld.filters.revealtrans.duration * = 1000 ); else document.body.start(); } } function MakeSldVis()=20 { var fTrans=3Dg_showAnimation && SldHasTrans() if( fTrans )=09 { if( g_bgSound ) { idx=3Dg_bgSound.indexOf(","); pptSound.src=3Dg_bgSound.substr( 0, idx ); pptSound.loop=3D -(parseInt(g_bgSound.substr(idx+1))); } SlideObj.filters.revealtrans.Apply()=09 } SlideObj.style.visibility=3D"visible" if( fTrans ) SlideObj.filters.revealtrans.Play() } function MakeNotesVis()=20 { if( !IsNts() ) return false=20 SlideObj.style.display=3D"none" nObj =3D document.all.item("NotesObj") parent.SetHasNts(0) if( nObj ) {=20 nObj.style.display=3D"" parent.SetHasNts(1) } return 1 } function ChkAutoAdv() { if(SldHasTrans()) SlideObj.onfilterchange=3DAutoAdv else AutoAdv() } function AutoAdv() { if(!IsWin("PPTSld") || !gUseSldTimings )return var sld=3DGetCurSld() if( (sld.mAdvDelay>0) && !parent.IsFramesMode() ) setTimeout("parent.GoToNextSld()",sld.mAdvDelay) } function GetObj(id) { if(g_supportsPPTHTML) return document.all(id); else return document.getElementById(id); } function SldHasTrans() { return SlideObj.style.filter !=3D ""; } function GetSldId()=20 { var regExp =3D /file:\/\/\//i var pos =3D location.href.search(regExp) if (MHTMLPrefix !=3D "" && pos !=3D -1) sId =3D location.href.substring(pos) else { sId =3D RemoveFilePrefixFromHref(location.href); var regExp =3D /\// var fixedHref =3D sId var pos =3D -1 =09 pos =3D fixedHref.search(regExp) while (pos !=3D -1) { fixedHref =3D fixedHref.replace(regExp, "\\") pos =3D fixedHref.search(regExp) } =09 if (g_fBaseHyperlink =3D=3D true) sId =3D "file:///" + fixedHref; else sId =3D fixedHref.substring(fixedHref.lastIndexOf('\\') + 1) } =09 return sId } function HideMenu() { if( frames["PPTSld"] && PPTSld.document.all.item("ctx= tmenu") && PPTSld.ctxtmenu.style.display!=3D"none" ) { PPTSld.ctxtmenu.styl= e.display=3D'none'; return true } return false } function IsWin( name ) { return window.name =3D=3D name } function IsNts() { return IsWin("PPTNts") } function IsSldOrNts() { return( IsWin("PPTSld")||IsWin("PPTNts") ) } function SupportsPPTAnimation() { return( navigator.platform =3D=3D "Win32"= && navigator.appVersion.indexOf("Windows")>0 ) } function SupportsPPTHTML() { var appVer=3Dnavigator.appVersion, msie=3DappVer.indexOf("MSIE "), ver=3D0 if( msie >=3D 0 ) ver=3DparseFloat( appVer.substring( msie+5, appVer.indexOf(";",msie) ) ) else ver=3DparseInt(appVer) return( ver >=3D 4 && msie >=3D 0 ) } function _RSW() { if( !g_supportsPPTHTML || IsNts() || ( !g_scaleInFrame && (!IsWin("PPTSld") || !parent.IsFullScrMode()) ) ) return var padding=3D0; if( IsWin("PPTSld") && parent.IsFramesMode() ) padding=3D6 cltWidth=3Ddocument.body.clientWidth-padding cltHeight=3Ddocument.body.clientHeight-padding factor=3D(1.0*cltWidth)/g_origW if( cltHeight < g_origH*factor ) factor=3D(1.0*cltHeight)/g_origH newSize =3D g_origSz * factor if( newSize < 1 ) newSize=3D1 s=3DSlideObj.style s.fontSize=3DnewSize+"px" s.posWidth=3Dg_origW*factor s.posHeight=3Dg_origH*factor s.posLeft=3D(cltWidth-s.posWidth+padding)/2 s.posTop=3D(cltHeight-s.posHeight+padding)/2 if( g_scaleHyperlinks ) ScaleHyperlinks( factor ) } function _InitAnimations() { animRuntimeInstalled =3D ''+document.body.localTime !=3D 'undefined'; isFullScreen =3D (window.name =3D=3D "PPTSld") && !parent.IsFramesMode(); g_animUseRuntime =3D g_showAnimation && animRuntimeInstalled && !(isFullSc= reen && parent.IsSldVisited()); if( g_animUseRuntime ) { collSeq =3D document.all.tags("seq"); if( collSeq !=3D null ) { for(ii=3D0;ii numSlds ) gSldJumpIdx =3D numSlds; if ( gSldJumpIdx >=3D 0 ) { if ( gSldJumpIdx =3D=3D 0 ) gSldJumpIdx =3D 1; var jumpTo =3D parseInt(gSldJumpIdx); gSldJump =3D 0; gSldJumpIdx =3D ""; win.GoToSld( parent.GetSldList().mList[jumpTo-1].mSldHref ) } } } function _KDH() { if( event.keyCode =3D=3D 8 ) { event.returnValue =3D 0; parent.GoToPrevSld(); } } function DocumentOnClick() { if( IsNts() || parent.HideMenu() ) return; if( ( g_allowAdvOnClick && !parent.IsFramesMode() ) || (event && (event.keyCode=3D=3D32) ) ) parent.GoToNextSld(); } var g_supportsPPTHTML =3D SupportsPPTHTML(), g_scaleInFrame =3D 1, gId=3D""= , g_bgSound=3D"", g_scaleHyperlinks =3D false, g_allowAdvOnClick =3D 1, g_showInBrowser = =3D 0, gLoopCont =3D 0, gUseSldTimings =3D 1; var g_showAnimation =3D g_supportsPPTHTML && SupportsPPTAnimation() && ( (w= indow.name=3D=3D"PPTSld" && !parent.IsFramesMode()) || g_showInBrowser );va= r g_animManager =3D null; var g_animUseRuntime =3D false; var g_animItemsToHide, g_animInteractiveItems, g_animSlideTime; var g_animMainSequence =3D null; var ENDSHOW_MESG=3D"End of slide show, click to exit.", SCREEN_MODE=3D"Fram= es", gIsEndShow=3D0, NUM_VIS_SLDS=3D29, SCRIPT_HREF=3D"script.js", FULLSCR_= HREF=3D"fullscreen.htm"; var gCurSld =3D gPrevSld =3D 1, g_offset =3D 0, gNtsOpen =3D gHasNts =3D gO= tlTxtExp =3D 0, gHasNarration =3D 0, gOtlOpen =3D true window.gPPTHTML=3DSupportsPPTHTML() var g_fBaseHyperlink =3D false; var gMainDoc=3Dnew Array(new hrefList("slide0033.htm",1,-1,1),new hrefList(= "slide0074.htm",1,-1,1),new hrefList("slide0034.htm",1,-1,1),new hrefList("= slide0035.htm",1,-1,1),new hrefList("slide0038.htm",1,-1,1),new hrefList("s= lide0039.htm",1,-1,1),new hrefList("slide0040.htm",1,-1,1),new hrefList("sl= ide0041.htm",1,-1,1),new hrefList("slide0037.htm",1,-1,1),new hrefList("sli= de0036.htm",1,-1,1),new hrefList("slide0077.htm",1,-1,1),new hrefList("slid= e0078.htm",1,-1,1),new hrefList("slide0042.htm",1,-1,1),new hrefList("slide= 0080.htm",1,-1,1),new hrefList("slide0073.htm",1,-1,1),new hrefList("slide0= 044.htm",1,-1,1),new hrefList("slide0045.htm",1,-1,1),new hrefList("slide00= 46.htm",1,-1,1),new hrefList("slide0075.htm",1,-1,1),new hrefList("slide004= 8.htm",1,-1,1),new hrefList("slide0049.htm",1,-1,1),new hrefList("slide0050= .htm",1,-1,1),new hrefList("slide0051.htm",1,-1,1),new hrefList("slide0052.