Understanding Childhood Trauma

Childhood trauma events are scary and/or dangerous experiences that involve actual harm Elementary school children: or the threat of harm before age 18. Despite our • Worrying about safety best efforts to keep children safe, traumatic • Feeling guilty or anxious events still happen. About two out of every three • Having trouble sleeping children experience a traumatic event before age • Not paying attention at school 16. Middle and high school students: While every child reacts differently to trauma, • Feeling more sad than usual these experiences can negatively affect their • Withdrawing health and well-being. It’s important to identify • Engaging in risky behavior children struggling from trauma in order to give • Self-harm them the support they need to heal. • Eating disorders

Examples of childhood trauma: Recovery from trauma: There are many types of childhood trauma, Every child reacts in different ways to trauma, but including: children are often resilient. For many children, the • Physical, sexual, or emotional abuse emotional and physical reactions to trauma • naturally fade over time. • Family violence • Community or school violence However, other children need different types of • Sudden loss of a loved one support to heal from trauma. Some people will • Family using alcohol or drugs even deal with the effects of childhood trauma • Serious accidents or life-threatening illness their whole lives. • Natural disasters What are adverse outcomes due to trauma? How do children react to trauma? For some children, there are more negative Reactions right after a trauma include: outcomes from trauma. With intense trauma, • Fear and anxiety children can go on to develop post-traumatic • Guilt stress disorder, or PTSD. Symptoms of PTSD in • Feeling helpless and overwhelmed children include: • Denial

• Elevated heartbeat and breathing • Flashbacks or nightmares of the trauma • Nausea and vomiting • Avoiding people, places, or things linked to the • Fatigue or exhaustion trauma • Feeling faint • Intrusive thoughts about the trauma • Being constantly on edge/alert Over time, children can also react to trauma in • Being easily startled different ways depending on their age. • Irritability, angry outbursts, or being physically aggressive Preschool children: • Crying or screaming The more adverse experiences that children go • Losing weight through, especially without adequate treatment, • Having difficulty sleeping the more likely they are to have negative • Wanting to be closer to their parents outcomes as adults. These outcomes may • Bed wetting (when it had not been occurring include: previously)

• Trouble in school • Difficulty keeping a job There are many ways to support children after • Being unable to have a healthy relationship trauma: • Mental health issues, including and • Offering comfort anxiety • Helping them feel safe • Alcohol and drug abuse • Keeping their routines • Physical health problems, including cancer and • Supporting them to talk about their feelings diabetes • Explaining that they are not responsible for the trauma Supporting children after trauma: • Developing relaxation and other coping skills Most survivors of trauma go on to recover. • Support in schools or other areas of their life Support, positive experiences, and protective factors can prevent children from lifelong effects If a child is struggling after a traumatic event, help of trauma. is available. Mental health professionals can help children and families cope after trauma and Protective factors after trauma include: recover. Reach out to a doctor, school counselor, • Family support or religious leader for a referral. • Optimism, positive thinking, gratitude • Positive religious coping • Supportive and safe neighborhood and school

By Nicholas Thompson, Medical Student University of Wisconsin School of Medicine

Reviewed by Claudia Reardon, M.D., Associate Professor University of Wisconsin School of Medicine and Public Health Department of Psychiatry

References

• Center for Substance Abuse Treatment (US). Trauma-Informed Care in Behavioral Health Services. Rockville (MD): Substance Abuse and Mental Health Services Administration (US); 2014. (Treatment Improvement Protocol (TIP) Series, No. 57.) Exhibit 1.3-1, Immediate and Delayed Reactions to Trauma. Available from: https://www.ncbi.nlm.nih.gov/books/NBK207191/table/part1_ch3.t1/ • Centers for Disease Control. Adverse Childhood Experiences (ACEs). Accessed at: https://www.cdc.gov/violenceprevention/childabuseandneglect/acestudy/aboutace.html • The Child Traumatic Stress Network. What is Childhood Trauma? Accessed at: https://www.nctsn.org/ • Moore KA, Ramirez AN. Adverse childhood experience and adolescent well-being: do protective factors matter? Child Indicators Res. 2016;9:299–316. • Schaefer, L. M., Howell, K. H., Schwartz, L. E., Bottomley, J. S., & Crossnine, C. B. (2018). A concurrent examination of protective factors associated with resilience and posttraumatic growth following childhood victimization. & neglect, 85, 17-27. • Substance Abuse and Mental Health Services Administration. Understanding Childhood Trauma. Accessed at: https://www.samhsa.gov/child-trauma/understanding-child-trauma