Summary: <div>Complex Trauma in Children and Adolescents</div> <div></div> <div>CEUs can be earned for this presentation at <a href="https://www.allceus.com/member/cart/index/product/id/158/c/">https://www.allceus.com/member/cart/index/product/id/158/c/</a> </div> <div></div> <div>Resources<br> ~ This presentation is based, in part, upon<br> ~ a white paper from the National Child Traumatic Stress Network: “Complex Trauma in Children and Adolescents” 2003<br> ~ Child-Witnessed Domestic Violence and its Adverse Effects on Brain Development https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4193214/<br> ~ The Adverse Childhood Experiences Study https://www.cdc.gov/violenceprevention/acestudy/</div> <div>Objectives<br> ~ Define complex trauma<br> ~ Define and explore Adverse Childhood Experiences<br> ~ Highlight the cost of complex trauma<br> ~ Examine the impact and diagnostic issues of complex trauma</div> <div>What is Complex Trauma<br> ~ Exposure to traumatic events plus the short and long term impact of exposure resulting in:<br> ~ Emotional dysregulation<br> ~ Loss of safety<br> ~ Inability to detect or respond to danger cues<br> ~ Inability to detect or respond to internal cues<br> ~ Generalization of cues</div> <div>More About Complex Trauma<br> ~ Complex Trauma is most likely to develop if the danger is unpredictable and uncontrollable (p.8)<br> ~ The greatest source of danger, unpredictability and uncontrollability is the absence of a caregiver who reliably and responsively nurtures and protects the child.</div> <div>Adverse Childhood Experiences<br> ~ ACEs measured in the study include:<br> ~ Physical, sexual, emotional abuse<br> ~ Physical or emotional neglect<br> ~ Mother treated violently<br> ~ Substance misuse within household<br> ~ Household mental illness<br> ~ Parental separation or divorce<br> ~ Incarcerated household member</div> <div>*Could happen anytime prior to 18th birthday<br> *Two thirds of the 17,000 people in the ACE Study had at least one ACE<br> Effects of ACEs<br> ~ Psychosocially induced biological alterations (in the brain and the HPA-Axis) related to maladaptation (especially post-traumatic stress disorder) in the context of child-witnessed DV</div> <div></div> <div>~ Child-Witnessed Domestic Violence and its Adverse Effects on Brain Development https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4193214/<br> Effects of ACEs<br> ~ Nearly 60% of women and 35% of men with 4 or more ACEs reported chronic depression<br> ~ The risk of perpetrating violence increased dramatically with the ACE score was over 5<br> ~ Those with at least 4 ACEs had nearly double the chance of being raped later in life.<br> ~ 18% of those with at least 4 ACEs attempted suicide.<br> National Incidence Study of Child Abuse and Neglect<br> ~ NIS-3 (1996)<br> ~ Harm Standard: 1,553,800<br> ~ Endangerment Standard 2,815,600<br> ~ Emotional (584,100)<br> ~ NIS-4 (2006)<br> ~ Harm Standard: 1,256,600 million (1:58)<br> ~ Endangerment Standard: 2,905,800 (1:25)<br> ~ Significant finding: Emotional (1,173,800)<br> 7 Domains of Impairment<br> ~ Attachment<br> ~ Biology<br> ~ Affect Regulation<br> ~ Dissociation<br> ~ Behavioral Regulation<br> ~ Cognition<br> ~ Self-Concept<br> As defined by the NCTSN Complex Trauma Taskforce</div> <div>Attachment<br> ~ Secure attachment<br> ~ Internalize regulation strategies<br> ~ Identify internal and external cues<br> ~ Learn to use support systems in the face of overwhelming experience</div> <div>Attachment<br> ~ Insecure attachment (80% maltreated children)<br> ~ 3 types<br> ~ Avoidant<br> ~ Rejecting caregiving—What does this look like<br> ~ Disregard and distrust self and others</div> <div>Attachment<br> ~ Ambivalent<br> ~ Parents alternate between validation and invalidation/detachment and enmeshment (Borderline-esque)<br> ~ Children become hypersensitive to cues and overgeneralize<br> ~</div>