= htm",1,-1,1),new hrefList("slide0055.htm",1,-1,1),new hrefList("slide0079.h= tm",1,-1,1),new hrefList("slide0058.htm",1,-1,1),new hrefList("slide0057.ht= m",1,-1,1),new hrefList("slide0071.htm",1,-1,1)); /********************************************* Frameset functions These functions control slide navigation and state of the frameset. **********************************************/ function RemoveFilePrefixFromHref(href) { var regExp =3D /^file:\/\/\//i; return href.replace(regExp, "") } function FullScrInit() { g_allowAdvOnClick =3D GetCurSld().mAdvOnClk document.body.style.backgroundColor=3D"black" document.oncontextmenu=3Dparent._CM; document.onkeydown =3D _KDH; document.ondragstart=3DCancel document.onselectstart=3DCancel self.focus() } function Redirect( frmId ) {=09 var str=3Ddocument.location.hash,idx=3Dstr.indexOf('#'), sId=3DGetSldId() if(idx>=3D0) str=3Dstr.substr(1); if( window.name !=3D frmId && ( sId !=3D str) ) { obj =3D GetObj("Main-File") window.location.href=3Dobj.href+"#"+sId return 1 } return 0 } var MHTMLPrefix =3D CalculateMHTMLPrefix();=20 function CalculateMHTMLPrefix() { if ( document.location.protocol =3D=3D 'mhtml:') {=20 href=3Dnew String(document.location.href)=20 Start=3Dhref.indexOf('!')+1=20 End=3Dhref.lastIndexOf('/')+1=20 if (End < Start)=20 return href.substring(0, Start)=20 else=20 return href.substring(0, End)=20 } return ''; } function GetTags(base,tag) { if(g_supportsPPTHTML) return base.all.tags(tag); else return base.getElementsByTagName(tag); } function UpdNtsPane(){ if(frames["PPTNts"]) PPTNts.location.replace( MHTMLP= refix+GetHrefObj( gCurSld ).mNtsHref ) } function UpdNavPane( sldIndex ){ if(gNavLoaded) PPTNav.UpdNav() } function UpdOtNavPane(){ if(gOtlNavLoaded) PPTOtlNav.UpdOtlNav() } function UpdOtlPane(){ if(gOtlLoaded) PPTOtl.UpdOtl() } function SetHasNts( fVal ) { if( gHasNts !=3D fVal ) { gHasNts=3DfVal UpdNavPane() } } function ToggleOtlText() { gOtlTxtExp=3D!gOtlTxtExp UpdOtlPane() } function ClearMedia() { // Clear any sounds playing before launching another browser window. Other= wise, // in fullscreen mode, you'll continue to hear the sound in the frames mod= e. if (PPTSld.pptSound) PPTSld.pptSound.loop =3D 0; } function FullScreen() {=20 if ( PPTSld.g_animUseRuntime ) PPTSld.document.body.pause(); ClearMedia(); var href =3D ( document.location.protocol =3D=3D 'mhtml:') ? FULLSCR_HREF = : FULLSCR_HREF+"#"+GetHrefObj(gCurSld).mSldHref; if (MHTMLPrefix !=3D "") href =3D RemoveFilePrefixFromHref(href) if(PPTNav.event.ctrlKey) { var w =3D (window.screen.availWidth * 1.0) / 2.0 var h =3D w * (PPTSld.g_origH * 1.0) / PPTSld.g_origW win =3D window.open( MHTMLPrefix+href,null,"toolbar=3D0,resizable=3D1,top= =3D0,left=3D0," + "width=3D"+ w + ",height=3D" + h ); if( win.document.body && PPTSld.g_animUseRuntime ) win.document.body.PPTSldFrameset=3Dwindow; } else { win =3D window.open( MHTMLPrefix+href,null,"fullscreen=3Dyes" ); if( win.document.body && PPTSld.g_animUseRuntime ) win.document.body.PPTSldFrameset=3Dwindow; } } function ToggleVNarration() { rObj=3DPPTSld.document.all("NSPlay") if( rObj && !PPTSld.g_animUseRuntime ) { if( (rObj.playState =3D=3D 1)||(rObj.playState =3D=3D 0) ) rObj.Play() else if( rObj.playState =3D=3D 2 ) rObj.Pause() else return; } else if( PPTSld.g_animUseRuntime ) { narObj =3D PPTSld.document.all("narrationID") if( narObj ) narObj.togglePause() } } function GetCurSldNum() { =20 obj=3DGetHrefObj(gCurSld) if( obj.mOrigVis =3D=3D 1 ) return obj.mSldIdx else =20 return gCurSld } function GetNumSlds() { =20 if( GetHrefObj(gCurSld).mOrigVis =3D=3D 1 ) return GetSldList().mNumVisSlds; else return GetSldList().mList.length } function GetSldNum( href ) { for(ii=3D0; ii 1 ) PopSldList(); else if( !IsFramesMode() ) { if( gLoopCont ) GoToFirst() else EndShow() } } function GoToPrevSld() { ii=3DgCurSld-1 if( ii > 0 ) { obj=3DGetHrefObj(ii) while ( obj && ( obj.mVis =3D=3D 0 ) && ( ii>0 ) ) obj=3DGetHrefObj(--ii) if( ii =3D=3D 0 ) ii=3D1 GoToSldNum(ii) } } function GoToFirst(){ GoToSld( GetHrefObj(1).mSldHref ) } function GoToLast() { ii=3DGetSldList().mList.length if( ii !=3D gCurSld ) GoToSld( GetHrefObj(ii).mSldHref ) } function GoToSldNum( num ) { if( PPTSld.event ) PPTSld.event.cancelBubble=3Dtrue obj =3D GetHrefObj( num ) obj.mVis=3D1 gPrevSld=3DgCurSld gCurSld =3D num; =09 if (MHTMLPrefix !=3D "") PPTSld.location.replace(MHTMLPrefix+RemoveFilePrefixFromHref(obj.mSldHref= )) else PPTSld.location.replace(obj.mSldHref) =09 if( IsFramesMode() ) { UpdNavPane(); UpdOtlPane(); UpdNtsPane() } } function GoToSld( href ) { if( PPTSld.event ) PPTSld.event.cancelBubble=3Dtrue GetHrefObj( GetSldNum(href) ).mVis=3D1 if (MHTMLPrefix !=3D "") PPTSld.location.replace(MHTMLPrefix+RemoveFilePrefixFromHref(href)) else PPTSld.location.replace(href) } function SldUpdated( id ) { if( id =3D=3D GetHrefObj(gCurSld).mSldHref ) return gPrevSld=3DgCurSld gCurSld=3DGetSldNum(id) if( IsFramesMode() ) { UpdNavPane(); UpdOtlPane(); UpdNtsPane() } } function PrevSldViewed(){ GoToSld( GetHrefObj(gPrevSld).mSldHref ) } function HasPrevSld() { return ( gIsEndShow || ( gCurSld !=3D 1 && GetHrefO= bj( gCurSld-1 ).mVis =3D=3D 1 )||( GetCurSldNum() > 1 ) ) } function HasNextSld() { return (GetCurSldNum() !=3D GetNumSlds()) } function CloseWindow() { if( HideMenu() ) return; =09 var event =3D PPTSld.event; if( !IsFramesMode() && event && (event.keyCode=3D=3D27 || event.keyCode=3D= =3D32 || event.type=3D=3D"click" ) ) window.close( self ); CatchNumKeys( self, event ); } function Unload() { gIsEndShow=3D0; } function SetupEndShow() { gIsEndShow=3D1; PPTSld.document.body.scroll=3D"no"; PPTSld.document.onkeypress=3DCloseWindow; PPTSld.document.onclick=3DCloseWindow; PPTSld.document.oncontextmenu=3D_CM; } function EndShow() { if( IsFramesMode() ) return if( PPTSld.event ) PPTSld.event.cancelBubble=3Dtrue doc=3DPPTSld.document var dir =3D doc.body.dir if( dir !=3D "rtl" ) dir =3D "ltr"; doc.open() doc.writeln('

