Childhood (Developmental) Trauma

Question 1

Q1: What is developmental trauma?

Answer 1

Developmental trauma refers to the impact of chronic or severe traumatic experiences during critical stages of a child’s development, including abuse, neglect, and exposure to domestic violence.

Question 2

Q2: What are the types of abuse associated with developmental trauma?

Answer 2

Physical abuse: Hitting, punching, kicking, etc.
Sexual abuse: Exploitation, exposure to pornography, penetration.
Emotional abuse: Rejection, scapegoating, terrorizing, belittlement.
Neglect: Failure to meet basic needs, inadequate supervision, withholding affection.

Question 3

Q3: How does trauma impact brain development in children?

Answer 3

Disrupts attachment bonds with caregivers.
Impairs self-regulation capacities (biological, emotional, and cognitive).
Alters assumptions about self, others, and the world.
Affects templates for relationships.

Question 4

Q4: What is the Adverse Childhood Experiences (ACE) study?

Answer 4

A large-scale study that found links between childhood trauma and long-term outcomes, including higher rates of mental illness, substance use, physical health issues, and suicide attempts.

Question 5

Q5: What are the effects of neglect on brain development?

Answer 5

Hinders emotional regulation and empathy development.
Weakens attachment capabilities.
Impairs cognitive and relational growth.

Question 6

Q6: What are the four trauma responses in children described by Walker (2013)?

Answer 6

Fight: Aggression or defiance.
Flight: Avoidance or running away.
Freeze: Stillness or dissociation.
Fawn: People-pleasing or submission to reduce harm.

Question 7

Q7: What are common mental health outcomes linked to childhood trauma?

Answer 7

PTSD
Mood and anxiety disorders
Substance misuse
Aggressive and conduct problems
Eating disorders
Psychotic disorders like schizophrenia

Question 8

Q8: What physical health issues are associated with high ACEs?

Answer 8

Increased risk of chronic conditions like diabetes, cancer, and stroke.
Greater likelihood of medically unexplained symptoms.
Elevated rates of chronic fatigue and pain syndromes.

Question 9

Q9: What is dissociation in children, and why does it occur?

Answer 9

Dissociation is a psychological escape mechanism in response to unbearable trauma. It involves detachment from reality, often as a survival strategy when physical escape is impossible.

Question 10

Q10: What are the long-term impacts of developmental trauma?

Answer 10

Altered patterns of behavior and relationships.
Persistent changes in self-concept.
Increased sensitivity to stress and future vulnerability.
Physical and mental health challenges.

Question 11

Q11: What are the four main attachment styles in children?

Answer 11

Secure: Caregivers provide consistent support, enabling emotional regulation and trust.
Insecure-Resistant (Ambivalent): Caregivers respond inconsistently, leading to fear of abandonment and exaggerated distress.
Insecure-Avoidant: Caregivers reject emotional expressions, causing the child to minimize distress and avoid closeness.
Disorganized: Caregiver is both a source of comfort and fear, creating confusion and contradictory behaviors.

Question 12

Q12: How does emotional dysregulation manifest in children with trauma?

Answer 12

Difficulty managing emotions due to lack of attuned caregiving.
Overwhelmed by strong emotions, leading to hyperarousal or dissociation.
Struggles to self-soothe and respond appropriately to stress.

Question 13

Q13: What are common signs of hyperarousal in traumatized children?

Answer 13

Restlessness and inability to concentrate.
Constant movement or fidgeting.
Sense of unease within their body, often leading to self-harm or substance use.

Question 14

Q14: How does dissociation present in children?

Answer 14

“Lights on, no-one’s home” appearance (staring, frozen posture).
Loss of connection to emotions or surroundings.
Greater risk of dissociative disorders like DID with repeated trauma.

Question 15

Q15: How does developmental trauma differ from single-event trauma?

Answer 15

Developmental trauma is often chronic and occurs within family relationships, making it harder to escape.
It impacts critical stages of development, leading to complex trauma rather than PTSD.
Requires ongoing interaction with the abuser, complicating recovery.

Question 16

Q16: What are the gender differences in childhood trauma rates?

Answer 16

Girls experience higher rates of emotional abuse, sexual abuse, and neglect.
Boys and girls experience similar rates of physical abuse and exposure to domestic violence.

Question 17

Q17: What are some of the societal challenges in addressing childhood trauma?

Answer 17

Many view child abuse as less important than other societal issues (e.g., transport).
Belief that children lie about abuse is widespread.
Anxiety around discussing child abuse leads to avoidance and inaction.

Question 18

Q18: How does trauma affect a child’s sense of safety and trust?

Answer 18

Predictable caregiving fosters a sense of safety.
Unpredictable, neglectful, or abusive caregiving makes the world feel unsafe and untrustworthy.
Leads to hypervigilance and difficulties in forming healthy relationships.

Question 19

Q19: What is the “dose-response” relationship in trauma?

Answer 19

The greater the number of adversities (e.g., abuse types), the higher the risk of severe outcomes.

Two adversities increase risk 5x; three or more increase risk 30x for mental health issues like psychosis.

Question 20

Q20: How does childhood trauma affect future physical health?

Answer 20

Those with high ACE scores are significantly more likely to develop chronic illnesses (e.g., heart disease, COPD, diabetes).

Trauma increases the likelihood of medically unexplained symptoms and chronic pain syndromes.

Question 21

Q21: What are the impacts of trauma on a child’s relationship templates?

Answer 21

Early traumatic experiences disrupt attachment and create negative assumptions about relationships.

Leads to mistrust, fear of abandonment, and difficulty forming healthy bonds.

Shapes future relational behaviors, often perpetuating cycles of trauma.

Question 22

Q22: How do adverse childhood experiences (ACEs) correlate with mental health issues?

Answer 22

People with high ACEs are more likely to develop PTSD, depression, anxiety, and substance abuse disorders.

They are 4.6x more likely to have current PTSD and 4.5x more likely to have attempted suicide in the past year.

Question 23

Q23: What role does emotional neglect play in developmental trauma?

Answer 23

Emotional neglect undermines a child’s ability to regulate emotions and build self-esteem.

Creates a sense of unworthiness and difficulty recognizing or expressing feelings.

Often leads to long-term relational and emotional challenges.

Question 24

Q24: Why is it difficult for clinicians to diagnose trauma-related disorders in children?

Answer 24

Symptoms like hyperarousal, dissociation, or emotional dysregulation may mimic other conditions (e.g., ADHD, bipolar disorder).

Lack of training in trauma-informed care can lead to misdiagnosis, such as psychosis or borderline personality disorder.

Question 25

Q25: What is the long-term societal impact of unaddressed childhood trauma?

Answer 25

Increases healthcare costs due to chronic illnesses and mental health issues.

Higher rates of unemployment, substance abuse, and incarceration.

Perpetuates cycles of abuse and trauma within families and communities.

Question 26

Q27: What are the three main categories of ACEs?

Answer 26

Abuse: Physical, emotional, or sexual.
Neglect: Physical or emotional.
Household dysfunction: Domestic violence, substance abuse, mental illness, parental separation, or incarceration.

Question 27

How does addressing ACES offer critical public health opportunities?

Answer 27

Addressing ACES has positive impact on prevention of:

causes of serious mental illness, causes of drug and alcohol abuse in women, causes of HIV high-risk behaviour (IV drugs, promiscuity)