Complex Trauma
Complex Trauma 101
"The term complex trauma describes the dual problem of children’s exposure to traumatic events and the impact of this exposure on immediate and long-term outcomes. Complex traumatic exposure refers to children’s experiences of multiple traumatic events that occur within the caregiving system – the social environment that is supposed to be the source of safety and stability in a child’s life. Typically, complex trauma exposure refers to the simultaneous or sequential occurrences of child maltreatment—including emotional abuse and neglect, sexual abuse, physical abuse, and witnessing domestic violence—that are chronic and begin in early childhood. Moreover, the initial traumatic experiences (e.g., parental neglect and emotional abuse) and the resulting emotional dysregulation, loss of a safe base, loss of direction, and inability to detect or respond to danger cues, often lead to subsequent trauma exposure (e.g., physical and sexual abuse, or community violence)."
| Complex Trauma in Children and Adolescents - White Paper from NCTSN Complex Trauma Task Force |
"Exposure to intrafamilial violence and other chronic trauma results in pervasive psychological and biological deficits. Treatment needs to address issues of safety, stabilise impulsive aggression against self and others, promote mastery experiences, compensate for specific developmental deficits, and judiciously process both the traumatic memories and trauma-related expectations"
| Down will come baby, cradle and all: Diagnostic and therapeutic implications of chronic trauma on child development |
"PTSD captures only a limited aspect of post-traumatic psychopathology. One critical element in determining psychopathology outcomes is the developmental level at which the trauma occurs and whether it occurs in the context of a relationship with a caregiver or intimate partner. For example, victims of car accidents and natural disasters often have quite different clinical presentations than those who experienced abuse, deprivation, and/or neglect at the hands of their caregivers."
| Complex Trauma and Disorders of Extreme Stress (DESNOS) Diagnosis: Assessment and Treatment |
| Proposal to Include a Developmental Trauma Disorder Diagnosis for Children and Adolescents in DSM-V |
| Phenomenology and Psychological Assessment of Complex Posttraumatic States |
ARC provides a framework that seeks to recognize factors that derail normative development, and to work with children, families, and systems to build or re-build healthy developmental pathways.
| Cultural Adaptations of the ARC Framework |
Developmental Trauma Disorder
Whether or not they have symptoms of PTSD, children who have developed in the context of ongoing danger, maltreatment, and inadequate caregiving systems are ill-served by the current diagnostic system.
| Developmental Trauma Disorder: Towards a rational, empirically based diagnosis for traumatized children for the DSM 5 |