Childhood Trauma

What are the main points of the article?

Introduction

there is evidence to suggest that multiple exposures to trauma in childhood results in more adverse effects

this phenomena is known as poly-victimization or complex trauma = exposure to multiple types of recurring instances of interpersonal abuse, as well as, the child’s trauma stress symptoms in response to the maltreatment

experience can include emotional, sexul, physical abuse, negelect, witnessing domestic violence

trauma stress symptoms = the response observed in both directly following trauma and in the long-term

multiple impacts of trauma research shows that it is both immediately damaging and contributes to the emergence of significant problems later in life

children who experience

neglect are linked to higher instances of ADHD, ADD, ODD, and PTSD
trauma is linked to behaviors of overly compliant, explosive, inappropriately sexual, reckless, defiant, or withdrawn
Studies of adults of child abuse/neglect, also show:
75% of male sexual offenders had been sexually abused as children
in relationships: males show increased likelihood of violence and increased abusive behaviors in females

mental health: increased rates of major depressive disorder, personality disorders, self harming, and suicidal behaviors
trauma has also been associated with developmental delays in neurobiology which then has effects on functioning and contributes to risk of pathology
children exposed to multiple traumas has been linked to cognitive, language, motor, and social skills
struggle to develop internal schemas and appropriate ways of identifying and coping with their emotions
prenatal stress affects the development of all structures involved with the HPA axis whereas the hippocampus is most vulnerable in early childhood
problems may lead to emotional disorders
the prenatal exposure to stress leaves their brains more developmentally vulnerable and thus more susceptible to adverse effects if their is childhood trauma
it is hypothesized that there is a sensitive period after birth in which high levels of stress alter the developmental pathways of the brain = stress - responsive pathways
the brain is not unable to cope with stress responses, rather, early exposure to adverse environments directs development so it is designed to allow the individual to cope with high levels of stress, and to optimize their chances of survival and reproduction.
this pathway becomes problematic when in non-threatening environments
PTSD - a severe anxiety disorder
stress of adolescence coupled with this brain wiring may contribute to higher rates of PTSD, generalized anxiety disorder
over activation of stress system leads to the suppression of the immune system, putting individuals at risk for development of health problems
exposure to multiple trauma compounds effects of single trauma
For this study trauma and trauma stress symptoms are measured by Child and Adolescent Needs and Strengths
describes the extent and quality of both trauma experiences, traumatic stress, and other behavioral and emotional challenges.
Complex trauma has been linked to problems in 7 domains
attachment, biology, affect regulation, dissociation, behavior control, cognition, and self-concept.
purpose of this study = determine whether there are developmental differences in the needs and responses of children and youth exposed to complex trauma
Methods
3,732 cases of children or youth who have experienced complex trauma
had DCFS contact between 2005-2010
11,988 observations
assessed using Child and Adolescents Needs and Strengths
Will compare the frequency and type of trauma stress responses according to following age groups
0-2, 2-4, 5-6, 7-11, 12-15,16-18 years old
Results
main effect for age and complex trauma were significant
interaction of age and complex trauma was significant
results showed -- children and youth with complex trauma have far more trauma stress symptoms, as children age, the experiences involve increasingly high levels of trauma stress symptoms, and finally, the impact of complex trauma on trauma stress symptoms is greater for older adolescents than for children.
children with complex trauma experiences were more likely to have motor, communication, failure to thrive, regulatory problems, parent/siblings developmental problems, lower maternal availability, and fewer identified strengths (i.e. playfulness and curiosity)
children without complex trauma experiences were more likely to have birth weight, prenatal care
Discussion
complex trauma is associated with different symptom presentations from children to adolescents
could be reflective of three phenomenons
greater resiliency on the part of children
a developmental unfolding process with regard to the manifestation of responses to trauma
differential trauma responses in children and youth
All ages were significantly different than each other with the exception that 12-15 was not significantly different than 16-18
Traumatic stress symptoms increase in severity from early childhood to older youth
older children would need the most treatment to relieve symptoms
early childhood interventions may be able to prevent the development of pathology in adulthood - leading to lower costs and increased functioning

What is the article’s theoretical relevance to the course?

The article provides a framework for a clinician or Child Social Worker that may allow them to be more understanding of the trauma symptoms a client is displaying. This article offers a viewpoint founded in neurobiology and extensive quantitative data to show common short and long terms effects of complex trauma and with rationale in neurobiological explanations.

How does this article add to our understanding of the case you are

presenting?
The clientele that comes into contact with the Department of Children and Family Services (DCFS) can often be classified as having experienced complex trauma. If not before initial contact with DCFS, contact itself can be traumatic, thus creating complex trauma. Understanding complex trauma, and all of the implications, is critical to work in DCFS, and making accurate assessments of the child and family.

What is your critical evaluation of the article? What are its theoretical strengths and deficiencies in terms of helping social work practitioners better understand children and adolescents behavior?
Overall the article offered a strong contribution to complex trauma research. Its main strengths lie in its ability to use a combination or quantitative research to show outcomes of complex trauma and neurobiology to explain the results. This detailed explanation allows the clinician to more fully understand the symptoms and thus, be able to adapt an intervention that will be most effective for the client. The article is deficient in offering a solution. It brilliantly points out short and long term effects of complex trauma, but offers little as to where an intervention might be most helpful, or how to mitigate the negative effects. It also does not adequately explore individuals with complex trauma who did not exhibit negative effects.