' + ENDSHOW_MESG + '
') doc.close() } function SetSldVisited(){ GetSldList().mList[gCurSld-1].mVisited=3Dtrue } function IsSldVisited(){ return GetSldList().mList[gCurSld-1].mVisited } function hrefList( sldHref, visible, advDelay, advClk ) { this.mSldHref=3D this.mNtsHref =3D sldHref this.mOrigVis=3D this.mVis =3D visible this.mVisited=3D false this.mAdvDelay=3D advDelay this.mAdvOnClk=3D advClk } function SldList(arr,curSld,fEnd) { this.mCurSld =3D curSld; this.mList =3D new Array(); var idx =3D 1; for(ii=3D0;ii 0) { PushSldList(sldList,fEnd); gCurSld =3D 1; } else if( PPTSld.event ) PPTSld.event.cancelBubble=3Dtrue } function PushSldList(arr,fEnd) { var ii =3D gSldStack.length; gSldStack[ii] =3D new SldList(arr,gCurSld,fEnd); GoToSld( gSldStack[ii].mList[0].mSldHref ); } function PopSldList() { if (gSldStack[gSldStack.length-1].fEndShow) EndShow() else { gCurSld =3D gSldStack[gSldStack.length-1].mCurSld; gSldStack[gSldStack.length-1] =3D null; gSldStack.length--; var sldList =3D gSldStack[gSldStack.length-1]; GoToSld( sldList.mList[gCurSld - 1].mSldHref ); } } var custShowList=3Dnew Array(); /********************************************* Navigation button implementation There are 2 types of buttons: ImgBtn, TxtBtn implemented as function objects. They share a similiar interface so the event handlers can call SetActive, for example, on a button=20 object without needing to know exactly=20 what type of button it is. **********************************************/ //---------------------------------- function ImgBtn( oId,bId,w,action ) //---------------------------------- { var t=3Dthis t.Perform =3D _IBP t.SetActive =3D _IBSetA t.SetInactive=3D _IBSetI t.SetPressed =3D _IBSetP t.SetDisabled=3D _IBSetD t.Enabled =3D _IBSetE t.ChangeIcon =3D null t.UserAction =3D action t.ChgState =3D _IBUI t.mObjId =3D oId t.mBorderId=3D bId t.mWidth =3D w t.mIsOn =3D t.mCurState =3D 0 } function _IBSetA() { if( this.mIsOn ) { obj=3Dthis.ChgState( gHiliteClr,gShadowClr,2 ) obj.style.posTop=3D0 } } function _IBSetI() { if( this.mIsOn ) { obj=3Dthis.ChgState( gFaceClr,gFaceClr,1 ) obj.style.posTop=3D0=20 } } function _IBSetP() { if( this.mIsOn ) { obj=3Dthis.ChgState( gShadowClr,gHiliteClr,2 ) obj.style.posLeft+=3D1; obj.style.posTop+=3D1 } } function _IBSetD() { =20 obj=3Dthis.ChgState( gFaceClr,gFaceClr,0 ) obj.style.posTop=3D0=20 } function _IBSetE( state ) { var t=3Dthis GetObj( t.mBorderId ).style.visibility=3D"visible" if( state !=3D t.mIsOn ) { t.mIsOn=3Dstate if( state ) t.SetInactive() else t.SetDisabled() } } function _IBP() { var t=3Dthis if( t.mIsOn ) { if( t.UserAction !=3D null ) t.UserAction() if( t.ChangeIcon ) { obj=3DGetObj(t.mObjId) if( t.ChangeIcon() ) obj.style.posLeft=3Dobj.style.posLeft+(t.mCurState-4)*t.mWidth else obj.style.posLeft=3Dobj.style.posLeft+(t.mCurState-0)*t.mWidth } t.SetActive() } =20 } function _IBUI( clr1,clr2,nextState ) { var t=3Dthis SetBorder( GetObj( t.mBorderId ),clr1,clr2 ) obj=3DGetObj( t.mObjId ) obj.style.posLeft=3Dobj.style.posLeft+(t.mCurState-nextState)*t.mWidth-obj= .style.posTop t.mCurState=3DnextState return obj } //----------------------------------------- function TxtBtn( oId,oeId,action,chkState ) //----------------------------------------- { var t=3Dthis t.Perform =3D _TBP t.SetActive =3D _TBSetA t.SetInactive=3D _TBSetI t.SetPressed =3D _TBSetP t.SetDisabled=3D _TBSetD t.SetEnabled =3D _TBSetE t.GetState =3D chkState t.UserAction =3D action t.ChgState =3D _TBUI t.mObjId =3D oId t.m_elementsId=3D oeId t.mIsOn =3D 1 } function _TBSetA() { var t=3Dthis if( t.mIsOn && !t.GetState() ) t.ChgState( gHiliteClr,gShadowClr,0,0 ) } function _TBSetI() { var t=3Dthis if( t.mIsOn && !t.GetState() ) t.ChgState( gFaceClr,gFaceClr,0,0 ) } function _TBSetP() { if( this.mIsOn ) this.ChgState( gShadowClr,gHiliteClr,1,1 ) } function _TBSetD() { =20 this.ChgState( gFaceClr,gFaceClr,0,0 ) this.mIsOn =3D 0 } function _TBSetE() { var t=3Dthis if( !t.GetState() ) t.ChgState( gFaceClr,gFaceClr,0,0 ) else t.ChgState( gShadowClr,gHiliteClr,1,1 ) t.mIsOn =3D 1 } function _TBP() { var t=3Dthis if( t.mIsOn ) {=20 if( t.UserAction !=3D null ) t.UserAction() if( !t.GetState ) return if( t.GetState() ) t.SetPressed() else t.SetActive() } =20 } function _TBUI( clr1,clr2,lOffset,tOffset ) { SetBorder( GetObj( this.mObjId ),clr1,clr2 ) Offset( GetObj( this.m_elementsId ),lOffset,tOffset ) } function Offset( obj, top, left ){ obj.style.top=3Dtop; obj.style.left=3Dle= ft } function SetBorder( obj, upperLeft, lowerRight ) { s=3Dobj.style; s.borderStyle =3D "solid" s.borderWidth =3D 1=20 s.borderLeftColor =3D s.borderTopColor =3D upperLeft s.borderBottomColor=3D s.borderRightColor =3D lowerRight } function GetBtnObj(){ return gBtnArr[window.event.srcElement.id] } function BtnOnOver(){ b=3DGetBtnObj(); if( b !