Childhood Trauma Effects and Treatment
Factors Contributing to Childhood Trauma
When a child experiences trauma, it disrupts his or her sense of safety and could result in long-lasting impact. In the United States, about 5 million children experience some form of trauma each year. Factors and events that are traumatic to children include:
- Unsafe environment
- Separation from a parent
- Physical, sexual, or emotional abuse
- Domestic violence
- Natural disasters
- Life threatening medical procedures
- Serious illness
- Exposure to violence in the community
- Parental neglect - physically or emotionally
Impact of Childhood Trauma
Clinical psychologist, Dr. Tian Dayton, in her book, explains the science behind various types of trauma and the impact on children even into their adulthood. The ACOA Trauma Syndrome, The Impact of Childhood Pain on Adult Relationships,
Traumatic events have a shattering effects on children, and negatively impact their social, physical, cognitive, and emotional development. Trauma is an event more devastating than a person normally would be expected to experience. This psychic trauma occurs as a result of overwhelming, terrifying external events over which the child has no control.
According to Dr Bruce D. Perry, traumatic events during childhood could result in many problems. These include:
- Social problems such as teenage pregnancy, drug abuse, and failure at school
- Psychological effects of childhood trauma, including, post-traumatic stress disorder (PTSD), dssociatve disorder, and conduct disorder
- Medical problems, such as, heart disease and asthma
Post-traumatic stress disorder (PTSD) develops in response to specific extreme stresses, and results in symptoms such as intrusive memories of the traumatic events, emotional with withdrawal, and increased autonomic arousal. Children usually present a mix of intrusive and avoidant symptoms. The most common intrusive symptom is a nightmare that the child sometimes cannot remember. In terms of avoidance symptoms, typically children resist attempts to talk about the events of the trauma, and may appear withdrawn and cautious.
Some children are exposed to multiple or chronic traumatic experiences, such as childhood physical or sexual abuse, or being raised in a war zone or violent neighborhood. It seems that children become emotionally numb, and appear detached with no feelings Also, in many cases, children try to stop thinking about the traumatic experience.
Consequences of Children's Exposure to Violence and Trauma
Psychological Effect of Childhood Trauma: PTSD
The body has set responses to threat, and one common response is called the “flight or fight” reaction. The experience of trauma induces intense and prolonged stress response. When a child experiences trauma, he no longer feels that the world is safe, thus the activated survival response continues. The body is in a constant state "fight or flight" which could result in PTSD symptoms.
Children and teen could suffer from PTSD if they have experienced traumatic events such as sexual and physical abuse, disaster including floods, and school shooting. Factors like the severity of the trauma, lack of support system, and children's proximity to the trauma could increase their chance of suffering from PTSD.
Kronenberger & Meyer (2001) explain that while children with PTSD show many similarities in behavior, there are some differences based on the child’s personality and the type of trauma that is experienced. Children exposed to a single traumatic episode retain detailed intrusive memories of the event, which could affect their level of functioning in various areas including school.
The symptoms of PTSD in children and teens may not be the same as adults. For children who are very young, the symptoms may include bed-wetting, forgetting how to talk, and being unusually clingy to their parents. However, the symptoms might be the same as in adults for older children and teens. In addition, children and teens may develop disrespectful and disruptive behaviors, which may reflect the overwhelming effects of intrusive symptoms.
Through our Eyes: Children, Violence and Trauma
What do you think?
What is the greatest impact of childhood trauma?
