effects of trauma on children
DESCRIPTION
EFFECTS OF TRAUMA ON CHILDREN. Armen Sarkissian, EdD HSPP Cummins Behavioral Health Systems, Inc October 15, 2011. DEFINITIONS. TRAUMATIC EVENT ACTUAL OR THREATENED DEATH OR SERIOUS INJURY OR THREAT TO PHYSICAL INTEGRITY RESPONDED WITH INTENSE FEAR, HELPLESSNESS OR HORROR. DEFINITIONS…. - PowerPoint PPT PresentationTRANSCRIPT
EFFECTS OF TRAUMA ON CHILDREN
Armen Sarkissian, EdD HSPPCummins Behavioral Health Systems, IncOctober 15, 2011
DEFINITIONS
TRAUMATIC EVENTACTUAL OR THREATENED DEATH OR SERIOUS INJURY OR THREAT TO PHYSICAL INTEGRITYRESPONDED WITH INTENSE FEAR, HELPLESSNESS OR HORROR
DEFINITIONS…
TRAUMATIC EVENTEvents over which we have no controlPublic or Private Events
DEFINITIONS…
TRAUMATIC EVENTPUBLIC
Natural DisastersWarsTerrorismHostage situations
DEFINITIONS…
TRAUMATIC EVENT: PRIVATESexual Assault/RapeChildhood Physical AbuseChildhood Sexual AbuseChildhood NeglectBullyingVictim of, or Witness to ViolenceDomestic Violence
IMPACT OF TRAUMA
THE IMPACT OF TRAUMAS ARE CUMULATIVE. IF LEFT UNADDRESSED, TRAUMA UNDERLIES A WIDE RANGE OF SOCIAL, PHYSICAL AND BEHAVIORAL HEALTH PROBLEMS
IMPACT OF TRAUMA…
Trauma resulting from prolonged, repeated exposures to violent events can be the most severeTrauma, especially when untreated, can have severe negative impacts on a person’s physical and emotional well-being
IMPACT OF TRAUMA…
Persistent stress leads to:Elevations in heart rate, blood pressure, and stress hormones, which in turn impair:Brain architecture, immune status, metabolic systems, and cardiovascular systems
IMPACT OF TRAUMA…Exposure to traumatic events seems to change the way infants react to future stressorsAnimal and human studies show changes in hormones and brain chemicals after traumaThese brain changes can be long lasting, leading the child to feel numb or anxious
IMPACT OF TRAUMA…
SOCIALSCHOOL PROBLEMSHOMELESSNESSPROSTITUTIONDELINQUINCYCRIMINAL BEHAVIORINABILITY TO HOLD A JOB
IMPACT OF TRAUMA…PHYSICAL HEALTH
HEART DISEASECHRONIC LUNG DISEASELIVER DISEASEHIV-AIDSSKELETAL FRACTURESFIBROMYALGIA
IMPACT OF TRAUMA…
BEHAVIORAL HEALTH51 to 98 PERCENT OF CONSUMERS OF PUBLIC BEHAVIORAL HEALTH SERVICES HAVE TRAUMA HISTORIES
SAME PREVELANCE RATES AS SUBSTANCE ABUSE DISORDERS
IMPACT OF TRAUMA…
IN CHILDREN AND YOUTHTRAUMA RELATED DISORDERS ARE OFTEN INACCURATELY DIAGNOSED AS:
DEPRESSIONBIPOLAR DISORDERADHD/ADDODD
IMPACT OF TRAUMA…
IN CHILDREN AND YOUTHTRAUMA RELATED DISORDERS ARE OFTEN INACCURATELY DIAGNOSED AS…
SEPARATION ANXIETY DISORDERREACTIVE ATTACHMENT DISORDERCONDUCT DISORDERGENERALIZED ANXIETY DISORDERADJUSTMENT DISORDERS
IMPACT OF TRAUMA…
Life areas affected by trauma:
SafetyTrustPower and Sense of CompetenceSelf sufficiency, esteem, ability to self-soothe Intimacy
IMPACT OF TRAUMA…
Trauma perpetrated by humans seems to have a more severe and longer lasting impact on victims than natural disasters
IMPACT OF TRAUMA…
Trauma victims are at a much higher risk for co-occurring mental health and substance related disorders
TRAUMA VICTIMS…
Violence victimizationViolence perpetrationSelf-injuryHost of other coping mechanisms which themselves have devastating human, social, and economic costs
TRAUMA VICTIMS…
Trauma has been linked to:Hallucinations and delusionsDepressionSuicidal tendenciesChronic anxietyIrritabilityHostility and chronic anger
TRAUMA VICTIMS…
Trauma has been linked to…Interpersonal sensitivity or poor “social skills”Somatization such as “fibromyalgia”Eating disordersDissociation
TRAUMA VICTIMS…
IN CHILDREN AND YOUTH:Inability to have loving feelingsDevelopmental regressionNew separation anxietyNew onset of aggressionNew fearsDisruption of play activities