=3D null ) b.SetActive() } function BtnOnDown(){ b=3DGetBtnObj(); if( b !=3D null ) b.SetPressed() } function BtnOnOut(){ b=3DGetBtnObj(); if( b !=3D null ) b.SetInactive() } function BtnOnUp() { b=3DGetBtnObj() if( b !=3D null ) b.Perform() else Upd() } function GetNtsState(){ return parent.gNtsOpen } function GetOtlState(){ return parent.gOtlOpen } function GetOtlTxtState(){ return parent.gOtlTxtExp } function NtsBtnSetFlag( fVal ) { s=3Ddocument.all.item( this.m_flagId ).style s.display=3D"none" if( fVal ) s.display=3D"" else s.display=3D"none" } function _BSetA_Border(){ b =3D gBtnArr[this.mObjId]; if( b !=3D null ) b.S= etActive() } function _BSetI_Border(){ b =3D gBtnArr[this.mObjId]; if( b !=3D null ) b.S= etInactive() } function _BSetP_Border(){ b =3D gBtnArr[this.mObjId]; if( b !=3D null ) b.S= etPressed() } function _BSetA_BorderImg() {=20 b =3D gBtnArr[this.mBorderId]=20 if( b !=3D null && this.mIsOn && !b.GetState() ) { obj=3Dthis.ChgState( gHiliteClr,gShadowClr,2 ) obj.style.posTop=3D0 } } function _BSetI_BorderImg() {=20 b =3D gBtnArr[this.mBorderId] if( b !=3D null && this.mIsOn && !b.GetState() ) { obj=3Dthis.ChgState( gFaceClr,gFaceClr,1 ) obj.style.posTop=3D0 } } var gHiliteClr=3D"THREEDHIGHLIGHT",gShadowClr=3D"THREEDSHADOW",gFaceClr=3D"= THREEDFACE" var gBtnArr =3D new Array() gBtnArr["nb_otl"] =3D new TxtBtn( "nb_otl","nb_otlElem",parent.ToggleOtlPan= e,GetOtlState ) gBtnArr["nb_otlElem"] =3D new TxtBtn( "nb_otl","nb_otlElem",parent.ToggleOt= lPane,GetOtlState ) gBtnArr["nb_nts"] =3D new ImgBtn( "nb_nts","nb_ntsBorder",10,parent.ToggleN= tsPane ) gBtnArr["nb_nts"].SetActive =3D _BSetA_BorderImg; gBtnArr["nb_nts"].SetInactive =3D _BSetI_BorderImg; gBtnArr["nb_ntsBorder"] =3D new TxtBtn( "nb_ntsBorder","nb_ntsElem",parent.= ToggleNtsPane,GetNtsState ) gBtnArr["nb_ntsElem"] =3D new TxtBtn( "nb_ntsBorder","nb_ntsElem",parent.To= ggleNtsPane,GetNtsState ) gBtnArr["nb_prevBorder"] =3D gBtnArr["nb_prev"]=3D new ImgBtn( "nb_prev","n= b_prevBorder",30,parent.GoToPrevSld ) gBtnArr["nb_nextBorder"] =3D gBtnArr["nb_next"]=3D new ImgBtn( "nb_next","n= b_nextBorder",30,parent.GoToNextSld ) gBtnArr["nb_sldshw"]=3D new ImgBtn( "nb_sldshw","nb_sldshwBorder",18,parent= .FullScreen ) gBtnArr["nb_sldshwBorder"] =3D new TxtBtn( "nb_sldshw","nb_sldshwBorder",pa= rent.FullScreen,null ) gBtnArr["nb_sldshwBorder"].SetActive =3D _BSetA_Border; gBtnArr["nb_sldshwBorder"].SetInactive =3D _BSetI_Border; gBtnArr["nb_sldshwText"] =3D new TxtBtn( "nb_sldshw","nb_sldshwText",parent= .FullScreen,null ) gBtnArr["nb_sldshwText"].SetActive =3D _BSetA_Border; gBtnArr["nb_sldshwText"].SetInactive =3D _BSetI_Border; gBtnArr["nb_voice"] =3D gBtnArr["nb_voiceBorder"] =3D new ImgBtn( "nb_voice= ","nb_voiceBorder",18,parent.ToggleVNarration ) gBtnArr["nb_otlTxtBorder"] =3D gBtnArr["nb_otlTxt"]=3D new ImgBtn( "nb_otlT= xt","nb_otlTxtBorder",23,parent.ToggleOtlText ) gBtnArr["nb_ntsBorder"].m_flagId=3D "nb_nts" gBtnArr["nb_ntsBorder"].SetFlag =3D NtsBtnSetFlag gBtnArr["nb_otlTxt"].ChangeIcon=3D GetOtlTxtState /********************************************* Context menu implementation _CM() is the function that's hooked up to the oncontextmenu event. Once we're asked to show the menu, we first build it by creating DIVs on-the-fly. Then we position it=20 within the screen area so it doesn't get clipped. Creating the DIVs using createElement() means we don't have to write out any extra HTML into the slide HTML files. **********************************************/ var sNext=3D"Next",sPrev=3D"Previous",sEnd=3D"End Show",sFont=3D"Arial",sAr= row=3D"Arrow",sFreeform=3D"Freeform",sRect=3D"Rectangle",sOval=3D"Oval" function ShowMenu() { BuildMenu(); var doc=3DPPTSld.document.body,x=3DPPTSld.event.clientX+doc.scrollLeft,y= =3DPPTSld.event.clientY+doc.scrollTop m =3D PPTSld.document.all.item("ctxtmenu") m.style.pixelLeft=3Dx if( (x+m.scrollWidth > doc.clientWidth)&&(x-m.scrollWidth > 0) ) m.style.pixelLeft=3Dx-m.scrollWidth m.style.pixelTop=3Dy if( (y+m.scrollHeight > doc.clientHeight)&&(y-m.scrollHeight > 0) ) m.style.pixelTop=3Dy-m.scrollHeight m.style.display=3D"" } function _CM() { if( !parent.IsFullScrMode() ) return; if(!PPTSld.event.ctrlKey) { ShowMenu() return false } else HideMenu() } function BuildMenu() { if( PPTSld.document.all.item("ctxtmenu") ) return var mObj=3DCreateItem( PPTSld.document.body ) mObj.id=3D"ctxtmenu" mObj.style.visibility=3D"hidden" var s=3DmObj.style s.position=3D"absolute" s.cursor=3D"default" s.width=3D"120px" SetCMBorder(mObj,"menu","black") var iObj=3DCreateItem( mObj ) SetCMBorder( iObj, "threedhighlight","threedshadow" ) iObj.style.padding=3D2 CreateMenuItem( iObj,sNext,M_GoNextSld,M_True ) CreateMenuItem( iObj,sPrev,M_GoPrevSld,M_HasPrevSld ) =09 CreateSeparator( iObj ) CreateMenuItem( iObj,sEnd,M_End,M_True ) mObj.style.visibility=3D"visible" } function Cancel() { window.event.cancelBubble=3Dtrue; window.event.returnVa= lue=3Dfalse } function Highlight() { ChangeClr("activecaption","threedhighlight") } function Deselect() { ChangeClr("threedface","menutext") } function Perform() { e=3DPPTSld.event.srcElement if( e.type=3D=3D"menuitem" && e.IsActive() ) e.Action() else PPTSld.event.cancelBubble=3Dtrue } function ChangeClr( bg,clr ) { e=3DPPTSld.event.srcElement if( e.type=3D=3D"menuitem" && e.IsActive() ) { e.style.backgroundColor=3Dbg e.style.color=3Dclr } } function M_HasPrevSld() { return( parent.HasPrevSld() ) } function M_GoNextSld() { if( gIsEndShow ) M_End(); else GoToNextSld() } function M_GoPrevSld() { if( gIsEndShow ) { gIsEndShow=3D0; history.back();= PPTSld.event.cancelBubble=3Dtrue; } else GoToPrevSld() } function M_True() { return true } function M_End() { window.close( self ) } function CreateMenuItem( node,text,action,eval ) { var e=3DCreateItem( node ) e.type=3D"menuitem" e.Action=3Daction e.IsActive=3Deval e.innerHTML=3Dtext if( !e.IsActive() ) e.style.color=3D"threedshadow" e.onclick=3DPerform e.onmouseover=3DHighlight e.onmouseout=3DDeselect s=3De.style; s.fontFamily=3DsFont s.fontSize=3D"9pt" s.paddingLeft=3D2 } function CreateSeparator( node ) { var sObj=3DCreateItem( node ) SetCMBorder(sObj,"menu","menu") var s=3DsObj.style s.borderTopColor=3D"threedshadow" s.borderBottomColor=3D"threedhighlight" s.height=3D1 s.fontSize=3D"0px" } function CreateItem( node ) { var elem=3DPPTSld.document.createElement("DIV") node.insertBefore( elem ) return elem } function SetCMBorder( o,ltClr,rbClr ) { var s=3Do.style s.backgroundColor=3D"menu" s.borderStyle=3D"solid" s.borderWidth=3D1 s.borderColor=3DltClr+" "+rbClr+" "+rbClr+" "+ltClr } ------=_NextPart_01C932A3.5A5B22F0 Content-Location: file:///C:/D4F25912/Day1Glaser_files/fullscreen.htm Content-Transfer-Encoding: quoted-printable Content-Type: text/html; charset="us-ascii" ------=_NextPart_01C932A3.5A5B22F0 Content-Location: file:///C:/D4F25912/Day1Glaser_files/notes_flag.gif Content-Transfer-Encoding: base64 Content-Type: image/gif R0lGODlhCgAKAPcAAAAAAIAAAACAAICAAAAAgIAAgACAgICAgMwENMTExPz8/AAAAAAAAAAAAAAA AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA AAAAAAAAAAAAAAAAAAAAAMDAwP8AAAD/AP//AAAA//8A/wD//////ywAAAAACgAKAEAIKgDx4UNA sKDAgQUTJiCogGHDhBAfFlRAMSFCiAguTozYUGJEiAk0EhQYEAA7 ------=_NextPart_01C932A3.5A5B22F0 Content-Location: file:///C:/D4F25912/Day1Glaser_files/buttons.gif Content-Transfer-Encoding: base64 Content-Type: image/gif R0lGODlhWAESAPf4AAAAAIAAAACAAICAAAAAgIAAgACAgICAgAQEBISEBASEBISEhAQEhMTExAQE /KTM9Pz8/ERERPz8BAT8/KSkpGRkhMTcxCRkxAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA AAAAAAAAAAAAAAAAAAAAAMDAwP8AAAD/AP//AAAA//8A/wD//////yH5BAEAAPgALAAAAABYARIA QAj/APEJHEiwoMGDCBMqXMiwocOHECNKnEixosWLGCEiQKCRo8YDIEHig2DxAD4LKD1avDDhgUuV GUOGbHBR5QGYFBG4fHAB58EKECJEwCfUYAWPFGAygLCRKQIIUKM6WAohKUGgCikcFWh1INWoYKVS 7SrQ41GbIhGYLAuVQVOoC+IyXUuUAkG1HE3KFDhAwkgJc5/qDZmxsOHDiBMrXsy4sePDGyP7lChT 5MULmDPnlDw5YmW6FTNrfgi0aNGEZPEtbfo2bNTUpYeeRph69dPWrqvCNFuBIGG1A59CYPAVQtwF cw0OxWdTIOiBCQAjaAB17fOFII8voGmRc+eOkilm/z9OvTtnjN4hYk1YoT3H2rnBOphPAB9skgq3 2lcaX/5YnJVt9BloAar12UEIRGCZdQghMABI1Tn32IQUVthYexhmqGGGMBHAgIfEhSiiiATAtOGJ GnYI4ogsEldicAYOGNJGZaml3Y0L3NTZUBz1xlB0PUoUI0jlVWRSVN89xBKSGB1YU1TMoRfVBEle hR9HQs1GEHxQ3RZZbveZthxt/LEmXHyp5XWABSCpaRJwbM13gAACPHVccgJFgF+NEhqUAEkQSCfc ddhVhh5dVTaEAEsTUNlkZUWKN9BNGDE6QU8OrSdbllzpxyVTTrU21Uj3scfhp7nNpyoDaTIEJ3P9 If8J2kbLNYegg9JRBwGhFvbq66+ZUiDssMQWK2yHxiZLrInKNotss8l+B5yBrr5p2UIJvortANoC 6+234IbLla/elRtZjeamh5CC3Sb0YLvixivvYkDFGlZqBNh7r4n6goVvv6/ZlCicN+kL71ALTnpQ dCIZp7CihkLA3UQmoWRBogyxtBPGCTnZncVR1rSTo5nuydC/Eo8kUH+lOoTyyvjoCuZu+PjYIKLD rZybtrM1d10C0QXKEVz48GrQkEeWdFJKlbb0UmEeV0SzyC6RvNB646LWIVjUNeC1zAFb+RDKXksM 9r531bwmpQW9+hQDDsx5pqwDRWBXcFES2hc+gEn/wJGdEEWdE6LoWcoxQweaTNmkhydkKaYMYY2Q p1unbLl/pPKbn3v7EZRvrKvqlja2ONvrtoIw9tn2g32/tQBlhtYkU+MNikZ7QYlPDPuMldpOmuJX nVo5VF3HjI+q89mteX5IDd/fVFClma5kiE4f2XUJhlz09gj2NbTDRifkmu7zXjR++RVJ/lPznuvr QH2iD6S+UewP9Dnon6d2NLwN8n90BB6hC68cFMCHoe+ACASP9c4DowUyEF0OPFcDI0ij/VXPaAKC UfhS95AKGoQ7IBRICI1HwhGaUIQoLGEKT6jCFrLwhSuMoQtlCMMZ2rCGOKShDm+4wxzy8Ic+DGIP B4cIRCKGMCAAOy== ------=_NextPart_01C932A3.5A5B22F0 Content-Location: file:///C:/D4F25912/Day1Glaser_files/frame.htm Content-Transfer-Encoding: quoted-printable Content-Type: text/html; charset="us-ascii" Slide 1 ------=_NextPart_01C932A3.5A5B22F0 Content-Location: file:///C:/D4F25912/Day1Glaser_files/outline.htm Content-Transfer-Encoding: quoted-printable Content-Type: text/html; charset="us-ascii"

