Childhood Abuse and Neglect and Posttraumatic Stress Syndrome

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Introduction

This study briefly reviews complex trauma and discusses how it manifests in adolescents with a history of childhood abuse and neglect. A history of childhood abuse and neglect often leads to long-term emotional, behavioral and physical dysregulation that do not always fit the American Psychiatric Association Diagnostic and Statistical Manual of Mental Disorders (DSM-IV-TR) diagnostic criteria for Posttraumatic Stress Disorder (PTSD). This has led to the proposal of a separate but related diagnosis termed Developmental Trauma Disorder (Cook, Blaustein, Spinazzola & van der Kolk, 2003; van der Kolk, 2005; Najjar, Weller, Weisbrot & Weller, 2008). This diagnosis is based on an assessment of the literature on complex trauma and its long-term mental and physical health consequences. In this study, we will review the following: 1) the scope of complex trauma in terms of its general impact on individuals and society; 2) a description of the phenomenology of complex trauma; 3) the developmental impact of complex trauma on adolescents; and 4) the diagnosis, treatment, and prevention of complex trauma in adolescents.

Complex trauma refers to both the exposures and the developmental impact of long-term exposure to traumatic events during childhood and adolescence. Traumatic exposures are commonly of an interpersonal nature, including childhood physical, sexual, and emotional abuse and neglect. Traumatic exposures can also include repeated surgical procedures, chemotherapy or other adverse events during childhood. Complex trauma has a significant developmental impact across the life-span.

In a large epidemiological survey, the Adverse Childhood Experiences (ACE) study, of more than 17,000 adults from the general popula...

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