Complex Trauma In Childhood

“Complex trauma (i.e., exposure to chronic, interpersonal trauma in childhood) has been associated with structural and functional alterations in brain development, which in turn can result in cognitive and neuropsychological deficits” (Gabowitz, Zucker & Cook, 2008, p. 163). Typically, complex traumatic experiences begin in childhood and refer not only to the child’s exposure to the event but also the impact of these exposures on development (Gabowitz et al., 2008; Lawson, Davis & Brandon, 2013). Such exposures include repeated incidence of abuse (sexual, emotional and physical); neglect; loss; and witnessing domestic violence over an extended period of time (Gabowitz et al., 2008; Lawson et al., 2013). Ongoing childhood trauma has adverse

Threat is mediated by the brain via a number of predictable systems of response that are neurobiological, neuroendocrine and neuropsychological in nature (Perry et al., 1995). The most common response to threat is known as the “fight or flight” response (Perry et al., 1995). The major adaptive neuronal responses to threat in children therefore are the hyperarousal (defense or “fight or flight”) continuum and the dissociation (freezing and surrendering) continuum (Perry et al., 1995). It is more common for a child’s response to threat to be along the dissociation continuum as the “fight or flight” response can be somewhat impractical in their situation (Perry et al.,

An alarm reaction is triggered in the initial stages of threat and is characterised by increased activity in the sympathetic nervous system (Perry et al., 1995). The sympathetic nervous system is active in increasing heart rate and blood pressure (Weber & Reynolds, 2004). A child whose predominant adaptive response style to threat is the hyperarousal continuum may develop a sensitised hyperarousal response (Perry et al., 1995). Norepinephrine that results in a cardiovascular response is released by the central nervous system that allows for hypervigilance (Weber & Reynolds, 2004). These systems are reactivated when a child is reminded of the trauma they experience as well as when the child even just thinks about the trauma and can over time become generalised; Perry et al., (1995) gives the example of a specific perpetrator becoming generalised to any strange male. Despite lack of exposure to the actual trauma, the hyperarousal system is continuously reactivated as a result of the use-dependent activation (Perry et al., 1995). The area of the brain activated with this reaction is involved in attention, concentration and arousal (Weber & Reynolds, 2004) and therefore sensitisation of this response within the neurotransmitter systems and the functional changes that occur in the brain as a result have an effect on the cognitive, behavioural and emotional functions that are mediated by these systems (Perry et al., 1995). Repetitive exposure to trauma