Childhood Traumatic Stress

Childhood traumatic stress is a term that is commonly used in the field of mental health to describe the psychological impact of traumatic events on children and youth where the usual coping abilities to extreme stressors are overwhelmed. According to the National Child Traumatic Stress Network (NCTSN), about one in every four children will experience at least one traumatic event before the age of 16. A child who experiences trauma may develop symptoms of posttraumatic stress or post-traumatic stress disorder (PTSD).

According to the Diagnostic and Statistical Manual of Mental Disorders, PTSD is a disorder that results from exposure to traumatic events that involve actual or threatened death or serious injury to self or to another. To meet diagnostic criteria for the disorder, an individual would need to have reexperiencing symptoms, and in children, this is often exhibited in the form of repetitive play about traumatic events, disturbing memories, and/or frightening dreams. Avoidance behaviors would also need to be present, such as avoiding thoughts, activities, and places associated with the traumatic event as well as increased arousal in the form of hypervigilance, irritability, and sleep disturbance. All of the aforementioned symptoms would need to be present for at least 1 month and cause significant impairment in social, occupational, or other important areas of functioning. Traumatic stress symptoms can also interfere with the child's ability to concentrate, learn, and perform daily activities at home and in school. In fact, some children will experience academic difficulties. Even for children and youth who do not necessarily meet diagnostic criteria for PTSD, their sense of identity, self-esteem, and their view of the world as a safe place is often altered. Additionally, following traumatic events children and youth can experience heightened anxiety, externalizing or acting out behaviors, as well as physical and somatic symptoms. Noteworthy to mention is that child [Page 85]responses to traumatic events will vary from one child to another depending on age, developmental stage, and the quality of and access to support systems. Furthermore, there may be a cultural dimension to how trauma is conceptualized and responded to by different groups. For mental health practitioners, diagnosing PTSD or other related conditions in very young children may be a challenging task, especially in the absence of primary caregivers or in the presence of atypical symptoms or a complex presentation of chronic exposure to traumatic events. It is important to note, however, that not every child who experiences a traumatic event develops symptoms of posttraumatic stress or the full-blown disorder. In fact, some children and youth become more resilient in the face of adversity. Froma Walsh defines resilience as the ability to overcome life challenges and experience positive outcomes despite trauma, or what is often referred to as “bouncing back” from negative events.