Childhood trauma may represent a single acute trauma, like a motor vehicle accident, or more chronic, ongoing forms of trauma. This latter form of trauma, which clinicians label Complex Trauma, refers to various categories of interpersonal betrayal, and/or what clinicians describe as Adverse Childhood Experiences (ACE).
Complex trauma arises from interpersonal experiences that often involve betrayal by trusted others, and that are repetitive and/or prolonged. Adverse childhood experiences that are associated with Complex Trauma include childhood abuse, neglect and family issues that interfere with a parent's ability to provide their children with a secure, psychologically healthy environment.
Adverse childhood experiences include a range of concerns like maltreatment, and abuse, various forms of attachment trauma, bullying by a peer or sibling, or the witnessing of domestic violence. Family stressors, like alcoholism or mental illness in a parent, represent examples of adverse childhood circumstances that are associated with Complex Trauma. Community violence or the military abuse that rages across war torn parts of our world are also examples of conditions that can contribute to complex trauma in children.
So too are neglect or abandonment by primary caregivers and others in positions of trust, and/or traumatic losses in those relationships.
As many as 50% of children will experience some form of trauma before their 18th birthday.
Yet few will receive the trauma based assessments required, to determine the extent and nature of their trauma behaviors and symptoms, and appropriate treatment options. Instead children who have suffered, or continue to suffer from Complex Trauma, are often misdiagnosed as suffering from numerous other mental health disorders, when trauma is the primary concern.Typical misdiagnoses may include Attention Deficit Hyperactivity Disorder, or an anxiety disorder, or Oppositional Defiant Disorder or another aggressive behavior disorder. Each of these disorders, share some of the symptoms that characterize a Post Traumatic Stress Disorder.
One trauma expert, who has explored the effects of child abuse noted that when psychiatrists and psychologists see these children as young adults " they come up with all kinds of diagnoses, when in fact what they are simply doing is clumping together some of the outcomes from the pervasive early trauma."
Childhood trauma symptoms, whatever their root, include various cognitive, behavioral, social and emotional concerns that are associated with Post Traumatic Stress Disorder (PTSD). As noted, child trauma victims may be diagnosed
with various mental health concerns, such as depression, or anxiety or ADHD, and/or
other impulse control or executive function issues.They may show withdrawal/avoidant and/or fearful and anxious behaviors, as well as externalizing, acting out and aggressive
behaviors. They may also show high levels of physiological arousal (e.g., hyperactivity) and problems with attention and concentration.
In addition, trauma has long been been recognized as a risk factor for a range of psychological problems in children and adolescents alike. Trauma may also exacerbate any such pre-existing conditions in children, as well as adults.
Children who suffer from childhood trauma, whatever its root, are likely to benefit from a trauma based psychological assessment to determine the nature and extent of the child's trauma related symptoms, and their impact on her functioning at home, at school and in the community.