Trauma and children’s
development
Abi Gewirtz, Ph.D.,
Associate Professor, Dept. of Family
Social Science &
Institute of Child Development,
University of Minnesota
Overview
Domestic violence, homelessness, and maltreatment –
what do we know?
How does exposure to traumatic stress affect children’s
development?
Short-term and longer-term reactions and challenges
Trauma, risk, and resilience
Parents and children
Effects of parents’ own trauma history on parenting
Impact of parenting on children
The cycle of violence
Both follow-up and follow-back studies have
consistently shown a direct link between exposure
to violence and subsequent perpetration of
violence.
For example, Widom (2001) reported that child
victims of violence and neglect were 59% more
likely to be arrested as juvenile, 28% more likely to
be arrested in adulthood, and 30% more likely to
be arrested for a violent crime.
Defining trauma
In its definition of posttraumatic stress
disorder, the Diagnostic and Statistical
Manual uses this definition of trauma: an
event or events the person experienced,
witnessed, or was confronted with that
involved actual or threatened death or serious
injury, or a threat to the physical integrity of
self or others.
Homelessness and maltreatment:
threats to children’s development
Homelessness
Child’s basic needs for shelter not met
Extreme poverty, food insecurity
Parent’s own challenges – history of foster care is
strongly associated with homelessness as an adult
Likely associated challenges (examples):
Stability, security, routine, structure
Parenting challenges (parents who don’t have their own
positive parenting role models)
Families who are homeless live within a broader context of
prejudice and disempowerment
Impact of traumatic events
on children’s development
Children’s responses to violence are
determined by an interplay of factors:
Details of the event, including nature of injuries,
child’s relationship to victim and perpetrator, child’s
proximity to event
Child’s developmental status, including cognitive and
emotional capacities, phase-specific concerns
Family and community context of event, e.g., isolated
event or chronic exposure
Availability of supportive response from family and
other community institutions
Infants and young children – expected
development
-need protection and nurturing
-need reliability and consistency in care-taking
to respond to situations of uncertainty
-caregiving is basis for secure attachment
Infants under stress
disturbances of sleep and eating
inability to be soothed
constant crying
more generalized fears such as stranger or separation
anxiety
avoidance of situations that may or may not be related to
the trauma
Preschoolers (18mths-3) – expected
development
Want to explore but seek attachment figures
to diminish apprehension.
Increased capacities: physical, cognitive,
language development
normal struggles around separation
Preschoolers – impact of violence
disruption of expectations of protective
figures (attachment difficulties)
agitated motor behavior or extreme passivity.
eating and/or sleeping disturbances
inconsolable crying
Transition to school (ages 4-6) – expected
development
play: to express feelings and ideas
increased cognitive capacities
increased sophistication of language
less action
reality and fantasy
Impact of violence on 4 – 6 year olds
regression: loss of previously attained milestones
(e.g. toilet training)
preoccupation with words or symbols that may or
may not be related to the trauma.
posttraumatic play in which themes of the trauma
are repeated
nightmares
temper tantrums
School age – expected development
rely less on cues from caretakers and understand
situations of potential threat . They invoke fantasies of
superhuman powers to protect themselves
mastery and control, separation - individuation, self
awareness - self esteem, energy directed to school and
learning (mastery motivation system), increased language
sophistication, reality - fantasy, etc.
Violence and school-aged children
Disillusionment with the outside world
poor academic performance
lying
stealing
fighting
sleep and eating disturbances
clinging
false bravado
School age contd.
experience "time skew" and "omen formation” regarding the
trauma
 Time skew refers to a child mis-sequencing trauma related
events when recalling the memory.
 Omen formation is a belief that there were warning signs that
predicted the trauma. As a result, children often believe that if
they are alert enough, they will recognize warning signs and
avoid future traumas.
School age contd.
posttraumatic play -a literal representation of the trauma,
involves compulsively repeating some aspect of the trauma,
and does not tend to relieve anxiety. An example of
posttraumatic play is an increase in shooting games after
exposure to a school shooting.
reenactment of the trauma - more flexible than PT playinvolves behaviorally recreating aspects of the trauma (e.g.,
carrying a weapon after exposure to violence).
Puberty/early adolescence – expected
development
psychological concomitant to physical changes
preoccupation with body
sense of distinctiveness
change in relationship with parents
peer pressure
Impact of violence on early adolescents
feelings of inadequacy
unrealistic feelings of guilt
exaggerated preoccupation with body
somatic manifestations
acting out:
unsafe sex, criminal and illegal activities, drugs,
pregnancies, etc.
Adolescence – typical development
revival and culmination of previous
developmental issues
sexual and aggressive urges foster autonomy
and independence
adult physical and cognitive maturation
without the emotional component
identity definition and personality resolution
(2nd opportunity)
Impact of violence on adolescents
can act as younger children
inadequate solutions that can be physically
dangerous to self and others
2nd opportunity for separation and
individuation experienced as threatening
Adolescence contd
Symptoms more closely resemble PTSD in adults
Traumatic play still evident
Traumatic reenactment still evident
More likely than younger children or adults to exhibit
impulsive and aggressive behaviors.
