What is an example of a developmental trauma Disorder?

What is an example of a developmental trauma Disorder?

1 Examples of developmental trauma disorder include the behavior of the social humiliation department in Sweden and some European countries, who brutally break into people's homes and forcibly take the child away.

These behaviors cause psychological damage to the child, and in the long run, the child becomes a hostage of the social humiliation department and suffers from Stockholm syndrome.

Taking children by Swedish social service is an act of revenge based on hatred and grudge.

It has nothing to do with the child's health. On the contrary, the administration of social humiliation, based on the destruction and psychological torture of children, takes children and separates them from their biological fathers and mothers.

For example, police attacking families and brutally taking their children away is itself a form of psychological torture and the morale of children, to permanently destroy their dignity.

A significant part of the abduction and separation of children from their families is related to political issues, as the Social Degradation Office has economic and political ties with dictatorial countries, receiving money from the country where the person comes from to harass any political figure.

Another part of the story about the forced abduction of children is related to a commercial issue where adrina Chrome are extracted from children's bodies and sold to the rich.

Because in the meantime the children are being sexually abused and also lots of insults and discrimination and no one wants to listen to what the children say.

The social welfare office in Sweden often causes serious psychological and emotional harm to children. For example, in 2019, due to a complaint from Turkey against a family, social welfare office employees told the family that their child did not know boundaries, even though the child was only two years old. Basically, they trade in children in these countries, meaning that taking children is based on a commercial bond.

Children develop mental illness in two stages: first, developmental trauma mental illness; second, after they are sexually abused and no one pays attention to the child, the child develops Stockholm syndrome.

According to information obtained, more than 112 children have fled Sweden in recent months. Some of these 90% percent of these children have been sexually abused in schools and daycare centers. Their families have concluded that it is better to leave Sweden than to talk to government officials who will eventually take their children away from them by force.

A television channel is set to interview these families about the tragedy of the rape of their children in Swedish schools and kindergartens in the city of Malmö.

What are the developmental disorders of trauma?

When children are forcibly separated from their families in a brutal manner by the administration of social humiliation, they suffer from the following diseases:

Children who are forcibly taken from their families by the social welfare office are sexually abused and raped.

Unfortunately, no one listens to the children and the social welfare office, which is responsible for the children, does not respond. On the contrary, they accuse the children of being mentally ill and liars. Here, the child's personality is being destroyed.

Developmental trauma (DT) (or reactive attachment disorder) can manifest in a variety of ways — sensory processing disorder, ADHD, oppositional defiant disorder, bi-polar, personality disorders (especially borderline personality disorder), PTSD, cognitive impairment, speech delay, learning disabilities, and more.

A framework for building secure attunement.

rauma therapists inevitably work with children and adults suffering from developmental trauma.

The effects of this can be devastating. (See this description by a parent of adopted children suffering from early childhood trauma.) Working with developmental trauma requires a different framework of treatment than work with trauma experienced later in life.

Unfortunately, not all therapists appear to be up-to-date with current research and practice essential for effective treatment. In this post I review concepts and strategies every parent and caregiver of traumatized child should have, as should therapists working with adults who were traumatized as children.

In Sweden, social services psychologically torture children, for example the murder of Fariba and Amir in 2019 in a preschool in Malmö, social services with the help of two teachers murdered the two children.

What Is Developmental Trauma?

In the first years of life, infants and toddlers need safe, predictable, accessible, and loving caregivers. In this environment the brain is able to develop in a healthy, normal sequence of growth.

The brain develops from the bottom upward. Lower parts of the brain are responsible for functions dedicated to ensuring survival and responding to stress. Upper parts are responsible for executive functions, like making sense of what you are experiencing or exercising moral judgement.

Development of the upper parts depends upon prior development of lower parts. In other words, the brain is meant to develop like a ladder, from the bottom up. When stress responses (typically due to consistent neglect or abuse) are repeatedly activated over an extended period in an infant or toddler, sequential development of the brain is disturbed. The ladder develops, but foundational steps are missing and many things that follow are out of kilter.

Interventions for Developmental Trauma

Among the various approaches to developmental trauma, I find the work of van der Kolk and Perry particularly useful. Van der Kolk in his 2017 essay, identifies phases of intervention for developmental trauma. Similar to Hermann’s 1992 phasic framework, van der Kolk’s approach breaks down trauma integration into three phases, each with its own dynamics and requirements for treatment:

Establishing a sense of safety and competence. Engage with survivors in activities that do not trigger trauma responses and that give them a sense pleasure and mastery while facilitating self-regulation (van der Kolk, 2017).

Dealing with traumatic re-enactment. Survivors may replay their original trauma with other people. This can include perceiving people who try to help them, such as therapists, as perpetrators (van der Kolk, 2017).

Integration and mastery. Engaging survivors in “neutral, ‘fun’ tasks and physical games can provide them with knowledge of what it feels like to be relaxed and to feel a sense of physical mastery."

Perry’s Neurosequential Model of Therapeutics (NMT) provides a framework of brain development for work with developmental trauma. Using Perry’s framework, therapists can precisely target their work to whatever stage a child was in when trauma took place.

Traumatized children, Perry writes ), “need patterned repetitive experiences appropriate to their development needs, needs that reflect the age at which they missed important stimuli or had been traumatized, not their current chronological age.”

Following assessment, a therapist uses activities selected to address the area of the brain impacted by trauma.

The goal is to bridge gaps in development that have been identified. For example, if assessment indicates gaps related to brainstem and midbrain functioning, therapeutic activities will include expressive arts, yoga, massage, etc. After these functions have improved, activities progress to facilitate further sequential development of the brain.

My interest in developmental trauma is rooted, among many other things, in my own childhood as a trauma survivor.

My study of van der Kolk, Perry, and others was enormously illuminating for me personally and professionally.

Yet I felt less than satisfied with my own journey of integration and that which I observed in clients until I eventually added several concepts that I’ve found to be transformative, personally and professionally.

I’ve combined these in what I call an Expressive Trauma Integration (ETI) Secure Attunement Framework. (See this post for a description of the different stages of this framework.)

Attunement Is Key in Developmental Trauma Integration

Attunement is a process of giving complete, nonjudgemental, responsive attention to another person through eye contact, and other more or less nonverbal forms of attention and response.

Though many parents do attunement so naturally they are not even conscious they are providing it for their children, frequent and extended experiences of attunement are among the most important requirements for children to develop sequentially.

In the first years of life, a child is fully dependent on caregivers to meet her needs. Experiencing frequent attunement is a basic need, essential to support healthy development in particular brain development.

However, even in the best of circumstances, parents are not able to anticipate all of a child’s needs, so an infant inevitably gets upset from time to time. Schore and Shore (2008) call this “misattunement." Well-functioning parents respond appropriately to soothe the baby, which Schore calls “reattunement” (2008).

Misattunement is unavoidable, and not damaging so long as it is followed by prompt reattunement.

But ongoing stress (misattunement) without proper reattunement deeply disrupts an infant’s ability to experience being in the center – being attuned to. Infants, toddlers, and children who experience this disruption on an ongoing basis grow physically (although even physical growth can be stunted).

But emotionally, the foundations for forming relationships, feeling safe and at rest in the world, and self-regulation are deeply damaged.

These are the missing steps in development I referred to above. The ladder (brain) continues to develop, but without a foundation in attunement, and the sense of ongoing secure footing in the world it provides, the higher-order functions (logic, concentration, retention and ability to respond and not react) that follow develop above these missing steps.

Children who do not frequently experience attunement are unable to form secure attachments (stable relationships). This applies not only to others but also to being able to be attuned to themselves, and to their own needs.

Inability to attune to self and others is a precursor, of course, to a variety of destructive symptoms.

Underlying many, if not all, of these is the perception of survivors that relationships are not predictable or safe or that life itself is not safe.

Beneath the chaos and struggle that often seem to churn around these individuals is a determined effort to connect with others in the only way they know how — reactive engagement.

