Trauma Types Between Children and Youth?
What Is a Traumatic Event?
A traumatic event is a frightening, dangerous, or violent event that poses a threat to a child’s life or bodily integrity. Witnessing a traumatic event that threatens life or physical security of a loved one can also be traumatic. This is particularly important for young children as their sense of safety depends on the perceived safety of their attachment figures.
Traumatic experiences can initiate strong emotions and physical reactions that can persist long after the event. Children may feel terror, helplessness, or fear, as well as physiological reactions such as heart pounding, vomiting, or loss of bowel or bladder control. Children who experience an inability to protect themselves or who lacked protection from others to avoid the consequences of the traumatic experience may also feel overwhelmed by the intensity of physical and emotional responses.
Even though adults work hard to keep children safe, dangerous events still happen. This danger can come from outside of the family (such as a natural disaster, car accident, school shooting, or community violence) or from within the family, such as domestic violence, physical or sexual abuse, or the unexpected death of a loved one.
What Experiences Might Be Traumatic?
Physical, sexual, or psychological abuse and neglect (including trafficking)
Natural and technological disasters or terrorism
Family or community violence
Sudden or violent loss of a loved one
Substance use disorder (personal or familial)
Refugee and war experiences (including torture)
Serious accidents or life-threatening illness
Military family-related stressors (e.g., deployment, parental loss or injury)
When children have been in situations where they feared for their lives, believed that they would be injured, witnessed violence, or tragically lost a loved one, they may show signs of child traumatic stress.
Bullying, also known as peer victimization, is a deliberate and unsolicited action that occurs with the intent of inflicting social, emotional, physical, and/or psychological harm to someone who often is perceived as being less powerful. Bullying typically happens repeatedly and is a form of aggression and harassment that prevents someone from enjoying a safe, stress-free living, learning, or working environment. The harmful effects of bullying may be exacerbated by the frequency, pervasiveness, and severity of the behavior, as well as the power differential between the perpetrator and the target. Bullying can be physical (hitting, tripping, kicking, etc.), verbal (name calling, teasing, taunting, threatening, and sexual comments), and social (spreading rumors, embarrassing someone in public, being purposefully exclusive). Cyberbullying includes sending negative, harmful, and/or false content electronically via text messages or email, as well as posting mean text or hurtful pictures online through social media, blogs, etc.
Community violence is exposure to intentional acts of interpersonal violence committed in public areas by individuals who are not intimately related to the victim. Common types of community violence that affect youth include individual and group conflicts (e.g., bullying, fights among gangs and other groups, shootings in public areas such as schools and communities, civil wars in foreign countries or “war-like” conditions in US cities, spontaneous or terrorist attacks). Although people can anticipate some types of traumatic events, community violence can happen suddenly and without warning. Consequently, youth and families who live with community violence often have heightened fears that harm could come at any time and experience the world as unsafe and terrifying. In addition, although some types of trauma are accidental, community violence is an intentional attempt to hurt one or more people and includes homicides, sexual assaults, robberies, and weapons attacks (e.g., bats, knives, guns).
Complex trauma describes both children’s exposure to multiple traumatic events—often of an invasive, interpersonal nature—and the wide-ranging, long-term effects of this exposure. These events are severe and pervasive; such as abuse or profound neglect. They usually occur early in life and can disrupt many aspects of the child’s development and the formation of a sense of self. Since these events often occur with a caregiver, they interfere with the child’s ability to form a secure attachment. Many aspects of a child’s healthy physical and mental development rely on this primary source of safety and stability.
Natural disasters include hurricanes, earthquakes, tornadoes, wildfires, tsunamis, and floods, as well as extreme weather events such as blizzards, droughts, extreme heat, and wind storms. These events can lead to many adversities for children and families, including displacement, loss of home and personal property, changes in schools, economic hardship, loss of community and social supports, and even the injury and death of loved ones.
Early childhood trauma generally refers to the traumatic experiences that occur to children aged 0-6. Because infants’ and young children’s reactions may be different from older children’s, and because they may not be able to verbalize their reactions to threatening or dangerous events, many people assume that young age protects children from the impact of traumatic experiences. A growing body of research has established that young children may be affected by events that threaten their safety or the safety of their parents/caregivers, and their symptoms have been well documented. These traumas can be the result of intentional violence—such as child physical or sexual abuse, or domestic violence—or the result of natural disaster, accidents, or war. Young children also may experience traumatic stress in response to painful medical procedures or the sudden loss of a parent/caregiver.
Intimate Partner Violence
Intimate Partner Violence (IPV), also referred to as domestic violence, occurs when an individual purposely causes harm or threatens the risk of harm to any past or current partner or spouse. While abuse often occurs as a pattern of controlling and coercive behavior, an initial episode of abuse may also be cause for concern. Tactics used in IPV can be physical, sexual, financial, verbal, or emotional in nature against the partner. Individuals may also experience stalking, terrorizing, blame, hurt, humiliation, manipulation, and intentional isolation from social supports and family. IPV can vary in frequency and severity.