No= tes

Slide Show

Outline

1

Pre and post natal brain development and the impact of the environment<= /a>

Danya Glaser

Great Ormond Street Hospital, London

Family Justice Council

International Society for the Prevention of Child Abuse and Neglect (ISPCAN)

2

Some meanings of= living with child maltreatment

Deprivation of experiences

Lack of empathy

Models of aggression

Exposure to frightening and traumatic experiences

Pain

Emotional insults

Lack of affect regulation

Unpredictability

3

Brain and Mind

Mind =3D cognition, emotion & behaviour

Brain includes structure & function – cells, synapses; neurotransmitters;

All mind functions reflect functions of the brain, autonomic nervous system and some body sensations

Different brain areas involved in different mind functions, with multiple connections

Mind effects of CAN well documented

CAN effects on brain being studied with postulated explanations for = mind effects

4

Brain-mind Equivalents=

Left frontal lobe activity associated with approach behaviour and positive emotion

Right frontal lobe activity associated with withdrawal behaviour and negative emotion

Right brain development dominant in infancy – including attach= ment experiences

Right brain dominant for emotion processing (+ limbic system)

Prefrontal cortex –

Executive function:

Inhibition or response, set shift, selective attention, planning

Emotion regulation

5

6

Brain Developmen= t (1)

Most neurons formed / migrated in embryo/early post-natal life.

Brain growth greatest in 1^st&n=
bsp;yr, spurt continuing into 4^th year.

In 1^st 2 yrs, serial overproduction of axons & dendrites, their myelination, glial cells and vasculature.

Randomly connected synapses

Genetically determined stepwise sequence of synaptogenesis in brain = areas & later pruning of synapses.

7

Brain Developmen= t (2)

Experience determines which synapses are pruned

(Critical) sensitive periods for different brain areas to remain open/receptive to normal, expected & required experiences

=3D Experience expectant development

If no experience during (long) sensitive period, capacity for that function is lost

Nature of experience will determine which synapses will survive (e.g. sounds in a particular language- ‘r’ & ‘l̵= 7; not in Japan)

8

Brain Developmen= t (3)

Experience dependent development =3D new learning

Not dependent on critical/sensitive periods

New synapses formed

Lifelong learning & neural plasticity

BUT - New learning/synapses do not replace previous synapses

The longer the ‘old’ information continues, the longer l= ater learning of ‘replacement information’ takes

9

Five issues<= /font>

Effects on developing brain, of:-

Prenatal exposure and experience

Extreme deprivation

Adaptation to experiences

Stress

and

Gene-environment interactions

10

Prenatal Factor= s

Alcohol abuse

Drug abuse

Maternal Stress

No legal mandate to influence maternal behaviour & therefore no legal protection of foetus

11

Prenatal factor= s

Opiates

Probably no damage to brain but stress of withdrawal

Cocaine

Cocaine affects devel= oping systems in the brain (dopamine, serotonin, noradrenaline (“Reward” neurotransmitters) &ag= rave; executive function and regulation of level of emotion= al arousal

crucial to how brain forms structurally

Also critical to connectivity across brain regions, e.g., which imp= acts the gating of levels of stimulation to prefrontal cortex and hence, when “switch” between predominantly executive and autom= atic responding occurs

Neurobehavioral effects including

increased emotional lability, distractibility, impulsivity, impaired attention to novel, structured tasks, decreased inhibition & switching

Longer response times (disrupted connectivity in frontal brain regi= ons)

12

Prenatal effect= s

Foetal alcohol syndrome

Foetal alcohol effects

Structural effects on total brain size, hippocampus, frontal lobes, corpus callosum and basal ganglia

Neurobehavioural effects

Delayed motor and speech

Hearing impairments

Slower or less efficient information processing

Mathematical and short term memory deficits

Mental retardation

Behavioral problems

13

Extreme deprivation/neglect

Probable sensitive period for developing stranger wariness < 3 yr= s.