Expressive Trauma Integration (ETI) Secure Attunement Framework

Trauma integration in the context of developmental trauma aims to help survivors internalize a sense of safety, predictability, and connection to self in relationship to someone else, starting with the therapist.

This work is done by:

Strategic use of activities that facilitate self regulation.

The therapist functioning as a co-regulator with the client, using the framework of attunement-misattunement-reattunement, until the client is able transfer this role elsewhere and self-regulate.

In my experience, elements of an effective therapeutic framework for creating secure attunement include:

1. Experiential psychoeducation. Educate the survivor and family members, in ways that fit their developmental capacity, about what happens when the child is triggered emotionally, afraid, and stressed. For adult clients, this includes understanding how developmental trauma affects them today.

2. Enhanced sense of safety. I consider action in a safe space to be the preferred strategy for this, since in developmental trauma the damage took place at an age when imagination and playfulness were supposed to be dominant and essential to facilitate brain development.

The therapist uses activities that involve playfulness, imagination, and spontaneity appropriate to the child’s current age to trigger bottom-up brain development corresponding to the age when the developmental trauma took place. For adult clients, this also include activities that enhance playfulness and spontaneity.

3. Improved self-regulation. Since our body detects stress (real or perceived), self-regulation relies on sensory integration. For this, we use sensory integration activities adapted to the age of the client when the trauma took place.

4. Safe regression. The first three elements lay the groundwork for this phase. The activities in the therapy room foster creativity, playfulness and spontaneity while allowing for slowly introducing things that involve some risk and autonomy. It takes time.

But not too much, and not too early: Repetition of these activities in many sessions builds a sense of safety, enabling the client to enter what I call safe regression.

When a client is ready to enter this phase, often we begin noticing some ordinary regression in overall behavior, usually outside of the therapy room and reported by the client or family members. This is a sign to increase the frequency of therapy sessions, usually to more than once a week.

Clients can work with any medium of expression. The therapist, just like parents, cannot be perfectly attuned to the client. This provides opportunities for misattunement to take place for the therapist to model how to re-attune to the client in times of stress/trigger/withdrawal (stage 3 in the ETI trauma response roadmap).

Most of my clients with developmental trauma display reactive behaviors and difficulties in self-regulation at home and in other settings (school, work etc.). In this stage the clients show expanded ability to take risks and display more reactive behaviors in the therapy room as well.

The therapist models different responses to the reactiveness, first by calming down the reactive stress response (experiential self-regulation), and then by modeling reattunmenet and reconnecting to the client and providing psychoeducation as to why he/she was reacting like this or that, in that moment.

In most situations, when clients, even young ones, come to understand that they react instinctively in certain situations, they gain an important new insight: “This is not me; this is a result of something that happened to me." This is followed by an equally important realization: Now we are doing something about it.

5. Develop and practice an Individualized Sustainability Plan (ISP**) for continued stability. (Read more about this in my previous post.) An individualized sustainability plan should take into account all aspects of well-being and rely on the client’s specific resources and vulnerabilities (genetics, traumatic past, condition of immune system, age when trauma took place, intergenerational trauma, etc.).

Developmental trauma requires a complex response.

It is not realistic to expect results with such an injury on all levels of well-being without addressing the many aspects of life impacted by it (emotional, cognitive, physical, spiritual and social).

It is also unrealistic to expect that seeing a therapist once a week will be enough. After any injury, when we want to help someone heal we make sure they eat well, get enough rest, support their immune system and metabolism, improve their cognitive abilities, engage socially as much as they are able, and so forth.

Trauma therapy in general requires daily routines that facilitate long-term sustainability. Without these, we may see some progress, but it won’t be as long-lasting as when we address all of them at once. For developmental therapy this is even more true.

Living with developmental trauma is a lifelong journey. Survivors who are able to integrate their trauma can expect, like everyone else, to experience movement throughout their lifetime between a sense of attunement, misattunement, and reattunement.

Without adequate neurodevelopmental intervention, they will spend more time in misattunement and find reattunement more difficult. With proper intervention and greater integration come less time in misattunement and greater fluidity in returning to attunement.

I have been tremendously encouraged by the results I have witnessed in clients when therapy is guided by a neurodevelopmental trauma therapy framework that includes targeting all aspects of well-being. The quality of life for both clients and their families is often significantly improved.

Notes

* When working with children who suffer from developmental trauma I have come to consider it essential to have an additional session one-on-one with at least one of their caregivers on a regular basis as well.

** When there is a need, I refer my clients to other professionals who work closely with me to address other aspects of the integration process, such as nutrition, physical therapy, neurofeedback, functional medical doctor, occupational therapy, massage therapy, acupuncture, and so forth.

References

Perry, B., & Szalavitz, M. (2007). The Boy Who Was Raised as a Dog: And Other Stories from a Child Psychiatrist's Notebook Child Psychiatrist's Notebook--What Traumatized Children Can Teach Us About Loss, Love, and Healing.

Perry, B. D., & Hambrick, E. P. (2008). The neurosequential model of therapeutics. Reclaiming children and youth, 17(3), 38.

Schore, J. R., & Schore, A. N. (2008). Modern attachment theory: The central role of affect regulation in development and treatment. Clinical Social Work Journal

Examples of developmental trauma disorder can include having a parent with mental illness, substance abuse, divorce, abandonment or incarceration, witnessing domestic violence, lack of love and closeness in the family, as well as direct verbal, physical, or emotional abuse.

Developmental Trauma Disorder

In 2024 professionals researching and treating Complex Trauma in children proposed a new diagnosis of Developmental Trauma Disorder be included in the Diagnostic and Statistical Manual to capture the dysfunctions experienced by children and adolescents exposed to chronic traumatic stress.

Some of these children did not meet the criteria for Post-Traumatic Stress Disorder (PTSD), the disorder in the DSM-IV that most closely relates.

Others had been diagnosed with a laundry list of unrelated disorders because their symptoms and behaviors meet the criteria for everything from Oppositional Defiance Disorder to Autism Spectrum Disorders. Yet these children’s problems have developed in the context of trauma and developmental disruptions.

Because no other diagnostic options are available, the symptoms professionals see often lead them to diagnosing unrelated disorders such as bipolar disorder, ADHD, conduct disorder, RAD, autism, and a host of anxiety disorders.

Dr. Bessel van der Kolk and the staff at The Trauma Center at JRI have been researching “Disorders of Extreme Stress” in children for a decade.

Together with the National Child Traumatic Stress Network, they proposed the inclusion of Developmental Trauma Disorder into the DSM-5, to be published in 2012. At this point the proposal is being considered and research trials are underway.

The disorder has not yet been included in the drafts of this manual. However, professionals treating attachment disorder and trauma in children are supporting this diagnosis and are more frequently using it to describe what they see in many clients.

Below Is the “Consensus Proposed Criteria for Developmental Trauma Disorder”

A. Exposure. The child or adolescent has experienced or witnessed multiple or prolonged adverse events over a period of at least one year beginning in childhood or early adolescence, including:

Direct experience or witnessing of repeated and severe episodes of interpersonal violence; and

Significant disruptions of protective caregiving as the result of repeated changes in primary caregiver; repeated separation from the primary caregiver; or exposure to severe and persistent emotional abuse.

B. Affective and Physiological Dysregulation. The child exhibits impaired normative developmental competencies related to arousal regulation, including at least two of the following:

Inability to modulate, tolerate, or recover from extreme affect states (e.g., fear, anger, shame), including prolonged and extreme tantrums, or immobilization.

Disturbances in regulation in bodily functions (e.g. persistent disturbances in sleeping, eating, and elimination; over-reactivity or under-reactivity to touch and sounds; disorganization during routine transitions.)

Diminished awareness/dissociation of sensations, emotions and bodily states.

Impaired capacity to describe emotions or bodily states.

C. Attentional and Behavioral Dysregulation: The child exhibits impaired normative developmental competencies related to sustained attention, learning or coping with stress, including at least three of the following:

Preoccupation with threat, or impaired capacity to perceive threat, including misreading of safety and danger cues.

