Microtrauma

https://en.wikipedia.org/wiki/Complex_post-traumatic_stress_disorder

Symptoms[edit]

Children and adolescents[edit]

The diagnosis of PTSD was originally developed for adults who had suffered from a single event trauma, such as rape, or a traumatic experience during a war.^[9] However, the situation for many children is quite different. Children can suffer chronic trauma such as maltreatment, family violence, and a disruption in attachment to their primary caregiver.^[10] In many cases, it is the child's caregiver who caused the trauma.^[9] The diagnosis of PTSD does not take into account how the developmental stages of children may affect their symptoms and how trauma can affect a child’s development.^[9] Currently there is no proper diagnosis for this condition, but the term developmental trauma disorder has been suggested.^[10] This developmental form of trauma places children at risk for developing psychiatric and medical disorders.^[10]

Repeated traumatization during childhood leads to symptoms that differ from those described for PTSD.^[11] Cook and others describe symptoms and behavioural characteristics in seven domains:^[12][13]

• Attachment – "problems with relationship boundaries, lack of trust, social isolation, difficulty perceiving and responding to others' emotional states, and lack of empathy"
• Biology – "sensory-motor developmental dysfunction, sensory-integration difficulties, somatization, and increased medical problems"
• Affect or emotional regulation – "poor affect regulation, difficulty identifying and expressing emotions and internal states, and difficulties communicating needs, wants, and wishes"
• Dissociation – "amnesia, depersonalization, discrete states of consciousness with discrete memories, affect, and functioning, and impaired memory for state-based events"
• Behavioural control – "problems with impulse control, aggression, pathological self-soothing, and sleep problems"
• Cognition – "difficulty regulating attention, problems with a variety of 'executive functions' such as planning, judgement, initiation, use of materials, and self-monitoring, difficulty processing new information, difficulty focusing and completing tasks, poor object constancy, problems with 'cause-effect' thinking, and language developmental problems such as a gap between receptive and expressive communication abilities."
• Self-concept – "fragmented and disconnected autobiographical narrative, disturbed body image, low self-esteem, excessive shame, and negative internal working models of self".