Appearance and Features of PTSD
PTSD is an anxiety disorder that develops in response to psychological and physical trauma. Post-traumatic stress disorder symptoms usually start within three months of a traumatic event. However, in few cases, PTSD symptoms may not appear until years after the event. The symptoms are grouped into three categories:
Re-experiencing symptoms (intrusive memories)
- Flashbacks, or reliving the traumatic events over and over
- Upsetting thoughts and dreams about the traumatic event
- Avoiding thoughts, places, objects and events associated with the traumatic event
- Feelings of emotional numbness
- Avoiding or losing interest in activities that were once enjoyable
- Being easily startled or frightened
- Having angry outbursts
- Experiencing difficulty sleeping
- Self-destructive behavior
- Feelings of guilt and shame
Other signs common of PTSD in children include sleep problems, nightmares, exaggerated startle response, panic, and immature or regressed behavior,
Summary of Contributing Factors and Effects of Childhood Trauma
Some Contributing Factors
Impact of Childhood Trauma
Features of PTSD
Violent and unsafe environment
Social problems such as teenage pregnancies and drug abuse
Reliving the traumatic event
Parental separation from child
Psychological problems such as PTSD
Avoiding things that are associated with the traumatic events
Physical and sexual abuse
Medical problems such as heart disease
Feelings of numbness
Natural disasters such as floods
Disrespectful or disruptive behavior
Serous illnesses or intrusive medical procedures
Mentally separating self from the experience
The Child Advocacy Center Model
If you suspect that your child may be suffering from trauma be sure to get him or her assessed and treated promptly by a trained mental health professional.
Psychological Assessment Strategies
Administration of psychological testing assesses the presence and strength of PTSD symptoms. Before treating PTSD, there are several tests that are administered to children and adolescents including the following:
- Cognitive assessment, for example, administering a Wechsler Scale could suggest the degree to which some abilities have been affected by PTSD symptoms.
- Psychological assessment, such as MMPI (for adolescents) and projective personality tests like Rorschach.
- Behavioral assessment, such as, Parental and Teacher Reports, and Child Report may be useful in identifying features associated with PTSD
- Syndrome specific tests, such as, Post-Traumatic Disorder Rating Scales, and the Trauma system Checklist for Children (Kronenberger & Meyer , 2001).
Treating PTSD in Children
PTSD that results from childhood trauma could severely impact the functioning of children, in their childhood and as adults, so early treatment is very important.
1. Cognitive-behavioral Therapy (CBT)
According to the National Center for PTSD, CBT is the most effective method to treat children with PTSD. Specifically, trauma-focused CBT, helps the children to talk about their memories of the trauma. Cognitive-behavioral interventions are used to teach children techniques such as relaxation and cognitive restructuring to deal with intrusive thoughts. Cognitive restructuring techniques also help children to adopt new thoughts and feelings about the trauma.
CBT also uses psycho-education strategies to teach children and their parents about PTSD. An understanding of the disorder helps both child and parent to know what to expect, and so they are better able to deal with the symptoms.
2. Behavioral Interventions
Usually, gradual exposure to the stimuli associated with the trauma, is used to treat children with PTSD. In addition, parents are instructed to provide structure in the lives of children to give then a sense of normalcy. To achieve this, children need clearly defined boundaries and roles. This also gives the children a sense of competence, and feelings of belonging they need.
3. Play Therapy
Non-directive play is usually used with young children to help to treat PTSD. In a safe and structured environment, the child reenacts the traumatic event, using games, drawings, and other methods. This allows children to process their thoughts, and feelings about the traumatic event.
In some cases, medication is prescribed to treat symptoms such as depression and anxiety. This could include anti-depressant such as imipramine, and anxiety-reducing medication such as lorazepam. These could help children to cope better in school and in other activities.
Key Points On Childhood Trauma
Worldwide, many children are severely impacted by events such as sexual and physical abuse, natural disasters such as hurricanes, and life - threatening medical procedures. When they experience traumatic events in childhood, this could impact all area of functioning including the emotional, social, and cognitive domains.
Psychological disorders including PTSD could develop following such traumatic events. This disorder is characterized by re-experiencing, avoidance, and hyper-arousal symptoms. Early intervention is essential, and a number of treatments are available including CBT which utilizes various techniques to reduce children's anxieties.
References and Further Reading
Kronenberger, W. G. & Meyer, R. G. (2001). The child clinician’s handbook (2nd ed.). Needham Heights, MA: Allyn & Bacon.
Mayo Clinic (2013). Post-traumatic stress disorder (PTSD). Accessed June 20, 2013.
National Institute of Mental health (n.d.). What is post-traumatic stress disorder, or PTSD? Accessed June 19, 2013.
National Center for PTSD (2012). PTSD in children and teens. Accessed June 20, 2013.
Perry, B. D. (2003). The effects of traumatic events on children. Accessed June 19, 2013..
© 2013 Yvette Stupart PhD