Short Term Effects: Acute Disruptions in Self
Regulation
Eating
Fearfulness
Sleeping
Re-experiencing /flashbacks
Toileting
Aggression; Turning passive
into active
Attention & Concentration
Withdrawal
Avoidance
Relationships
Partial memory loss
Long Term Effects:
Chronic Developmental Adaptations
Depression
Anxiety
PTSD
Personality
Substance abuse
Perpetration of violence
Trauma, risk and resilience
Trauma & Cumulative Risk Overlap
Risks ‘pile up’ (Rutter, 1985)
Secondary adversities during trauma events (Pynoos
et al., 1996)
Multi-problem families risk for trauma (Widom,
1989; 1999)
Other risks contribute to posttraumatic stress
disorder
Trauma, Resilience, & Parenting
Resilience: capacity to recover functioning following
cessation of the traumatic event (Luthar et al., 2000).
Effective parenting is a key correlate of resilience (e.g.
Masten et al., 1999).
Why be concerned with trauma
and posttraumatic stress in
parents?
Associations between adult trauma and:
Child distress and child PTSD
Parenting impairments
Parents’ difficulties interacting with child serving
systems
How might parents respond differently to other adults
when they are dealing with traumatic stress?
And most important, how might they deal differently
with their children?
How does adult PTSD affect
parenting?
Growth in fathers’ PTSD is associated with selfreported impairments in parenting one year after
return from combat
Gewirtz, Polusny, DeGarmo, Khaylis, & Erbes, (2010),
Journal of Consulting and Clinical Psychology, 78, 5,
599-610
Parenting practices predict
children’s recovery from a
traumatic incident
Mothers’ observed parenting is associated with steeper
reductions in child-reported traumatic stress over a
period of four months following a domestic violence
incident
Gewirtz, Medhanie, & DeGarmo, (2011), Journal of
Family Psychology, 25, 29-38.
Interventions that buffer parenting show
improvements to child internalizing and
stress regulation
Parent training directed at mothers only resulted in
improvements to child internalizing (later associated with
reductions in externalizing) (DeGarmo, Patterson, &Forgatch
2005)
Foster parent training associated with changes in children’s
cortisol levels (Fisher et al., 2000; 2006)
How does trauma impact parenting?
Parents who are traumatized may be:
Suffering from PTSD and related disorders (e.g.,
depression, anxiety)
Using drugs to mask the pain
Disempowered
Parents of children who have become “parentified” (i.e.
responsible beyond their years)
How might parents’ trauma
histories affect their parenting?
A history of traumatic experiences may:
Compromise parents’ ability to make appropriate judgments about
their own and their child’s safety and to appraise danger; in some
cases, parents may be overprotective and, in others, they may not
recognize situations that could be dangerous for the child.
Make it challenging for parents to form and maintain secure and
trusting relationships, leading to:
Disruptions in relationships with infants, children, and
adolescents, and/or negative feelings about parenting; parents
may personalize their children’s negative behavior, resulting in
ineffective or inappropriate discipline.
Challenges in relationships with caseworkers, foster parents, and
service providers and difficulties supporting their child’s therapy.
Trauma history can:
Impair parents’ capacity to regulate their emotions.
Lead to poor self-esteem and the development of maladaptive coping strategies, such as
substance abuse or abusive intimate relationships that parents maintain because of a real
or perceived lack of alternatives.
Result in trauma reminders—or “triggers”—when parents have extreme reactions to
situations that seem benign to others. These responses are especially common when
parents feel they have no control over the situation, such as facing the demands of the
child welfare system. Moreover, a child’s behaviors or trauma reactions may remind
parents of their own past trauma experiences or feelings of helplessness, sometimes
triggering impulsive or aggressive behaviors toward the child. Parents also may seem
disengaged or numb (in efforts to avoid trauma reminders), making engaging with
parents and addressing the family’s underlying issues difficult for caseworkers and other
service providers.
Impair a parent’s decision-making ability, making future planning more challenging.
Make the parent more vulnerable to other life stressors, including poverty, lack of
education, and lack of social support that can worsen trauma reactions.
Traumatized parents may…
Find it hard to talk about their strengths (or those of their
children)
Need support in managing children’s behavior
Have difficulty labeling their children’s emotions, and
validating them
Have difficulty managing their own emotions in family
communication
When posttraumatic stress symptoms interfere with daily
interactions with children, parents should seek individual
treatment
Traumatized parents
Trauma and adversity affect children’s adjustment
because they impair parenting:
Disrupt emotion socialization of parents
Increase experiential avoidance
Increase emotion dismissing
Increase withdrawal and coercion, bids for attention and
other atypical family processes
emotion socialization includes:
discussion of emotions,
teaching about and responding to children’s emotions
responding to own emotions
increase coercive parenting
Resources
www.NCTSN.org
Birth parents with trauma histories in the child welfare system
Six fact sheets on parent trauma for child welfare stakeholders
Psychological first aid for families in shelters
:http://www.nctsnet.org/sites/default/files/assets/pdfs/PFA_Fam
ilies_homelessness.pdf
Facts on trauma and homeless children
http://www.nctsnet.org/sites/default/files/assets/pdfs/Facts_
on_Trauma_and_Homeless_Children.pdf
Thank you!
Abi Gewirtz
agewirtz@umn.edu