Children are often the hidden or silent victims of IPV, and some are directly injured, while others are frightened witnesses. Children with IPV exposure are more likely to have also experienced emotional abuse, neglect, physical abuse, and community violence. As the scope of the problem has become understood, IPV is now identified as a significant legal and public health issue, not only a private family problem.
Abuse can affect families and communities across generations, and can occur across the lifespan, from dating teens to elderly couples. There are laws in every state that address IPV. Abuse occurs in all types of relationships and among people with varying backgrounds of age, race, religion, financial status, sexual orientation, gender identity, and education. Although the majority of victims of IPV are women, it is important to acknowledge that men can be victims too. IPV disproportionately affects members of the LGBTQ community, who experience barriers to assistance from community resources such as shelters or police.
Pediatric medical traumatic stress refers to a set of psychological and physiological responses of children and their families to pain, injury, serious illness, medical procedures, and invasive or frightening treatment experiences. Medical trauma may occur as a response to a single or multiple medical events.
Physical abuse is one of the most common forms of child maltreatment. Legal definitions vary from state to state, but broadly, physical abuse occurs when a parent or caregiver commits an act that results in physical injury to a child or adolescent, such as red marks, cuts, welts, bruises, muscle sprains, or broken bones, even if the injury was unintentional.
Many refugees, especially children, have experienced trauma related to war or persecution that may affect their mental and physical health long after the events have occurred. These traumatic events may occur while the refugees are in their country of origin, during displacement from their country of origin, or in the resettlement process here in the US.
The sections below provide information about Refugees and Refugee Trauma, including basic definitions, a description of refugee core stressors, and recommendations related to screening, assessment, and intervention. Information and resources are available for multiple audiences including mental health professionals, healthcare providers, school personnel, policy makers, and more. To browse resources for a particular audience, visit the NCTSN Resources page below.
Child sexual abuse is any interaction between a child and an adult (or another child) in which the child is used for the sexual stimulation of the perpetrator or an observer. Sexual abuse can include both touching and non-touching behaviors. Non-touching behaviors can include voyeurism (trying to look at a child’s naked body), exhibitionism, or exposing the child to pornography. Children of all ages, races, ethnicities, and economic backgrounds may experience sexual abuse. Child sexual abuse affects both girls and boys in all kinds of neighborhoods and communities.
Terrorism and Violence
Families and children may be profoundly affected by mass violence, acts of terrorism, or community trauma in the form of shootings, bombings, or other types of attacks. The impact will vary depending on the nature of the event and on the experiences of children and families during and afterwards. Some adults and children may have been physically injured and will require medical treatment and long-term rehabilitation. Some may worry about the safety of family members and friends or need to adjust to the death of a loved one. Children and teens may react differently depending on their age and prior experiences. How long it takes to recover will depend on what happened to each individual child and family. Over time, many will return to normal routines, while others may struggle. It is important to be supportive and understanding of different reactions.
While many children adjust well after a death, other children have ongoing difficulties that interfere with everyday life and make it difficult to recall positive memories of their loved ones. A child may have a traumatic reaction after a death that was sudden and unexpected (e.g., through violence or an accident) or a death that was anticipated (e.g., due to illness). If the child’s responses are severe or prolonged and interfere with his or her functioning, the child maybe experiencing Childhood Traumatic Grief.
What Is Child Traumatic Stress?
Children who suffer from child traumatic stress are those who have been exposed to one or more traumas over the course of their lives and develop reactions that persist and affect their daily lives after the events have ended. Traumatic reactions can include a variety of responses, such as intense and ongoing emotional upset, depressive symptoms or anxiety, behavioral changes, difficulties with self-regulation, problems relating to others or forming attachments, regression or loss of previously acquired skills, attention and academic difficulties, nightmares, difficulty sleeping and eating, and physical symptoms, such as aches and pains. Older children may use drugs or alcohol, behave in risky ways, or engage in unhealthy sexual activity.
Children who suffer from traumatic stress often have these types of symptoms when reminded in some way of the traumatic event. Although many of us may experience reactions to stress from time to time, when a child is experiencing traumatic stress, these reactions interfere with the child’s daily life and ability to
function and interact with others. At no age are children immune to the effects of traumatic experiences. Even infants and toddlers can experience traumatic stress. The way that traumatic stress manifests will vary from child to child and will depend on the child’s age and developmental level.
Without treatment, repeated childhood exposure to traumatic events can affect the brain and nervous system and increase health-risk behaviors (e.g., smoking, eating disorders, substance use, and high-risk activities). Research shows that child trauma survivors can be more likely to have long-term health problems (e.g., diabetes and heart disease) or to die at an earlier age. Traumatic stress can also lead to increased use of health and mental health services and increased involvement with the child welfare and juvenile justice systems. Adult survivors of traumatic events may also have difficulty in establishing fulfilling relationships and maintaining employment.
Hosier, David, (2019), a Beginner’s Guide to Childhood Trauma: Types, Effects and Treatments, version kindle.