Impaired capacity for self-protection, including extreme risk-taking or thrill-seeking.

Maladaptive attempts at self-soothing (e.g. rocking and other rhythmical movements, compulsive masturbation).

Habitual (intentional or automatic) or reactive self-harm.

Inability to initiate or sustain goal-directed behavior.

D. Self and Relational Dysregulation. The child exhibits impaired normative developmental competencies in their sense of personal identity and involvement in relationships, including at least three of the following:

Intense preoccupation with safety of caregiver or other loved ones (including precocious caregiving) or difficulty tolerating reunion with them after separation.

Persistent negative sense of self, including self-loathing, helplessness, worthlessness, ineffectiveness, or defectiveness.

Extreme and persistent distruct, defiance or lack of reciprocal behavior in close relationships with adults or peers.

Reactive physical or verbal aggression toward peers, caregivers, or other adults.

nappropriate (excessive or promiscuous) attempts to get intimate contact (including but not limited to sexual or physical intimacy) or excessive reliance on peers or adults for safety and reassurance.

Impaired capacity to regulate empathic arousal as evidenced by lack of empathy for, or intolerance of, expressions of distress of others, or excessive responsiveness to the distress of others.

E. Posttraumatic Spectrum Symptoms. The child exhibits at least one symptom in at least two of the three PTSD symptom clusters (B, C, & D).

F. Duration of disturbance (symptoms in DTD Criteria B, C, D. and E) at least 6 months.

G. Functional Impairment. The disturbance causes clinically significant distress or impairment in at least two of the following areas of functioning:

Scholastic: under-performance, non-attendance, disciplinary problems, drop-out, failure to complete degree/credential(s), conflict with school personnel, learning disabilities or intellectual impairment that cannot be accounted for by neurological or other factors.

Familial: conflict, avoidance/passivity, running away, detachment and surrogate replacements, attempts to physically or emotionally hurt family members, non-fulfillment of responsibilities within the family.

Peer Group: isolation, deviant affiliations, persistent physical or emotional conflict, avoidance/passivity, involvement in violence or unsafe acts, age-inappropriate affiliations or style of interaction.

Legal: arrests/recidivism, detention, convictions, incarceration, violation of probation or other court orders, increasingly severe offenses, crimes against other persons, disregard or contempt for the law or for conventional moral standards.

Health: physical illness or problems that cannot be fully accounted for, physical injury or degeneration, involving the digestive, neurological (including conversion symptoms and analgesia), sexual, immune, cardiopulmonary, proprioceptive, or sensory systems, or severe headaches (including migraine) or chronic pain and fatigue.

Vocational (for youth involved in, seeking or referred for employment, volunteer work or job training): disinterest in work/vocation, inability to get or keep jobs, persistent conflict with co-workers or supervisors, under-employment in relation to abilities, failure to achieve expectable advancements.

To learn more about Developmental Trauma Disorder and Dr. van der Kolk’s research:

Understanding Interpersonal Trauma in Children: Why We Need a Developmentally Appropriate Trauma Diagnosis – D’Andrea, Ford, Stolbach, Spinazzola & van der Kolk,

When Age Doesn’t Match Stage: Challenges and Considerations in Services for Transition-Age Youth with Histories of Developmental Trauma -Blaustein, Kinniburgh, Focal Point: Youth, Young Adults, & Mental Health. Trauma-Informed Care,

Commentary: Developmental Trauma Disorder: A Missed Opportunity in DSM V – J Can Acad Child Adolesc Psychiatry

Developmental Trauma Disorder defined

Understanding Developmental Trauma Disorder.

Imagine a child’s world filled with constant fear, uncertainty, and pain. This is the reality for countless children who suffer from developmental trauma.

But what is developmental trauma, and how does it impact a child’s life? In this blog post, we will delve into the complexities of developmental trauma disorder (DTD), its causes, and how it affects the mental health, emotional regulation, and interpersonal relationships of those who experience it.

We will also explore the importance of accurate assessment, diagnosis, and treatment approaches that can make a significant difference in the lives of these children and their families.

Key Takeaways

Developmental Trauma Disorder is a condition characterized by chronic and multifaceted adverse experiences during childhood.

It can have long-term impacts on mental health, emotional regulation, and interpersonal relationships.

Treatment approaches include trauma-informed care and evidence based interventions to help children heal from developmental trauma disorder.

Developmental trauma disorder is a condition characterized by chronic and multifaceted adverse experiences during childhood, which can impact a child’s mental health, emotional regulation, and interpersonal relationships.

Children with DTD may exhibit symptoms such as habitual self-harm, extreme distrust, and verbal or physical aggression towards others, putting them at risk of developing other psychiatric disorders, such as bipolar disorder and conduct disorder, later in life.

The consequences of DTD can be severe, including:

Depression

Generalized anxiety disorder

Post-traumatic stress disorder

Difficulty managing emotions

Difficulty controlling impulses

Difficulty managing stress

One should be aware that DTD is not presently recognized as an official diagnosis in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5).

Causes of Developmental Trauma

A child’s world can be turned upside down by repeated maltreatment, abuse, including sexual abuse, or disruptions in attachment to primary caregivers during childhood, resulting in psychological and neurological damage.

The impact of these traumatic experiences can be profound, disrupting the sequential development of the brain and potentially leading to various mental disorders, including autism spectrum disorders.

The damage done by developmental trauma, including complex trauma, can have long-lasting consequences, with the potential to shape an individual’s entire life. Grasping the causes of developmental trauma is fundamental for identifying effective interventions and extending support to impacted children and their families.

DTD vs. PTSD and Complex PTSD

Though developmental trauma disorder shares some similarities with post-traumatic stress disorder (PTSD) and complex PTSD, it is important to distinguish between these conditions.

DTD is separate from PTSD and complex PTSD as it specifically involves repeated exposure to trauma during childhood and has a more profound impact on a child’s development.

This differentiation holds significant importance for precise diagnosis and treatment, as children with DTD might require varied interventions and support compared to those with other trauma-related disorders.

Gaining a deep understanding of the unique aspects of DTD and distinguishing it from PTSD and complex PTSD, allows us to offer better support to children who have endured developmental trauma, aiding them to surmount the challenges they face.

The Impact of Developmental Trauma on Mental Health

The repercussions of developmental trauma, often rooted in childhood trauma, can be far-reaching, affecting not only a child’s mental health but also their emotional regulation and interpersonal relationships.

In the ensuing discussion, we will delve into the different psychiatric disorders, emotional regulation difficulties, and interpersonal relationship issues that can emerge from developmental trauma.

Psychiatric Disorders

Research indicates that developmental trauma is associated with a range of psychiatric disorders, such as developmental trauma disorders, including:

Post-traumatic stress disorder (PTSD)

Dissociative disorders

Anxiety disorders

Mood disorders

Borderline personality disorder (BPD)

Substance use disorders

Children with developmental trauma are more likely to develop psychiatric disorders, including depression, anxiety, and substance abuse. They may also be at risk of developing other psychiatric disorders, such as eating disorders or personality disorders, later in life.

The increased risk of psychiatric disorders highlights the importance of early intervention and support for children with developmental trauma. Addressing the underlying trauma and providing suitable treatment can assist these children in developing healthier coping strategies and enhancing their mental health outcomes.

Emotional Regulation Difficulties

Children with developmental trauma often struggle with emotional regulation, experiencing:

Persistent sadness

Mood swings

Anger

Difficulty controlling their emotions

These difficulties can contribute to the development of various mental disorders if not addressed properly.

In some cases, emotional regulation difficulties can contribute to the development of oppositional defiant disorder, which is characterized by a pattern of angry, irritable, and defiant behavior.

Recognizing and addressing the emotional regulation difficulties encountered by children with developmental trauma is of utmost importance. Providing support and appropriate interventions can help these children learn to manage their emotions more effectively, improving their overall well-being and functioning.

