Tag Archives: Complex Post-traumatic Stress Disorder

Why can Effects of Childhood Trauma be Delayed?

childhood_trauma_delayed_effects

Delayed onset post traumatic stress disorder (PTSD) ,which can occur as a result of a severely disrupted childhood, is defined by the DSM (Diagnostic Statistical Manual) as PTSD which develops at least six months after the traumatic event/s; however, PTSD can take much longer than this to manifest itself.

One reason why PTSD may not become apparent immediately is that the individual who has been affected by  trauma is able, for a period of time, to employ coping mechanisms (either consciously or unconsciously) which keep the condition at bay. During this period, some of the effects of the traumatic experience/s lie dormant.However, due to the experiencing of  further triggers (stress-inducing reminders of the original trauma), the person’s neurobiological processes (already harmed by the original trauma) may be further adversely affected until a ‘tipping point’ is reached and the s/he meets the criteria for being diagnosed with the disorder.

In other words, there is an interaction between the original damage caused by the trauma and exposure to further stressors later on in life. It follows from this that the more severe the original trauma, and the more severe the stressors life throws at the individual subsequently, the greater is the his/her accumulated risk of developing PTSD. Indeed, this is borne out by the research.

ORIGINAL TRAUMA LEADS TO GREATER VULNERABILITY TO EFFECTS OF FURTHER STRESS :

The original trauma, then, makes the individual more susceptible to being affected adversely by further life stressors. In neurological terms, this is thought to be because the original trauma can damage an area of the brain known as the amygdala; damage to this region makes a person’s fear/anxiety response to stressors much more intense than is normally the case (click here to read my article on how the effects of childhood trauma can physically harm the brain).

The more the individual affected by the original trauma subsequently experiences stressful triggers (see above) which cause him/her to relive it, the more damaged, and hypersensitive to the effects of further stress, the amydala (see above) becomes. Eventually, the amygdala’s response to perceived threat and danger (there does not have to be any real threat or danger ; indeed, one of the hallmarks of PTSD is that it causes the sufferer to see threat everywhere, where it does not, in fact, exist)  become so exaggerated that the individual finds him/herself living in what amounts to a state of almost constant terror (indeed, I myself was in just such a state for more time than I care to recall).

VICIOUS CYCLE:

As the individual starts to perceive, irrationally, threat everywhere, the range of triggers (see above) s/he experiences grows ever wider; this, in turn, yet further sensitizes the amygdala and reinforces the individual’s stress response. Thus, a vicious cycle develops.

CRITICAL PERIOD OF BRAIN VULNERABILITY :

I will finish with a quote from the psychologist Shalev, which I think speaks for itself and requires no further elucidation from me :

‘Following trauma there is a critical period of brain plasticity during which serious neuronal changes may occur in those who go on to develop PTSD.’

NB. To learn more about BRAIN PLASTICITY, and how we can take advantage of the phenomenon to aid our own recoveries,  click here to read my article).

 

 

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

Childhood Trauma: Complex Post Traumatic Stress Disorder (with Questionnaire).

 

complex post traumatic stress disorder questionnaire

Survivors of extreme trauma often suffer persistent anxiety, phobias, panic, depression, identity and relationship problems. Many times, the set of symptoms the individual presents with are not connected to the original trauma by those providing treatment (as certainly was the case for me in the early years of my treatment, necessitating me to undertake my own extensive research, of which this blog is partly a result) and, of course, treatment will not be forthcoming if the survivor suffers in silence.

Any treatment not linked to the original trauma will tend to be ineffective as THE UNDERLYING TRAUMA IS NOT BEING ADDRESSED. Also, there is a danger that a wrong diagnosis may be given; possibly the diagnosis will be one that may be interpreted, by the individual given it, as perjorative (such as a personality disorder).

ptsd

Individuals who have survived protracted and severe childhood trauma often present with a very complex set of symptoms and have developed, as a result of their unpleasant experiences, deep rooted problems affecting their personality and how they relate to others. The psychologist, Kolb, has noted that the post-traumatic stress disorder symptoms survivors of severe maltreatment in childhood might develop ‘may appear to mimic every personality disorder’ and that ‘severe personality disorganization’ can emerge.