If no selective attachment formed by 3 years, children may become disinihibited in their approach to strangers

?Sensitive periods for affect regulation

? Sensitive period for normal development of oxytocin – vasopressin system

No rise in TO & VP in ex-orphanage children following play with adopt. mothers

14

Neglect

Reduced brain size

Reduced brain activity

Reduced brain development

Corpus callosum

? Sensitive period or delayed maturation

15

Adaptation to a= busive experience

ERP response amplitudes elevated in physically abused children, when target is angry face (> happy face).

Physically abused children interpret ambiguous frightened/sad-angry<= /li>

facial expressions as angry.

Neglected children had more difficulty in distinguishing between different emotions.

Normally reared children distinguished different emotions.

16

Stress in CAN

Direct effect of physical violence

Fear, pain

Effect of observing domestic violence

Fear

Sexual abuse

Fear, powerlessness, psychological discomfort – trauma

Neglect

Fear of abandonment, discomfort/pain not alleviated, hunger or other deprivation

17

Stress Response=

Physiological & psychological coping mechanism

Necessary for survival

Enduring individual variations in stress response, based on differen= ces in temperament and on prior experience

18

Stress Response=

Sympathetic nervous system (immediate)

- adrenaline & noradrenaline

fight or flight response

elevated heart rate = & blood pressure

elevated blood gluco= se

Decreased vasopressin & oxytocin

Neurotransmitter system

Hypothalamic-pituitary-adrenal axis (HPA)

19

Oxytocin & vasopressin

Associated with

Reduced stress

Affiliative love

Maternal caregiving

20

Stress pathways=

21

Hypothalamic-pi= tuitary-adrenal Axis

Physiological hormonal pathway, connecting brain to adrenal cortex
Corticotropin Releasing Factor (CRF)

ACTH   adrenal cortex    cor= tisol

=3D Negative feedback loop

Diurnal cortisol level variation

– up morning,   down afternoon

CRF à vasopr= essin & oxytocin

22

Costs of stress response

Cortisol à   glial cell division <= /font>à

      myelination

Cortisol à r= educed immune & inflammatory response

Hippocampus & vermis harmed by    cortisol

High concentration of GC receptors.

Hippocampus concerned with memory

In 1 year old infants,

-ve correlation between ERPs recording hippocampal activity & salivary cortisol

23

Effects of stre= ss of CAN (1)

HPA axis dysregulation – elevated cortisol, altered diurnal variation, blunted cortisol stress response

Low morning cortisol level associated with externalising behaviour problems (? Genetic or 2º to early stress)

24

Effects of stre= ss of CAN (2)

Children with PTSD, sexually abused at 2-6, & phys. abused at 1-3, +DV à

Reduced brain volume on MRI

Reduced middle portion of corpus callosum &ag= rave;

decd. hemispheric integration

incd. hemispheric laterality

R frontal and temporal EEG dominance (=3Dreversal)

Abnormalities correlated +vely with duration of abuse

25

Genetic vulnera= bility

Children vulnerable to the effects of maltreatment

? Higher genetic stress reactivity

Low levels of a gene encoding neurotransmitter-metabolising enzyme = MAOA + maltreatment à antisocial behaviour

Genetic variant (short allele) of serotonin transporter gene + maltreatment à depression in late adolescence

26

Epigenetics –
developmental programming

Environment influences gene expression

Experience adaptive programming

Rat experiments Michael Meaney et al

Genetically-determined high maternal grooming transmitted to genetically low offspring with enduring effects on offsprings’ maternal behaviour

Mechanism of this lasting response =3D effects on gene expression in offsprings’ brain      (b= ut not heritable)

27

Effects of atta= chment security on brain functioning

Security of attachment in human infants is equivalent buffer of the = HPA axis

Strong association between salivary cortisol & distress during S= ST- in infants classified as disorganised/disorientated

Raised cortisol levels in young children with disorganised attachmen= t

28

Conclusions=

Experience determines pattern of brain development

Effect of serious deprivation

Most harm by

early experiences incorporated into neural networks

Effects of stress

Established connections not erasable but new learning (synapses) possible

Parental patterns often enduring

Secure attachment is protective of stress response

29

Conclusions=

Differential genetic vulnerability - ? Early identification of vulnerable children

Intervene early to

Maximise potential to compensate for irreversible damage

Minimise negative experiences affecting brain development

Minimise stress

= = = = = = = = =
------=_NextPart_01C932A3.5A5B22F0 Content-Location: file:///C:/D4F25912/Day1Glaser_files/filelist.xml Content-Transfer-Encoding: quoted-printable Content-Type: text/xml; charset="utf-8" ------=_NextPart_01C932A3.5A5B22F0--


	Ambiti= ous and only very partial exposition
	Enviro= nment specifically maltreatment &= #8211; abuse and neglect


	Contex= t for talk is the relationship between mi= nd and brain. Crudely – biology and psychology. Kandel’s review in A= m J of psychiatry traces the development of the divergence between the two.


	Althou= gh dentate gyrus of Hippocampus continues to generate new neurons postnatally=


	Prunin= g in order to minimise ‘noise’, reduce redundancy, reduce energy need in brain, although reduces plasticity.


	Early = stress greater fearfulness, and therefore greater stress response.

