Assume All Patients Have Been Affected By Trauma Psychiatrists Told

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The recent Congress of the Royal Australian And New Zealand College of Psychiatrists (RANZCP) has been told that the experience of childhood trauma is so ubiquitous that psychiatrists should assume that each and every one of their patients have been affected by trauma.

Trauma connected, both directly and indirectly, to violence (e.g. being a direct victim of physical abuse or witnessing domestic violence) was highlighted as a particular concern, and psychiatrists were informed that they had a responsibility to support the addressing of the conditions, political, economic, social and political (such as poverty, housing insecurity, reliance on caregivers and historical and intergenerational trauma (Warshaw) ) that give rise to violence within society rather than restricting themselves to treating the psychological effects of violence on its victims.

One expert at the congress emphasized the fact that 33% of all hospitalizations relating to domestic violence were of children and, furthermore, 25% of these children had incurred a brain injury.

It was further pointed out that for children to be adversely affected by trauma they need not be direct victims; they can also be indirect victims as many women who have been the victims of domestic abuse report that the physical maltreatment they experienced at the hands of their partners was witnessed by their children. This is an extremely serious problem as it has been found that violence within the family is associated with low birth weight, early pregnancy loss, ADHD, anxiety, and depression.

And there are other ways in which the child may be adversely impacted by domestic violence, Women who are physically abused by their partners are put at very significantly increased (three-fold to six-fold) risk of developing a mental health disorder such as major depression, psychotic symptoms, and self-harm, substance abuse disorder, and suicidal ideation (Warshaw) and it has been firmly established by other research (e.g. see the ACE study) that living in a household in which a member suffers from a mental health problem can be a serious form of toxic stress for the child potentially giving rise to detrimental psychological and physical effects.

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David Hosier BSc Hons; MSc; PGDE(FAHE).