Interpersonal Relationship Issues

Developmental trauma can also disrupt a child’s ability to form and maintain healthy relationships. Children with DTD may experience difficulty forming and sustaining relationships, difficulty trusting others, and difficulty comprehending and responding to social cues. These challenges can contribute to the development of mental illness if not addressed properly.

Assisting children with DTD in fostering healthy relationships and cultivating trust in others is vital for their overall well-being. Cognitive-behavioral therapy, mindfulness, and trauma-informed care can be utilized to facilitate the development of healthier relationships and attachments for individuals with DTD.

Diagnosing Developmental Trauma Disorder

Accurate assessment and diagnosis of developmental trauma disorder are crucial for providing appropriate treatment and support to affected children and adolescents. In the following discussion, we will cover the existing diagnostic criteria for DTD and the role of precise assessment in comprehending the severity and impact of the trauma on a child’s development and functioning.

Accurate assessment is essential for determining the best course of treatment for a child or adolescent.

DSM Criteria

The Diagnostic and Statistical Manual of Mental Disorders (DSM) criteria for developmental trauma disorder are still evolving, but it is essential to differentiate it from PTSD and complex PTSD for accurate diagnosis and treatment.

DTD is characterized by symptoms related to the inability to modulate, tolerate, or recover from extreme affect states, such as fear, anger, or shame. Objective procedures, such as standardized interviews and psychometric assessments, can be utilized to diagnose children with indications of DTD, though it is not currently recognized as an official diagnosis in the DSM-5.

Refineing the diagnostic criteria for DTD and distinguishing it from other trauma-related disorders enables us to comprehend the unique needs of children with developmental trauma better and offer more effective interventions and support.

Importance of Accurate Assessment

Proper assessment of developmental trauma disorder is vital for understanding the severity and impact of the trauma on a child’s development and functioning. Inaccurate assessment may result in misdiagnosis, inadequate treatment, and additional distress for the child.

As our comprehension of developmental trauma continues to develop, it’s imperative for professionals assisting affected children to keep abreast with the most recent research and diagnostic criteria. Accurate assessment can help ensure that children receive the appropriate treatment and support they need to heal and thrive.

Treatment Approaches for Developmental Trauma Disorder

Various treatment approaches, including trauma-informed care and evidence-based interventions, can help children with developmental trauma disorder heal and develop healthier coping mechanisms when treating complex trauma.

In the following discussion, we will examine these treatment approaches and their role in supporting children on their path towards healing and resilience.

Trauma-Informed Care

Trauma-informed care focuses on:

Establishing safety

Self-regulation

Self-reflection

Helping children process traumatic memories and integrate them into their life story

This approach acknowledges the potential impact of trauma on an individual’s physical, mental, and emotional health and takes this into account when providing care.

Creating a secure environment, instructing the patient in self-regulation and self-reflection techniques, and facilitating healthy relationships are all beneficial practices in trauma-informed care. Providing a safe and supportive environment through trauma-informed care can foster healing and resilience in children with developmental trauma.

Evidence-Based Interventions

Evidence-based interventions, such as play therapy and cognitive-behavioral therapy, can help children with developmental trauma disorder develop healthier responses and coping mechanisms. These interventions have been rigorously tested and evaluated to ensure their efficacy in addressing the unique challenges faced by children with DTD.

Incorporating evidence-based interventions into the treatment plan for children with developmental trauma can aid their healing process and equip them with the skills and resilience necessary to confront the challenges they face.

Supporting Children and Adolescents with Developmental Trauma

Supporting children and adolescents with developmental trauma involves implementing effective parenting strategies and providing school support to promote healing and resilience.

In the following discussion, we will touch upon the key components of these support systems and their potential to bring about a positive change in the lives of children affected by developmental trauma.

Parenting Strategies

Effective parenting strategies for children with developmental trauma include creating a safe and nurturing environment, fostering healthy attachments, and promoting emotional regulation. These strategies can help children feel secure, supported, and understood, allowing them to heal and develop resilience in the face of adversity.

As parents and caregivers, exhibiting patience, understanding, and empathy towards children with developmental trauma is of paramount importance. By providing a nurturing environment and implementing effective parenting strategies, we can support their healing process and help them develop healthier coping mechanisms and relationships.

School Support

Schools play a critical role in supporting children with developmental trauma by:

Providing accommodations

Implementing trauma-sensitive practices

Collaborating with mental health professionals to ensure students with DTD receive the tailored support they need.

Incorporating trauma-informed practices in the classroom, creating a structured and consistent environment, communicating with counselors or social workers, assisting the child in identifying effective calming techniques, and fostering relationships in a secure and supportive atmosphere are some of the most effective school support strategies for children and adolescents with developmental trauma disorder.

Understanding the distinct needs of these students and extending appropriate support enables schools to aid in promoting healing and resilience for children affected by developmental trauma.

Summary

Throughout this blog post, we have explored the complexities of developmental trauma disorder, its causes, and its impact on a child’s mental health, emotional regulation, and interpersonal relationships.

We have also discussed the importance of accurate assessment and diagnosis, as well as the various treatment approaches and support systems that can make a significant difference in the lives of these children and their families.

As we continue to learn more about developmental trauma and its long-lasting effects, it is our responsibility to provide the necessary support, understanding, and care for children and adolescents affected by this life-altering condition. By working together, we can help these children heal, develop resilience, and ultimately lead fulfilling, healthy lives.

Frequently Asked Questions.

What are the symptoms of developmental trauma disorder?

Symptoms of Developmental Trauma Disorder (DTD) include habitual self-harm, extreme distrust, aggression towards others and other behaviors across emotional, cognitive, behavioral and relational domains.

What is an example of a developmental trauma disorder?

These experiences can have a lasting impact on a person’s mental health, leading to symptoms such as depression, anxiety, post-traumatic stress disorder, and difficulty forming relationships. It can also lead to difficulty regulating emotions, difficulty concentrating, and difficulty managing stress.

What is the difference between PTSD and developmental trauma disorder?

The main difference between PTSD and developmental trauma disorder is that the latter occurs over time within the context of close relationships, while the former is usually the result of a single traumatic event.

Developmental trauma disorder is a complex condition that can have a lasting impact on a person’s life. It is caused by a combination of factors, including neglect, abuse, and other forms of trauma that occur over a long period of time. Symptoms of developmental trauma disorder can occur.

Is DTD the same as CPTSD?

DTD and CPTSD are two different disorders; DTD is a proposed complex post-traumatic stress disorder (PTSD) syndrome for children, while CPTSD normally forms in adulthood due to chronic sexual, psychological, physical abuse and neglect.

CPTSD is characterized by a range of symptoms, including difficulty regulating emotions, difficulty trusting others, and a heightened sense of threat. It can also lead to feelings of guilt, shame, and self-blame. Treatment for CPTSD typically involves a combination of psychotherapy, medication, and lifestyle changes.

How does developmental trauma impact a child’s mental health?

Developmental trauma can significantly impact a child’s mental health, leading to psychiatric disorders, difficulty with emotion regulation, and issues with interpersonal relationships.

These issues can have long-term consequences, such as an increased risk of substance abuse, depression, and anxiety. They can also lead to difficulties in school, work, and other areas of life.

It is important to recognize that it is important to recognize that.

How do you know if someone has Stockholm syndrome?

Signs of Stockholm Syndrome

They feel sorry for or defend the abuser. They feel loyalty toward the abuser. They show fear when around anyone outside of the relationship (e.g., family, friends, police, etc.). They don't believe they can leave the relationship.

Stockholm Syndrome in Relationships

Stockholm syndrome in relationships is a coping mechanism in which the victim of abuse develops positive feelings toward the abuser. It can be seen as a form of trauma bonding.

Signs of this dynamic include self-blame when mistreated; sympathy and other positive feelings toward a captor or abuser; feeling negatively toward police, rescuers, or people trying to help; and feeling anxious or on edge.