1	Pre and post natal brain development and the impact of the environment<= /a> Danya Glaser Great Ormond Street Hospital, London Family Justice Council International Society for the Prevention of Child Abuse and Neglect (ISPCAN)
2	Some meanings of= living with child maltreatment Deprivation of experiences Lack of empathy Models of aggression Exposure to frightening and traumatic experiences Pain Emotional insults Lack of affect regulation Unpredictability
3	Brain and Mind Mind =3D cognition, emotion & behaviour Brain includes structure & function – cells, synapses; neurotransmitters; All mind functions reflect functions of the brain, autonomic nervous system and some body sensations Different brain areas involved in different mind functions, with multiple connections Mind effects of CAN well documented CAN effects on brain being studied with postulated explanations for = mind effects
4	Brain-mind Equivalents= Left frontal lobe activity associated with approach behaviour and positive emotion Right frontal lobe activity associated with withdrawal behaviour and negative emotion Right brain development dominant in infancy – including attach= ment experiences Right brain dominant for emotion processing (+ limbic system) Prefrontal cortex – Executive function: Inhibition or response, set shift, selective attention, planning Emotion regulation
5
6	Brain Developmen= t (1) Most neurons formed / migrated in embryo/early post-natal life. Brain growth greatest in 1^st&n= bsp;yr, spurt continuing into 4^th year. In 1^st 2 yrs, serial overproduction of axons & dendrites, their myelination, glial cells and vasculature. Randomly connected synapses Genetically determined stepwise sequence of synaptogenesis in brain = areas & later pruning of synapses.
7	Brain Developmen= t (2) Experience determines which synapses are pruned (Critical) sensitive periods for different brain areas to remain open/receptive to normal, expected & required experiences =3D Experience expectant development If no experience during (long) sensitive period, capacity for that function is lost Nature of experience will determine which synapses will survive (e.g. sounds in a particular language- ‘r’ & ‘l̵= 7; not in Japan)
8	Brain Developmen= t (3) Experience dependent development =3D new learning Not dependent on critical/sensitive periods New synapses formed Lifelong learning & neural plasticity BUT - New learning/synapses do not replace previous synapses The longer the ‘old’ information continues, the longer l= ater learning of ‘replacement information’ takes
9	Five issues<= /font> Effects on developing brain, of:- Prenatal exposure and experience Extreme deprivation Adaptation to experiences Stress and Gene-environment interactions
10	Prenatal Factor= s Alcohol abuse Drug abuse Maternal Stress No legal mandate to influence maternal behaviour & therefore no legal protection of foetus
11	Prenatal factor= s Opiates Probably no damage to brain but stress of withdrawal Cocaine Cocaine affects devel= oping systems in the brain (dopamine, serotonin, noradrenaline (“Reward” neurotransmitters) &ag= rave; executive function and regulation of level of emotion= al arousal crucial to how brain forms structurally Also critical to connectivity across brain regions, e.g., which imp= acts the gating of levels of stimulation to prefrontal cortex and hence, when “switch” between predominantly executive and autom= atic responding occurs Neurobehavioral effects including increased emotional lability, distractibility, impulsivity, impaired attention to novel, structured tasks, decreased inhibition & switching Longer response times (disrupted connectivity in frontal brain regi= ons)
12	Prenatal effect= s Foetal alcohol syndrome Foetal alcohol effects Structural effects on total brain size, hippocampus, frontal lobes, corpus callosum and basal ganglia Neurobehavioural effects Delayed motor and speech Hearing impairments Slower or less efficient information processing Mathematical and short term memory deficits Mental retardation Behavioral problems
13	Extreme deprivation/neglect Probable sensitive period for developing stranger wariness < 3 yr= s. If no selective attachment formed by 3 years, children may become disinihibited in their approach to strangers ?Sensitive periods for affect regulation ? Sensitive period for normal development of oxytocin – vasopressin system No rise in TO & VP in ex-orphanage children following play with adopt. mothers
14	Neglect Reduced brain size Reduced brain activity Reduced brain development Corpus callosum ? Sensitive period or delayed maturation
15	Adaptation to a= busive experience ERP response amplitudes elevated in physically abused children, when target is angry face (> happy face). Physically abused children interpret ambiguous frightened/sad-angry<= /li> facial expressions as angry. Neglected children had more difficulty in distinguishing between different emotions. Normally reared children distinguished different emotions.
16	Stress in CAN Direct effect of physical violence Fear, pain Effect of observing domestic violence Fear Sexual abuse Fear, powerlessness, psychological discomfort – trauma Neglect Fear of abandonment, discomfort/pain not alleviated, hunger or other deprivation
17	Stress Response= Physiological & psychological coping mechanism Necessary for survival Enduring individual variations in stress response, based on differen= ces in temperament and on prior experience
18	Stress Response= Sympathetic nervous system (immediate) - adrenaline & noradrenaline fight or flight response elevated heart rate = & blood pressure elevated blood gluco= se Decreased vasopressin & oxytocin Neurotransmitter system Hypothalamic-pituitary-adrenal axis (HPA)
19	Oxytocin & vasopressin Associated with Reduced stress Affiliative love Maternal caregiving
20	Stress pathways=
21	Hypothalamic-pi= tuitary-adrenal Axis Physiological hormonal pathway, connecting brain to adrenal cortex Corticotropin Releasing Factor (CRF) ACTH adrenal cortex cor= tisol =3D Negative feedback loop Diurnal cortisol level variation – up morning, down afternoon CRF à vasopr= essin & oxytocin
22	Costs of stress response Cortisol à glial cell division <= /font>à myelination Cortisol à r= educed immune & inflammatory response Hippocampus & vermis harmed by cortisol High concentration of GC receptors. Hippocampus concerned with memory In 1 year old infants, -ve correlation between ERPs recording hippocampal activity & salivary cortisol
23	Effects of stre= ss of CAN (1) HPA axis dysregulation – elevated cortisol, altered diurnal variation, blunted cortisol stress response Low morning cortisol level associated with externalising behaviour problems (? Genetic or 2º to early stress)
24	Effects of stre= ss of CAN (2) Children with PTSD, sexually abused at 2-6, & phys. abused at 1-3, +DV à Reduced brain volume on MRI Reduced middle portion of corpus callosum &ag= rave; decd. hemispheric integration incd. hemispheric laterality R frontal and temporal EEG dominance (=3Dreversal) Abnormalities correlated +vely with duration of abuse
25	Genetic vulnera= bility Children vulnerable to the effects of maltreatment ? Higher genetic stress reactivity Low levels of a gene encoding neurotransmitter-metabolising enzyme = MAOA + maltreatment à antisocial behaviour Genetic variant (short allele) of serotonin transporter gene + maltreatment à depression in late adolescence
26	Epigenetics – developmental programming Environment influences gene expression Experience adaptive programming Rat experiments Michael Meaney et al Genetically-determined high maternal grooming transmitted to genetically low offspring with enduring effects on offsprings’ maternal behaviour Mechanism of this lasting response =3D effects on gene expression in offsprings’ brain (b= ut not heritable)
27	Effects of atta= chment security on brain functioning Security of attachment in human infants is equivalent buffer of the = HPA axis Strong association between salivary cortisol & distress during S= ST- in infants classified as disorganised/disorientated Raised cortisol levels in young children with disorganised attachmen= t
28	Conclusions= Experience determines pattern of brain development Effect of serious deprivation Most harm by early experiences incorporated into neural networks Effects of stress Established connections not erasable but new learning (synapses) possible Parental patterns often enduring Secure attachment is protective of stress response
29	Conclusions= Differential genetic vulnerability - ? Early identification of vulnerable children Intervene early to Maximise potential to compensate for irreversible damage Minimise negative experiences affecting brain development Minimise stress