This document provides a review of childhood trauma, including definitions, types of abuse and trauma, changes to PTSD diagnosis in the DSM-5, treatment options like TF-CBT, and steps to take if abuse is suspected. It defines childhood, trauma, abuse, and outlines types of abuse like neglect, verbal, physical, and sexual abuse. It also differentiates between simple and complex trauma and notes TF-CBT has been shown effective in randomized clinical trials. The author recommends medical attention, documentation, ensuring safety, and reporting to authorities like 1919 or family if abuse is suspected.

1. Childhood Trauma;
review and what to do.
Sarah Abdelbary Bougary, MD
US Board-Psychiatry
US fellowship-Child and Adolescent Psychiatry
Jan 15, 2015

2. Review

3. Definitions:
 Childhood: the state or period of being a child. 1
 Child maltreatment prevention: measures taken to prevent
child maltreatment before it occurs. 2
 Child protection: measures taken after child maltreatment
has occurred.2
 Trauma: a very difficult or unpleasant experience that causes
someone to have mental or emotional problems usually for a
long time.1
 Abuse: improper or excessive use or treatment. 1
 Molestation: to harm (someone) through sexual contact : to
touch (someone) in a sexual and improper way. 1

4. Types of childhood abuse:
Neglect
 Verbal
 Physical
 Sexual
 Bullying by peers ( in person or online)

5. Types of childhood trauma:
 Simple: one type of abuse happened once.
 Complex: more than one type of abuse happened once,
more than one type of abuse happened more than once. This
becomes pervasive and can effect formation of a self.3

6. DSM IV-TR revised vs. DSM 5 4
 Re-experiencing: previously called “intrusive recollection.
 Avoidance: previously called avoidant/numbing.
 Arousal: previously called hyper-arousal.
New criteria:
 Negative cognitions and mood.
New subtypes:
 Preschool subtype – for children less than 6 years old
 PTSD with prominent dissociative symptoms – such as being
detached from one’s mind or body, or experiences in which the
world seems unreal, dreamlike or distorted

7. TF-CBT Randomized Clinical
Trials (RCT)
 7 RCTs have been completed by the Cohen, Deblinger,
and Mannarino team
 One RCT in the Democratic Republic of Congo for sex
trafficked girls and child soldiers
 One RCT in Norway by Tine Jensen and her group King et al.
RCT

8. What to do?

9. Do we value privacy more than
life? Should we?

10. 1919

11. Does 1919 work?
 According to the Saudi National Society for Human Rights,
576 abuse cases were reported in 2013, a 77 percent jump
from 292 cases reported in 2012. 5

12. What to do when you suspect
abuse of any kind?
Medical attention and gather information.
 Who, what, when, how many times, symptoms.
 Document; writing and pictures. (sensitively)
Stop, Block and Tell.
 STOP: Stop the abuse.
 BLOCK: Ensure safety.
 TELL: 1919, family members, school, anyone that will listen.

13. Then what?
 Evaluate for acute stress disorder, PTSD, other psychiatric
issues.
 Treat as necessary.

14. References:
1. http://www.merriam-webster.com/dictionary/childhood
2. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3221137/
3. http://www.nctsn.org/trauma-types/complex-
trauma/resources
4. http://www.healthyplace.com/blogs/understandingcombatpt
sd/2013/12/18/ptsd-change-dsm-iv-dsm-5/
5. http://www.arabnews.com/news/533936

15. Further learning
 http://www.nctsn.org/resources/audiences/professionals/sear
ch-the-Literature
 http://www.nimh.nih.gov/health/publications/ptsd-listing.shtml
 http://www.psychologicalscience.org/index.php/news/release
s/why-some-soldiers-develop-ptsd-while-others-dont.html
 https://tfcbt.org/

16. Thank you.