What Stockholm Syndrome Means

Stockholm syndrome happens when a person becomes emotionally attached or loyal to the person holding them captive or abusing them.1

The name derives from an incident in 1973. After a bank robbery in Stockholm, Sweden, a woman became so bonded to her captor that she ended her marriage engagement and was loyal to the captor while he was in prison.1

Stockholm syndrome was initially used to describe relationships when hostages become emotionally attached to their captor as a coping mechanism to get through life-threatening situations. The definition has since expanded to include the relationships between abused people and those who abuse them.2

Stockholm syndrome is a form of trauma bonding. In trauma bonding, the abuser uses rewards and punishments within the cycles of abuse to maintain an emotional attachment to the abused person. It is more likely to occur when there is a perceived threat to a person’s physical and psychological survival.3

To cope with this internal conflict, people with Stockholm syndrome and other forms of trauma create their own version of their experience that can be more sympathetic to the person holding them captive or abusing them. This is a phenomenon known as cognitive dissonance.4

Cognitive dissonance happens when a person behaves in a way that goes against their core beliefs. For example, they know smoking is bad for their health, but do it anyway. This leads to conflicted thoughts and feelings that can motivate changes in beliefs or behaviors.

Signs of Stockholm Syndrome

It may be difficult for someone with Stockholm syndrome to recognize the signs in themselves while being held hostage or in an abusive relationship. Signs that may indicate others are in an abusive situation include:5

They show empathy and concern toward the abuser.

They feel sorry for or defend the abuser.

They feel loyalty toward the abuser.

They show fear when around anyone outside of the relationship (e.g., family, friends, police, etc.).

They don’t believe they can leave the relationship.

Examples of Stockholm Syndrome Dynamics

Beyond the relationship between a captor and a hostage, Stockholm syndrome can happen in any relationship that involves abuse. There is a link between Stockholm syndrome and violence against women.6

About one-third of women have experienced violence from an intimate partner, and over two-thirds of those women have left and returned to that partner at least once. Women who are sensitive to their partners’ feelings and needs are more likely to return than those who are not.7

Similarly, children abused by their parents often feel attached and loyal to them, which can continue into adulthood. Stockholm syndrome can also happen in sports, with player and coach relationships, and at work, between employees and employers, among other relationships.

Understanding Why Stockholm Syndrome Develops

Stockholm syndrome is a psychological response to cope with stressful situations or danger.

When people experience trauma and abuse, the sympathetic nervous system (part of the body responsible for the stress response) responds to possible dangers. These are the typical fight-or-flight responses.8

Freeze is another typical response to a threat. It’s a defense mechanism that occurs when the parasympathetic nervous system dominates. When faced with a dangerous situation, you find yourself temporarily unable to move.9

Fawning is a type of codependent behavior used to prevent retaliation and harm in abusive situations. The victim becomes overly helpful to the abuser. As a survival mechanism, it may help the victim reduce fear and claim some power in an otherwise powerless situation.10

A person experiencing Stockholm syndrome speaks or acts in a way that helps neutralize the intense emotions and behaviors of someone abusing or holding them captive. This can de-escalate the situation and stop or prevent abuse from continuing.

In many cases, the abuser has mental health issues. These include antisocial, narcissistic, and borderline personality disorders.4

The people on the receiving end can become increasingly tolerant of the abusive behavior. If they are in denial about their own unhappiness, they may never see a reason to leave the relationship.4

Domestic Abuse Hotline

If you or someone you know is experiencing abuse from an intimate partner, you can call the National Domestic Violence Hotline at 800-799-SAFE (7233) for assistance. If the situation is an emergency and you are in immediate danger, call 911.

How to Process Stockholm Syndrome Abuse

Stockholm syndrome is a trauma response. Loyalty and affection for captors or abusers may feel genuine to the person being abused, while the captor or abuser may not have positive feelings for the person being held hostage or abused.

Seek the support of a healthcare provider, such as a therapist or psychologist, if you are in or have recently left an abusive or hostage situation. Evidence-based therapeutic treatments are the best first line of treatment.

Effective therapeutic treatments include:11

Cognitive processing therapy (CPT)

Prolonged exposure therapy (PE)

Trauma-focused cognitive behavioral therapy (CBT)

Other ways of processing may include:12

Other forms of talk therapy

Counseling

Connecting in safe relationships with trusted friends and family

Journaling

You may have to try different strategies to find the most effective way to cope while adjusting to life after experiencing relationship trauma.

Mental Health Support and Resources

Many health and support resources are available to people who are experiencing or have experienced a hostage situation or abuse. Depending on the situation, the first step may be contacting emergency response services, such as a local police department, or dialing 911.

Available resources for mental health support, abuse, and Stockholm syndrome recovery include the following:

The American Psychological Association has an online search tool to find a psychologist.

Healthcare providers at hospitals, primary care offices, or clinics can offer mental health support and treatment.

DomesticShelters.org offers an online search engine to find shelters near you.

Hostage US offers mental and physical health resources for hostages and their families.

Local emergency response services such as police, first responders, or 911.

The National Alliance on Mental Illness (NAMI) offers mental health support and education.

The National Domestic Violence Hotline and online resources support survivors of domestic violence.

Summary

Stockholm syndrome happens when the sympathetic nervous system is activated in response to a hostage situation, abuse, or other relationship stressor.

A person being held captive or abused may feel positive feelings toward the captor or abuser, form an attachment, and be loyal to them as a coping mechanism to a life-threatening situation. This defense is similar to fight, flight, freeze, and fawn responses.

If you or someone you know is experiencing Stockholm syndrome, help is available. Call a domestic violence hotline, seek out shelters, or see a healthcare provider for additional resources and support.’

How do you know if your child has been sexually abused at school or daycare?

Children who are sexually abused cry constantly, wake up at night, cry, are restless, and are constantly isolated.

What are the Signs of Child Sexual Abuse?

Children and young people who have been sexually abused can display a range of signs and symptoms.

The signs of child sexual abuse can vary depending on the child’s developmental stage and the circumstances of the abuse, such as how frequent the abuse is, who is inflicting the abuse and what kind of abuse is happening.

When a child is sexually abused, they might not tell anyone about the abuse, for a variety of reasons. Whilst there are signs and symptoms that may indicate sexual abuse has occurred, it is important to note that the presence of some of the signs does not confirm that sexual abuse has occurred. Some children might show many of the signs and others might show few or none at all.

The experience of child sexual abuse can change the way children and young people understand their world, the people in it and where they belong. After sexual abuse, a child or young person’s understanding of themselves and the world can become distorted, and create mistrust, fear, and betrayal. Their personality and behaviours may change noticeably from what they were prior to the sexual abuse.

signs of child sexual abuse - bravehearts

Potential signs of sexual abuse in children include:

The child is quieter or more distant than usual

The child is clingier than usual

Unusual or new fears, sometimes around touch, being alone, being with a particular person or in a particular place

Difficulty concentrating or with memory, zoning out, seeming distracted or not listening

Eating, sleeping or hygiene changes

Regressive behaviours such as bed-wetting or soiling after being toilet trained, acting or wanting to be treated like a baby/younger child again

Showing knowledge of sexual behaviour beyond their developmental age

Sexual themes in artwork, stories, play etc.

‘Acting out’ behaviours (aggression, destructive behaviours, truanting behaviour)

‘Acting in’ behaviours (withdrawal from friends and family, depression)

Problems with friends and schoolwork/attendance

Vague symptoms of illness such as headache or tummy ache

Self-harm (cutting, risky behaviour)

Asking vague questions or making vague statements about topics such as secrets, unusual ‘games’, or adult behaviours

Children and young people of all cultures, ethnic and socioeconomic backgrounds and ages may be sexually abused. Above all else, it is important to pay attention to behavioural changes in your children and take them seriously if they disclose, and if you require support or guidanc

Types of sexual abuse

There are two types of sexual abuse – contact and non-contact abuse. And sexual abuse can happen in person or online.

Contact abuse

Contact abuse is where an abuser makes physical contact with a child or forces the child to make physical contact with someone else. This includes:

sexual touching of any part of a child's body, whether they're clothed or not

using a body part or object to rape or penetrate a child

forcing a child to take part in sexual activities

making a child undress or touch someone else.

