Complex trauma disorder among youth needs recognition, experts say


Complex trauma disorder among youth needs recognition, experts say
  1. Complex trauma disorder among youth needs recognition, experts say
    long-island.newsday.com
    Mental health experts are pressing for greater recognition of complex trauma disorder, a common condition among mistreated children and adolescents, with some practitioners asserting it should be included in the leading diagnostic manual of…
    New York (NY)

Mental health experts are pressing for greater recognition of complex trauma disorder, a common condition among mistreated children and adolescents, with some practitioners asserting it should be included in the leading diagnostic manual of psychiatry.

Mandy Habib, a clinical psychologist and co-director of the Institute for Adolescent Trauma Treatment and Training at Adelphi University, said the condition occurs among youths who have suffered repeated episodes of any one or several types of trauma: physical battery, neglect, verbal insults, threats, and sexual and emotional abuse.

The trauma often is perpetrated by an adult and leaves distinct psychological scars that can have lifelong consequences. Alcoholism, drug abuse, sexual promiscuity, food addiction, violent behavior and crime can have their roots in complex trauma that began in childhood, Habib and other experts said.

“It is such an underrecognized phenomenon,” Habib said, emphasizing that the disorder should be a stand-alone diagnosis in the Diagnostic and Statistical Manual of Mental Disorders, or DSM, which is in its fifth edition.

She is joined in that belief by colleagues at Northwestern University in Illinois, the National Child Traumatic Stress Network and The Trauma Center at Justice Resource Institute, a Massachusetts-based nonprofit.

The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, or DSM-5, published by the American Psychiatric Association. Photo Credit: Alamy / H.S. Photos

The stress network, established by Congress in 2000, is federally funded through an agency of the U.S. Department of Health and Human Services and jointly coordinated by UCLA and Duke University. Its mission is to work with scores of local grantees across the country to raise the standard of care and improve access to services for traumatized children, their families and communities.

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Habib and her collaborators, as part of efforts to spread the word, also served as the mental health professionals involved in a YouTube video aimed at teens to help them recognize the condition and seek help.

“When people hear the word trauma, they think of PTSD,” Habib said of post-traumatic stress disorder. “But with complex trauma, it is the difference between experiencing a traumatic event and having a traumatic life.”

PTSD, an official mental health diagnosis in the DSM, can emerge after a horrific event — often because of direct experience, but also because of being a witness. PTSD symptoms can include recurring nightmares, depression, anxiety, flashbacks and ongoing thoughts about the event.

Complex trauma disorder is marked by a broad constellation of problems, which have been cataloged by mental health experts.

Many youths with complex trauma have relationship problems with family members and peers. Most have low self-esteem and are plagued by shame and guilt. Thinking and learning are impaired and some young people are affected by depersonalization, a sense of being detached from or “not in” one’s body, according to data collected on the condition.

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As one example, Habib described the case study of a young woman who had experienced a life of neglect and abuse. Her earliest memories centered on her sixth birthday, when her angry father knocked her unconscious and tainted what should have been a happy occasion. The event was part of a pattern of abuse that occurred over many years.

Having an official diagnosis in the DSM would help eliminate the misdiagnosis of children and teens who are affected by complex trauma disorder. Many are diagnosed as being bipolar or as having attention deficit hyperactivity disorder, or ADHD.

Kids diagnosed with those conditions are prescribed potent medications. But those drugs not only fail to treat complex trauma, Habib and other experts said, they allow trauma symptoms to smolder unattended.

Alan Steinberg, associate director of the National Center for Child Traumatic Stress at UCLA, said proven therapies — group and/or one-on-one counseling — effectively address complex trauma disorder. Far more mental health professionals and laypeople need to be made aware of those treatments, he said.

Nearly 700,000 children are abused annually in the United States, according to the National Children’s Alliance, a nonprofit advocacy organization. Three-quarters of those cases involve neglect, 17.2 percent are physical mistreatment and 8.4 percent are sexual abuse. Some children are “polyvictimized,” which means they suffer more than one form of maltreatment.

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