Most Child Trauma Is Caused by Chronic Terrors: Physical Abuse Is No. 1: Most Research Is in Single-Incident Trauma, but Most Cases Involve Ongoing Situations

Article excerpt

VANCOUVER, B.C. -- More than 80% of traumatized children who require therapy have been victims of chronic or multiple terrors, rather than isolated situations such as motor vehicle accidents, natural disasters, or acts of terrorism, a surly of 39 U.S. childhood trauma centers has found.

Despite this, research funding for childhood trauma focuses almost exclusively on single-incident trauma rather than on ongoing trauma such as childhood sexual abuse or physical abuse, said Dr. Bessel A. van der Kolk, medical director of the trauma center at Arbour-H.R.I. Hospital, Brookline, Mass., and professor of psychiatry at Boston University.

"What gets funded is accidents, but in fact, what we're treating is people who have very severe disturbances in primary relationships," he said at a meeting on posttraumatic stress disorder (PTSD) sponsored by Vancouver General Hospital.

Dr. van der Kolk and several other speakers at the conference called into question the diagnostic criteria for PTSD in the DSM-IV-TR, which they said are far more reflective of experiences after single-incident trauma than multiple, chronic events.

To characterize the epidemiology of childhood trauma, a survey was conducted of the 39 centers that make up the National Child Traumatic Stress Network established in 2001.

The survey found that for most children requiring therapy, terrifying events began early in childhood and became a way of life.

The first traumatic event in a child's life was at age 5, and the average child seen within the network has suffered at least three different forms of trauma, within a range of 1-11 trauma subtypes. …