15. Childhood Trauma

  1. William M. Klykylo5 and
  2. Jerald Kay6
  1. Julia Huemer1,
  2. Sidney Edsall2,
  3. Niranjan S. Karnik3 and
  4. Hans Steiner4

Published Online: 30 MAR 2012

DOI: 10.1002/9781119962229.ch15

Clinical Child Psychiatry, Third Edition

Clinical Child Psychiatry, Third Edition

How to Cite

Huemer, J., Edsall, S., Karnik, N. S. and Steiner, H. (2012) Childhood Trauma, in Clinical Child Psychiatry, Third Edition (eds W. M. Klykylo and J. Kay), John Wiley & Sons, Ltd, Chichester, UK. doi: 10.1002/9781119962229.ch15

Editor Information

  1. 5

    Department of Psychiatry, Wright State University School of Medicine, 627 S. Edwin C Moses Blvd, P.O. Box 927, Dayton, OH 45401-0927, USA

  2. 6

    Department of Psychiatry, Wright State University School of Medicine, P.O. Box 927, Dayton, OH 45401-0927, USA

Author Information

  1. 1

    Department of Child and Adolescent Psychiatry, Medical University of Vienna, Waehringer Guertel 18-20, 1090 Vienna, Austria

  2. 2

    Department of Psychiatry, Stanford University, 401 Quarry Road, Palo Alto, CA 94305 Dorothyann Feldis, College of Education, 600 E Teacher's College, University of Cincinnati, PO Box 210022, Cincinnati, OH 45221-0022, USA

  3. 3

    Department of Psychiatry and Behavioral Sciences, The University of Chicago, 5841 S.Maryland, MC3077, Chicago, IL60637, USA

  4. 4

    Department of Psychiatry and Behavioral Sciences; Child and Adolescent Psychiatry Clinic, Stanford University School of Medicine, 401 Quarry Road, MC 5719, Stanford, CA 94305-5719, USA

Publication History

  1. Published Online: 30 MAR 2012
  2. Published Print: 30 MAR 2012

ISBN Information

Print ISBN: 9781119993346

Online ISBN: 9781119962229

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Keywords:

  • trauma;
  • post-traumatic stress disorder (PTSD);
  • developmental traumatology;
  • stress response;
  • catecholamine;
  • cortisol;
  • hypothalamic-pituitary-adrenal axis;
  • magnetic resonance imaging;
  • psychotherapy;
  • selective serotonin reuptake inhibitor (SSRI)

Summary

Childhood psychiatric trauma is a common presenting issue for the practicing clinician. The range of phenomena that bring about these issues can range from pediatric acute and chronic illness, to sexual abuse, and even entail mass trauma. Clinicians working with these varied populations of children need to be cognizant of current advances in the neurobiological underpinnings of trauma and post-traumatic stress, and its implications for treatment, as well as being sensitive to the social and family milieu that can help form the basis of good therapeutic interventions. The chapter begins by setting trauma-related diagnosis in its historical context, and goes on to consider the impact of traumatic events on children on three levels: the self, the community, and the environment. The prevalence of traumatic events and trauma-related pathology in childhood is considered. The relatively new field of developmental traumatology is introduced, and the role of various neurobiological processes in trauma responses and pathology is reviewed; these include alterations in the catecholamine system and changes in the hypothalamic-pituitary-adrenal axis. Imaging has revealed that neuroanatomical changes associated with traumatic stress differ in children and adults. Workup requires a careful and detailed approach, and the roles of the interview and assessment are examined. Mainstays of treatment are psychotherapy, psychoeducation, and psychopharmacology.