Another psychologist, Lenore Terr, has differentiated between two specific types of trauma: TYPE 1 and TYPE2. TYPE 1 refers to symptoms resulting from a single trauma; TYPE 2 refers to symptoms resulting from protracted and recurring trauma, the hallmarks of which are:

– emotional numbing
– dissociation
– cycling between passivity and explosions of rage

This second type of trauma response has been referred to as COMPLEX POSTTRAUMATIC STRESS DISORDER (COMPLEX PTSD) and more research needs to be conducted on it; however, an initial questionnaire to help in its diagnosis has been developed and I reproduce it below:

COMPLEX PTSD QUESTIONNAIRE

1) A history of, for example, severe childhood trauma

2) Alterations in affect regulation, including
– persistent dysphoria
– chronic suicidal preoccupation
– self-injury
– explosive or extremely inhibited anger (may alternate)
– compulsive or extremely inhibited sexuality (may alternate)

3) Alterations in consciousness, including
– amnesia or hypernesia for traumatic events
– transient dissociative episodes
– depersonalization/derealization
– reliving experiences, either in the form of intrusive post-traumatic stress disorder symptoms or in the form of ruminative preoccupation

4) Alterations in self-perception, including
– a sense of helplessness or paralysis of initiative
– shame, guilt and self-blame
– sense of defilement or stigma
– sense of complete difference from others (may include sense of specialness, utter aloneness, belief no other person can understand, or nonhuman identity)

5) Alterations in perceptions of perpetrator, including

– preoccupation with relationship with perpetrator (includes preoccupation with revenge)
– unrealistic attribution of total power to perpetrator (although the perpetrator may have more power than the clinician treating the individual is aware of)
– idealization or paradoxical gratitude
– sense of special or supernatural relationship
– acceptance of belief system or rationalizations of perpetrator

6) Alterations in relations with others, including

– isolation and withdrawal
– disruption in intimate relationships
– repeated search for rescuer (may alternate with isolation and withdrawal)
– persistent distrust
– repeated failures of self-protection

7) Alterations in systems of meaning
– loss of sustaining faith
– sense of hopelessness and despair

Why Is Complex PTSD Becoming More Common?

And the incidence of complex PTSD is increasing. What are the possible reasons for this increase in the prevalence of this very serious psychiatric disorder?

First, it is possible that as the general population and clinicians become more aware of the existence of the disorder and its link to childhood trauma it is becoming increasingly reported and diagnosed. However, there are several other possible explanations and I examine these briefly below :

POSSIBLE REASONS FOR THE INCREASE IN PREVALENCE OF COMPLEX POST TRAUMATIC STRESS DISORDER (Complex PTSD) :

1) Growing up in unstable environments :

More and more young people are growing up in unstable environments. Increasing rates of divorce and separation means that a higher and higher number of children and adolescents are growing up in single parent households (to read my article about the possible effects of divorce upon the child, click here).

2) Reduction in social support systems :

Research shows that a lack of social support makes individuals much more vulnerable to the adverse effects of stress. And, today, children tend to have less access to others who could provide them with emotional support than has been the case in the past due to, for example :

  • communities that are not as close-knit as in the past
  • less contact with wider family (e.g. aunts, uncles, grandparents) than in the past as wider family members are becoming more geographically dispersed than in past

3) Increase in number of working mothers :

This can lead to infants having inconsistent early care as they me be shuttled around from day-care to nursery care to babysitters and so on possibly leading to a variation in quality of care and less opportunity for the infant to develop his/her bond with the mother

4) Parental preoccupation with their careers :

In a ‘go-getting’ society, in which status and wealth are of fundamental importance to many people, individuals are becoming very driven, even obsessively driven, in connection with their careers, sometimes leading to workaholism; this leaves such persons with less time to interact in any really meaningful way with their offspring or leads to such exhaustion that they simply do not have enough energy left over for such meaningful interactions.

5) Unhelpful effects of media :

Young people are becoming increasingly obsessed with media, such as computer games and so on, which leaves them with less time for psychologically nourishing face-to-face interaction with friends and family.

6) Unhelpful effects of living in  consumer society :

Society has become increasingly obsessed with acquiring consumer goods and the accumulation of these is often linked in people’s minds to their ‘status’ and ‘worth as a human being.‘ Such attitudes may lead young people to develop false values which in turn may aggravate psychological problems.

Anyone who feels their condition may be reflected by the above is urged to seek professional intervention at the earliest opportunity.

Related post :  Complex  PTSD Treatment

RESOURCES :


Above eBook, Childhood Trauma And Its Link To CPTSD, now available on Amazon for immediate download. Click here.

 

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

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