Trauma, PTSD, and Secondary Trauma in Children and Adolescents

Abstract

Trauma and posttraumatic stress disorder (PTSD) in children and adolescents refer to reactions to extremely frightening and threatening events. For those who are interested in learning about PTSD and those subclinical trauma reactions referred to as acute stress disorders, there is often a tendency to go to the latest version of the Diagnostic and Statistical Manual of the American Psychiatric Association (DSM-5, 2013) where one encounters a list of symptoms such as intrusive thoughts, negative alterations in cognition and mood, and alterations in arousal and reactivity. The DSM-5 introduces a PTSD subtype for children 6 years and younger which requires avoidance or intrusive thoughts, rather than both, and thereby simplifies the diagnosis of young children. The problem with this approach to defining PTSD and trauma reactions is that the DSM provides a skeletal, and in many ways a distorted view, of what PTSD actually is, especially as seen from the viewpoint of practicing school and clinical psychologists. A major issue in trauma reactions, regardless of the age of the trauma victim, is an alteration of one’s self-view and a change in how the environment is perceived. These changes from prior levels of functioning are so profound that they tend to overshadow most of the specific DSM listed symptoms. The alteration in a child’s or adolescent’s perspective of themselves and their environments are characteristically in the more negative and pessimistic direction than they were before being traumatized (e.g., Ellis, 2005).