Trauma in Children and Teens: Why early intervention is crucial

Trauma is defined as severe psychological distress experienced as a result of exposure to an event, or events, that threaten the safety of oneself or a loved one, or by witnessing this type of event happen to someone else (Am erican Psychiatric Association 2013). In America, two-thirds of children and adolescents will be exposed to a traumatic event before reaching adulthood (Cohen & Mannarino, 2015; Lambert et al., 2017). Types of trauma include, but are not limited to, abuse, housing instability, foster care involvement, bullying, violence, loss of a loved one, a serious accident, school shootings, and natural disasters. Symptoms that traumatized children display may be seen as “problematic or difficult behaviors” if the adults around them are unaware of how trauma can show up in children. As a result, the conditions are not addressed (or worse, they’re punished), increasing the likelihood of the youth developing behavioral or mental health difficulties. 

Childhood trauma negatively impacts the development of the brain and nervous system, as well as personality formation, social skills, and judgement (Goldbeck & Jensen, 2017). The child or teen may not be able to react appropriately to situations. The brain and body remain in a heightened state of arousal, resulting in toxic stress. This can damage neural pathways in the brain, leading to deficits in memory, reasoning, and communication. 

Children with a history of trauma may exhibit oppositional behavior, social withdrawal, hyperactivity, tantrums, sleep disturbances, and bed-wetting. Adolescents may encounter difficulties in identity formation, forming healthy peer relationships, and gaining autonomy.  Higher rates of self-harm, suicidality, substance misuse, and reckless behavior in adolescents have been associated with traumatic events. This population also faces a greater probability of suspension or expulsion than their peers. 

Consequences of childhood trauma extend into adulthood. Studies such as the ACE Study (1998) show that adverse childhood experiences are linked with chronic diseases, sexually transmitted diseases, involvement with the legal system, mental illness, violence, and rape in adults. It has been associated with low academic performance, high unemployment rate, and low socioeconomic status. It also increases the likelihood of PTSD, trauma-and stressor-related disorders, mood and anxiety disorders, somatic disorders, substance abuse, and attempted or completed suicide (Child Welfare Information Gateway 2018; Gunaratnam & Alisic, 2017). To address this growing problem, recognizing the signs and intervening early is vital. 

References

American Psychiatric Association (2013) Diagnostic and statistical manual of mental disorders, 

5th edition (DSM-5). American Psychiatric Press, Washington, DC.

Child Welfare Information Gateway. (2018). Trauma-focused cognitive behavioral therapy: A 

primer for child welfare professionals. Washington, DC: U.S. Department of Health and 

Human Services, Children’s Bureau. 

Cohen, J., & Mannarino, A. (2015). Trauma-focused cognitive behavior therapy for traumatized 

children and families. Child Adolescent Psychiatric Clinics of North America, 24, 557-570.

Goldbeck, L., & Jensen, K. (2017). The diagnostic spectrum of trauma-related disorders in 

children and adolescents. In M.A. Landolt, Cloitre, M., & Schnyder, U (Eds.), Evidence-

based treatments for trauma-related disorders in children and adolescents (pp. 3-

23). Springer International Publishing.

Gunaratnam, S., & Alisic, E. (2017). Epidemiology of trauma and trauma-related disorders in 

children and adolescents. In M.A. Landolt, Cloitre, M., & Schnyder, U (Eds.), Evidence-

based treatments for trauma-related disorders in children and adolescents (pp. 29-

43). Springer International Publishing.

Lambert, H., Meza, R., Martin, P., Fearey, E., & McLaughlin, K. (2017). Childhood trauma as a 

public health issue. In M.A. Landolt, Cloitre, M., & Schnyder, U (Eds.), Evidence-based 

treatments for trauma-related disorders in children and adolescents (pp. 49-61). 

Springer International Publishing.

About the author: Allie Widener is a therapist at Pediatric and Family Behavioral Health with academic and clinical experience working with complex trauma. Allie specializes in children and adolescents who have a history of trauma. At PFBH in Charlotte, Allie works with clients ages 8 to 65 with a variety of struggles, including trauma, depression, anxiety, self-harm, and more.