TRAUMA VICTIMS…
Disruption of play activities:Repetitive actionsDriven qualityConstricted qualityPreoccupation with separation, loss, and reunionLoss of play activities, in cases of neglect
DISASTER TRAUMA
All disaster victims are likely to experience some form of traumaMany disaster survivors “recover” from grief and shock after a few months25 percent to 30 percent of those directly affected may develop PTSD
DISASTER TRAUMA…
People are most at risk who have had:
Prior exposure to any trauma; domestic violence, childhood abuse, disaster, etcHistory of mental illness or drug abuse
Post Traumatic Stress Disorder
SYMPTOMS OF PTSD
TRAUMATIC EVENTREEXPERIENCING THE EVENTAVOIDANCEAROUSAL
PREVALENCE OF PTSD
50-60 percent experience a trauma over their lifetimeLifetime PTSD prevalence rate:
Men 5-8 percent Women 10-14 percent
PREVALENCE OF PTSD…
Lifetime PTSD prevalence rate8 percent in US population
PTSD rates increase with type and severity of trauma50 percent of those with PTSD experience it chronically
PREVALENCE OF PTSD…
Most clinicians in the field believe that the prevalence is much higher than what is being reported since most people are reluctant to admit or acknowledge trauma
Can PTSD be prevented?
Trauma is a necessary but not sufficient condition for developing PTSDThe “weak link”Unclear if early intervention is helpful, as was clear post 9-11 and post KatrinaSeems discussion and altruistic activities are helpful for adultsSpiritually oriented adults, cope better
Can PTSD be prevented?
Resilience in youth is a protective factor against developing PTSDIndividual and environmental factors play a partThe most important protective factor is a healthy and well functioning parent
COMORBID CONDITIONS
FOR YOUTH:DEPRESSIONBIPOLAR DISORDERANXIETY / PANICOPPOSITIONAL DEFIANT DISORDERADDICTIONSADD/ADHD
COMORBID CONDITIONSFOR YOUTH…
REACTIVE ATTACHMENT DISORDERDISRUPTIVE BEHAVIOR DISORDERSADJUSTMENT DISORDERSCONDUCT DISORDERSEPARATION ANXIETY DISORDERENURESIS, ENCOPRESISPSYCHOTIC DISORDERS
Assessing for Trauma…
Take every trauma seriously, even if not taken seriously by the reporterAllow the youth to postpone discussing the trauma to a later session
Assessing for Trauma…
Even if the PTSD criteria are not met, trauma may still cause stress in the individual’s life and ability to cope with life situations
Assessing for Trauma…
Trauma causes a change in persons’ view of themselves and of the world around them, as it applies to them
Recognizing Trauma
Discuss with youth information about trauma in general, the effect it has on people, and the availability of effective treatment when relevant
Trauma informed care
Trauma may be addressed while working on concurrent issues, such as substance related disorders, depression, anxiety, panic, oppositional disorders, attention deficit disorders, etc
FINANCIAL COSTS OF TRAUMA
The financial burden of undiagnosed and untreated trauma to society is staggering
FINANCIAL COSTS…
Alcohol and Drug Abuse treatment costs due to untreated trauma were estimated at $160.7 billion in 2000
FINANCIAL COSTS…
The estimated cost to society of child abuse and neglect is $94 billion per year, or $258 million per day
FINANCIAL COSTS…
Long-term psychiatric and medical health care costs are estimated at $100 billion per year for childhood abuse survivors
RESOURCES
Indiana Association for Infant and Toddler Mental Health (iaitmh.org) 317/638-3501 EXT 221Zero to Three (www.zerotothree.org)National Child Trauma Stress Network (www.nctsnet.org)
RESOURCES
mentalhealth.samhsa.gov/nctic
www.thriveintiative.org
www.chadwickcenter.org