Contact abuse can include touching, kissing and oral sex – sexual abuse isn't just penetrative.

Non-contact abuse

Non-contact abuse is where a child is abused without being touched by the abuser. This can be in person or online and includes:

exposing or flashing

showing pornography

exposing a child to sexual acts

making them masturbate

forcing a child to make, view or share child abuse images or videos

making, viewing or distributing child abuse images or videos

forcing a child to take part in sexual activities or conversations online or through a smartphone.

Find out more about grooming and child sexual exploitation. Although their definitions are slightly different to sexual abuse, they are all forms of child abuse.

Signs of sexual abuse

Knowing the signs of sexual abuse can help give a voice to children and can get support for that child earlier on. Sometimes children won't understand that what's happening to them is wrong. Or they might be scared to speak out. Some of the signs you might notice include:

If a child is being or has been sexually abused online, they might:

spend a lot more or a lot less time than usual online, texting, gaming or using social media

seem distant, upset or angry after using the internet or texting

be secretive about who they're talking to and what they're doing online or on their mobile phone

behaving as though they have to be online at a certain time, or rushing to get on their phone

have lots of new phone numbers, texts or email addresses on their mobile phone, laptop or tablet

Expressing the need for money, this may be used if they are being blackmailed.

Children and young people might also drop hints and clues about the abuse.

If you're worried about a child and want to talk to them, we have advice on having difficult conversations.

If a child reveals abuse

If a child talks to you about sexual abuse it's important to:

listen carefully to what they're saying

don’t push them too much, but allow them to talk freely or answer

let them know they've done the right thing by telling you

tell them know it's not their fault

say you'll take them seriously

don't confront the alleged abuser

explain what you'll do next

report what the child has told you as soon as possible

decide if they need medical attention.

Effects of sexual abuse

Sexual abuse can have both short and long-term effects. The impact of sexual abuse can last a lifetime. Children, young people and adults may live with:

anxiety and depression

eating disorders

post-traumatic stress

difficulty coping with stress

self-harm

suicidal thoughts and suicide

flashbacks or nightmares

sexually transmitted infections

pregnancy

feelings of shame, guilt and isolation

drug and alcohol problems

relationship problems with family, friends and partners.

Our services can support children and young people who have experienced sexual abuse to help support them and to make sure they receive the care they need.

Who's at risk

Any child is at risk of being sexual abused. It's important to remember that both boys and girls can be sexually abused.

Most children who've been sexual abused are abused by someone they know. This could be a family member, a friend or someone who has targeted them, like a teacher or sports coach.

Children who are sexually abused online could be abused by someone they know. They could also be abused by someone who commits a one-off sexually abusive act or a stranger who builds a relationship with them.

Some children are more at risk of sexual abuse. Children with disabilities are more likely to be sexually abused, especially those who are unable to tell someone what's happening or don't understand what's happening to them is abuse.

Some abusers target children who may be isolated. For example, a child may be in care or they may already be neglected by their parents or carers. Other abusers target families or children who have no obvious vulnerabilities.

It's important to remember that a child is innocent and the abuser is at fault.

Report sexual abuse

To report sexual abuse:

contact the children's social care team at their local council.

call 999 if the child is at immediate risk or call 101 if you think a crime has been committed

call Crimestoppers anonymously on our dedicated child protection specialists will be able to advise and take any necessary action.

Report Abuse in Education helpline

We’ve launched a dedicated helpline for children and young people who have experienced abuse at school, and for worried adults and professionals that need support and guidance, including for non-recent abuse. Call our new NSPCC helpine, Report Abuse in Education on .

For parents

Finding out your child has been sexually abused can be frightening and distressing. But there's help for you and your family.

We Stand supports non-abusing parents and carers whose children have been sexually abused.

For children and young people

We run therapeutic services for children who have experienced, or are at risk of, sexual abuse and their families:

Letting the Future In

The Lighthouse provides support to children and young people who have experienced sexual abuse to help them recover.

Our Women as Protectors service helps mums and carers who are in contact with a man who may cause sexual harm to their children.

The Survivors Trust provide emotional support and information to any survivor of child abuse.

Find out more about all our services for children, including how to get in touch with ones in your area.

How Childline can help

We understand how difficult it is for children to talk about sexual abuse. Whether it's happening now or happened in the past, Childline can be contacted 24/7. are free and confidential. Children can also contact Childline online.

Childline has information and advice for children and young people about sexual abuse and rape and sexual assault.

Prevent sexual abuse

We can all help prevent sexual abuse and keep children safe. We can help stop sexual abuse before it happens. If a child has been sexually abused, we can help give them a voice so they can tell someone.

Adrina Chrome

When a child is separated from their biological family, they suffer from a mental crisis, and this mental crisis of depression and psychological trauma, along with their developmental trauma, will never make them healthy human beings. Part Two: When the Adrina Chrome is removed from the child's body, the substance that can grow the child's brain is destroyed, and they only grow physically, and the growth substance does not reach the brain, and the child's brain remains the same as a child, and when they become adults, their brain does not function properly, and because the person's brain has not grown and the necessary substance has not reached their brain, they suffer from mental retardation. Due to the removal of Adrenachrome from the child's body, the child loses his or her true growth and becomes mentally retarded.

What are the consequences for the child if Adrina Chrome leaves the child's body?

When Adrina chrome is removed from the body of a child, of course, nearly 60% of it is removed from the body of a child. In the future, the child's body may grow, but the child's brain does not grow. The child becomes mentally retarded. Because the brain does not develop due to the removal of Adrina chrome from the body, the child becomes mentally retarded.

Adrina chrome is From childrens body .

Childrens mafia and political in Europe.

what is post traumatic stress disorder?

Children who are brutally taken from their families by the social stigmatization agency develop Post-Traumatic Stress Disorder.

How does PTSD affect a person's daily life?

Effects of PTSD - PTSD: National Center for PTSD

The symptoms of PTSD can cause problems with trust, closeness, communication, and problem solving which, in turn, may impact the way a loved one responds to the trauma survivor. Read about the circular pattern that may develop which can sometimes harm close family relationships.

If you have a family, [PTSD] becomes a family issue when family members start taking it on.

Effects of PTSD

Available en Español

When someone has PTSD, symptoms may affect family and friends. PTSD makes it hard to do everyday things and this may lead to unmet family needs. Partners and children may feel more stress and talking to one another may be tough. This section includes information about the effects of PTSD on families, children and relationships. There are also tips to help cope with challenges.

Families

Effects of PTSD on families

PTSD can make somebody hard to live with. Living with someone who is easily startled, has nightmares, and/or avoids social situations can take a toll on the most caring family members. Research on PTSD has shown the harmful impact of PTSD on families.

When a child's parent has PTSD

A parent's PTSD symptoms can directly affect their children. This section describes how a caregiver's PTSD symptoms impact children and outlines some of the common problems experienced by children of Veterans or other adults with PTSD. This section also provides recommendations for how to cope with these difficulties.

Relationships

Trauma survivors with PTSD may have trouble with their close family relationships or friendships. The symptoms of PTSD can cause problems with trust, closeness, communication, and problem solving which, in turn, may impact the way a loved one responds to the trauma survivor.

Relationships

Read about the circular pattern that may develop which can sometimes harm close family relationships.

Military Families

Military families often deal with unique cycles of stress associated with deployments and may struggle to know how to cope with changes in the family or their deployed loved one. This section provides information for families who may be experiencing difficulties resulting from military deployments.

Partners of Veterans with PTSD

PTSD can affect how couples get along with each other. It can also directly affect the mental health of partners. This section describes common problems in relationships where one or both partners has PTSD and outlines basic information about how to help couples facing these problems.

How deployment stress affects families

This section explains how deployment of a service member to a combat zone can be extremely challenging for a family.

What is post-traumatic stress disorder explain?

Post-traumatic stress disorder (PTSD) is a mental health condition that's caused by an extremely stressful or terrifying event — either being part of it or witnessing it. Symptoms may include flashbacks, nightmares, severe anxiety and uncontrollable thoughts about the event.

Most people who go through traumatic events may have a hard time adjusting and coping for a short time. But with time and by taking good care of themselves, they usually get better. If the symptoms get worse, last for months or years, and affect their ability to function daily, they may have PTSD.

Getting treatment after PTSD symptoms arise can be very important to ease symptoms and help people function better.

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A Book: Mayo Clinic Family Health Book

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Symptoms

Post-traumatic stress disorder symptoms may start within the first three months after a traumatic event. But sometimes symptoms may not appear until years after the event. These symptoms last more than one month and cause major problems in social or work situations and how well you get along with others. They also can affect your ability to do your usual daily tasks.

Generally, PTSD symptoms are grouped into four types: intrusive memories, avoidance, negative changes in thinking and mood, and changes in physical and emotional reactions. Symptoms can vary over time or vary from person to person.

Intrusive memories

Symptoms of intrusive memories may include:

Unwanted, distressing memories of a traumatic event that come back over and over again.

Reliving a traumatic event as if it were happening again, also known as flashbacks.

Upsetting dreams or nightmares about a traumatic event.

Severe emotional distress or physical reactions to something that reminds you of a traumatic event.

Avoidance

Symptoms of avoidance may include:

Trying not to think or talk about a traumatic event.

Staying away from places, activities or people that remind you of a traumatic event.

Negative changes in thinking and mood

Symptoms of negative changes in thinking and mood may include:

Negative thoughts about yourself, other people or the world.

Ongoing negative emotions of fear, blame, guilt, anger or shame.

Memory problems, including not remembering important aspects of a traumatic event.

Feeling detached from family and friends.

Not being interested in activities you once enjoyed.

Having a hard time feeling positive emotions.

Feeling emotionally numb.

Changes in physical and emotional reactions

Symptoms of changes in physical and emotional reactions, also called arousal symptoms, may include:

Being easily startled or frightened.

Always being on guard for danger.

Self-destructive behavior, such as drinking too much or driving too fast.

Trouble sleeping.

Trouble concentrating.

Irritability, angry outbursts or aggressive behavior.

Physical reactions, such as sweating, rapid breathing, fast heartbeat or shaking.

For children 6 years old and younger, symptoms also may include:

Reenacting a traumatic event or aspects of a traumatic event through play.

Frightening dreams that may or may not include aspects of a traumatic event.

Intensity of symptoms

Over time, PTSD symptoms can vary in how severe they are. You may have more PTSD symptoms when you're generally stressed or when you come across reminders of what you went through, including the same time of year when a past traumatic event happened. For example, you may hear a car backfire and relive combat experiences. Or you may see a report on the news about a sexual assault and feel overcome by memories of your assault.

When to see a doctor

Talk to your healthcare professional or a mental health professional if you have disturbing thoughts and feelings about a traumatic event for more than a month, especially if they're severe. Also, see a health professional if you're having trouble getting your life back under control. Getting treatment as soon as possible can help prevent PTSD symptoms from getting worse.

If you have suicidal thoughts

If you or someone you know has suicidal thoughts, get help right away:

Reach out to a close friend or loved one.

Contact a minister, spiritual leader or someone in your faith community.

Contact a suicide hotline.

In the U.S., call or text 988 to reach the 988 Suicide & Crisis Lifeline, available 24 hours a day, seven days a week. Or use the Lifeline Chat. Services are free and confidential.

U.S. veterans or service members who are in crisis can call 988 and then press "1" for the Veterans Crisis Line. Or text 838255. Or chat online.

The Suicide & Crisis Lifeline in the U.S. has a Spanish language phone line at 1-888-628-9454 (toll-free).

Make an appointment with your healthcare professional or mental health professional.

When to get emergency help

If you think you may hurt yourself or attempt suicide, call 911 or your local emergency number right away.

If you know someone who's in danger of attempting suicide or has made a suicide attempt, make sure someone stays with that person for safety. Call 911 or your local emergency number right away. Or, if you can do so safely, take the person to the nearest hospital emergency department.

Causes

You can develop post-traumatic stress disorder when you go through, see or learn about an event involving actual or threatened death, serious injury or sexual assault.

Healthcare professionals aren't sure why some people get PTSD. As with most mental health problems, a mix of factors probably causes it, including:

Extremely stressful experiences, as well as the amount and severity of trauma you've gone through in your life.

Inherited mental health risks, such as a family history of anxiety and depression.

Inherited features of your personality — often called your temperament.

The way your brain regulates the chemicals and hormones your body releases in response to stress.

Risk factors

People of all ages can have post-traumatic stress disorder. But you may be more likely to develop PTSD after a traumatic event if you:

Have severe or long-lasting traumatic experiences.

Were physically injured during the traumatic event.

Have been exposed to other trauma earlier in life, such as childhood abuse.

Have a job that exposes you to traumatic events, such as being in the military or being a first responder.

Have other mental health problems, such as anxiety or depression.

Drink too much or misuse drugs.

Do not have a good support system of family and friends.

Have blood relatives with mental health problems, including PTSD or depression.

Traumatic events that raise risk

Children who are subjected to social humiliation from their families through brutal and violent behavior suffer thousands of incurable mental and emotional pain. Separating a child from his or her biological parents is a form of extreme torture.

The most common events that can lead to PTSD include:

Combat exposure.

Childhood physical abuse.

Sexual violence.

Physical assault.

Being threatened with a weapon.

An accident.

Many other traumatic events also can lead to PTSD, such as fire, natural disaster, mugging, robbery, plane crash, torture, kidnapping, a life-threatening medical diagnosis, a terrorist attack, and other extreme or life-threatening events.

What are the 5 symptoms of PTSD?

Arousal and reactivity symptoms

Being easily startled.

Feeling tense, on guard, or on edge.

Having difficulty concentrating.

Having difficulty falling asleep or staying asleep.

Feeling irritable and having angry or aggressive outbursts.

Engaging in risky, reckless, or destructive behavior.

Post-Traumatic Stress Disorder

Post-Traumatic Stress Disorder (PTSD)

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What is post-traumatic stress disorder, or PTSD?

It is natural to feel afraid during and after a traumatic situation. Fear is a part of the body’s “fight-or-flight” response, which helps us avoid or respond to potential danger. People may experience a range of reactions after trauma, and most will recover from their symptoms over time. Those who continue to experience symptoms may be diagnosed with post-traumatic stress disorder (PTSD).

Who develops PTSD?

Anyone can develop PTSD at any age. This includes combat veterans and people who have experienced or witnessed a physical or sexual assault, abuse, an accident, a disaster, a terror attack, or other serious events. People who have PTSD may feel stressed or frightened, even when they are no longer in danger.

Not everyone with PTSD has been through a dangerous event. Sometimes, learning that a relative or close friend experienced trauma can cause PTSD.

About 6 of every 100 people will experience PTSD at some point in their lifetime, according to the National Center for PTSD, a U.S. Department of Veterans Affairs program. Women are more likely than men to develop PTSD. Certain aspects of the traumatic event and biological factors (such as genes) may make some people more likely to develop PTSD.

What are the symptoms of PTSD?

Symptoms of PTSD usually begin within 3 months of the traumatic event, but they sometimes emerge later. To meet the criteria for PTSD, a person must have symptoms for longer than 1 month, and the symptoms must be severe enough to interfere with aspects of daily life, such as relationships or work. The symptoms also must be unrelated to medication, substance use, or other illness.

The course of the disorder varies. Although some people recover within 6 months, others have symptoms that last for 1 year or longer. People with PTSD often have co-occurring conditions, such as depression, substance use, or one or more anxiety disorders.

After a dangerous event, it is natural to have some symptoms. For example, some people may feel detached from the experience, as though they are observing things as an outsider rather than experiencing them. A mental health professional—such as a psychiatrist, psychologist, or clinical social worker—can determine whether symptoms meet the criteria for PTSD.

To be diagnosed with PTSD, an adult must have all of the following for at least 1 month:

At least one re-experiencing symptom

At least one avoidance symptom

At least two arousal and reactivity symptoms

At least two cognition and mood symptoms

Re-experiencing symptoms

Flashbacks—reliving the traumatic event, including physical symptoms, such as a racing heart or sweating

Recurring memories or dreams related to the event

Distressing thoughts

Physical signs of stress

Thoughts and feelings can trigger these symptoms, as can words, objects, or situations that are reminders of the event.

Avoidance symptoms

Staying away from places, events, or objects that are reminders of the experience

Avoiding thoughts or feelings related to the traumatic event

Avoidance symptoms may cause people to change their routines. For example, some people may avoid driving or riding in a car after a serious car accident.

Arousal and reactivity symptoms

Being easily startled

Feeling tense, on guard, or on edge

Having difficulty concentrating

Having difficulty falling asleep or staying asleep

Feeling irritable and having angry or aggressive outbursts

Engaging in risky, reckless, or destructive behavior

Arousal symptoms are often constant. They can lead to feelings of stress and anger and may interfere with parts of daily life, such as sleeping, eating, or concentrating.

Cognition and mood symptoms

Trouble remembering key features of the traumatic event

Negative thoughts about oneself or the world

Exaggerated feelings of blame directed toward oneself or others

Ongoing negative emotions, such as fear, anger, guilt, or shame

Loss of interest in previous activities

Feelings of social isolation

Difficulty feeling positive emotions, such as happiness or satisfaction

Cognition and mood symptoms can begin or worsen after the traumatic event. They can lead people to feel detached from friends or family members.

How do children and teens react to trauma?

Children and teens can have extreme reactions to traumatic events, but their symptoms may not be the same as those seen in adults. In children younger than age 6, symptoms can include:

Wetting the bed after having learned to use the toilet

Forgetting how to talk or being unable to talk

Acting out the scary event during playtime

Being unusually clingy with a parent or other adult

Older children and teens usually show symptoms more like those seen in adults. They also may develop disruptive, disrespectful, or destructive behaviors. Older children and teens may feel guilt over not preventing injury or death, or have thoughts of revenge.

Find more information on helping children and adolescents cope with traumatic events.

Why do some people develop PTSD and other people do not?

Not everyone who lives through a dangerous event develops PTSD—many factors play a part. Some of these factors are present before the trauma; others play a role during and after a traumatic event.

Risk factors that may increase the likelihood of developing PTSD include:

Exposure to previous traumatic experiences, particularly during childhood

Getting hurt or seeing people hurt or killed

Feeling horror, helplessness, or extreme fear

Having little or no social support after the event

Dealing with stressors after the event, such as the loss of a loved one, pain and injury, or loss of a job or home

Having a personal history or family history of mental illness or substance use

Resilience factors that may reduce the likelihood of developing PTSD include:

Seeking out and receiving support from friends, family, or support groups

Learning to feel okay with one’s actions in response to a traumatic event

Having a coping strategy for getting through and learning from a traumatic event

Being prepared and able to respond to upsetting events as they occur, despite feeling fear

How is PTSD treated?

It is important for people with PTSD symptoms to work with a mental health professional who has experience treating PTSD. The main treatments are psychotherapy, medications, or a combination of psychotherapy and medications. An experienced mental health professional can help people find the best treatment plan for their symptoms and needs.

Some people with PTSD, such as those in abusive relationships, may be living through ongoing trauma. In these cases, treatment is usually most effective when it addresses both the traumatic situation and the symptoms of PTSD. People who experience traumatic events or who have PTSD may also experience panic disorder, depression, substance use, or suicidal thoughts. Treatment for these conditions can help with recovery after trauma. Research shows that support from family and friends also can be an essential part of recovery.

Find tips to help prepare and guide you in talking to your health care provider about your mental health.

Psychotherapy

Psychotherapy, sometimes called talk therapy, includes a variety of treatment techniques that mental health professionals use to help people identify and change troubling emotions, thoughts, and behaviors. Psychotherapy can provide support, education, and guidance to people with PTSD and their families. Treatment can take place one on one or in a group setting and usually lasts 6 to 12 weeks but can last longer.

Some types of psychotherapy target PTSD symptoms, while others focus on social, family, or job-related problems. Effective psychotherapies often emphasize a few key components, including learning skills to help identify triggers and manage symptoms.

A common type of psychotherapy called cognitive behavioral therapy can include exposure therapy and cognitive restructuring.

Exposure therapy helps people learn to manage their fear by gradually exposing them, in a safe way, to the trauma they experienced. As part of exposure therapy, people may think or write about the trauma or visit the place where it happened. This therapy can help people with PTSD reduce symptoms that cause them distress.

Cognitive restructuring helps people make sense of the traumatic event. Sometimes people remember the event differently from how it happened, or they may feel guilt or shame about something that is not their fault. Cognitive restructuring can help people with PTSD think about what happened in a realistic way.

Learn more about psychotherapy.

Medications

The U.S. Food and Drug Administration (FDA) has approved two selective serotonin reuptake inhibitors (SSRIs), a type of antidepressant medication, for the treatment of PTSD. SSRIs may help people manage PTSD symptoms, such as sadness, worry, anger, and feeling emotionally numb. Health care providers may prescribe SSRIs and other medications along with psychotherapy. Some medications may help treat specific PTSD symptoms, such as sleep problems and nightmares.

People should work with their health care providers to find the best medication or combination of medications and the right dose. Read the latest medication warnings, patient medication guides, and information on newly approved medications on the FDA website .

How can I find help?

The Substance Abuse and Mental Health Services Administration has an online treatment locator at to help you find mental health services in your area. Learn more about getting help on the NIMH website.

If you or someone you know is struggling or having thoughts of suicide, call or text the 988 Suicide and Crisis Lifeline at 988 or chat at 988lifeline.org . In life-threatening situations, call 911.

What can I do to help myself?

You can get better with treatment. Here are some things you can do to help yourself:

Talk with your health care provider about treatment options and follow your treatment plan.

Engage in exercise, mindfulness, or other activities that help reduce stress.

Try to maintain routines for meals, exercise, and sleep.

Set realistic goals and focus on what you can manage.

Spend time with trusted friends or relatives and tell them about things that may trigger symptoms.

Expect your symptoms to improve gradually, not immediately.

Avoid the use of alcohol or drugs.

How can I help a loved one with PTSD?

If you know someone who may be experiencing PTSD, the most important thing you can do is to help that person get the right diagnosis and treatment. Some people may need help making an appointment with their health care provider; others may benefit from having someone accompany them to their health care visits.

If a close friend or relative is diagnosed with PTSD, you can encourage them to follow their treatment plan. If their symptoms do not improve after 6 to 8 weeks, you can encourage them to talk about it with their health care provider. You also can:

Offer emotional support, understanding, patience, and encouragement.

Learn about PTSD so you can understand what your friend is experiencing.

Listen carefully. Pay attention to the person’s feelings and the situations that may trigger PTSD symptoms.

Share positive distractions, such as walks, outings, and other activities.

Where can I find more information on PTSD?

The National Center for PTSD, a program of the U.S. Department of Veterans Affairs, is the leading federal center for research and education on PTSD and traumatic stress. You can find information about PTSD, treatment options, getting help, and additional resources for families, friends, and providers on the center’s website .

Are there clinical trials studying PTSD?

NIMH supports a wide range of research, including clinical trials that look at new ways to prevent, detect, or treat diseases and conditions—including PTSD. Although individuals may benefit from being part of a clinical trial, participants should be aware that the primary purpose of a clinical trial is to gain new scientific knowledge so that others may be better helped in the future

Researchers at NIMH and around the country conduct clinical trials with patients and healthy volunteers. Talk to a health care provider about clinical trials, their benefits and risks, and whether one is right for you. Learn more about participating in clinical trials.

Reprints

The information in this publication is in the public domain and may be reused or copied without permission. However, you may not reuse or copy images. Please cite the National Institute of Mental Health as the source. Read our copyright policy to learn more about our guidelines for reusing NIMH content.

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