POST TRAUMATIC STRESS
DISORDER
By Moira Mardero, Elsie Yip, Curtis Richardson & Marc Baureiss
"Post Traumatic Stress Disorder helps us make
resolution with the past. We must ride with it,
not run from it. Post Traumatic Stress Disorder
is not only a mental experience, but it is a
spiritual and karmic experience, as well. Once
you address the trauma clearly, own it and
recognize it, you can release the impact of what
occurred and what is not serving you. The past
has no business in the present. The memories
are painful, but they can't hurt you.”
Coral Anika Theill, BONSHEA: Making Light of the Dark
Myth or Fact?
 It happened a long time ago, time heals all wounds, you
should be over it.
 The impacts of traumatic events are often delayed
because people will banish the memories from their
consciousness.
 Medication is an option for people in healing from the
impacts of trauma.
 You will never really be normal again.
 The single hardest-hit group of trauma victims is
children.
Introduction &The History
of PTSD
 An emotional illness classified as an anxiety
disorder
 Usually the result of terribly frightening, life
threatening, or otherwise highly unsafe experience
 PTSD sufferers re-experience the traumatic event in
some way, tend to avoid places, people that remind
them of the event
 Are also exquisitely sensitive to normal life
experiences (hyper arousal)
History con’t
 Condition has been around since people first
experienced trauma
 PTSD recognized as a formal diagnosis in 1980
 Called “soldier heart” in the American civil war
 Called “combat fatigue” in WWI
 Called “gross stress reaction” in WWII
 Called “post-Vietnam syndrome” during Vietnam
war
 Also has been called “battle fatigue & shell shock”
Some Statistics
 7-8% of all people in the US will develop PTSD in
their lifetime
 10-30% of all combat veterans and rape victims will
develop PTSD
 Somewhat higher in African Americans, Hispanics
and Native Americans due to:
 A tendency to blame themselves, have less social
support, an increased perception of racism for these
ethnic groups and differences in how they may
express distress
Statistics con’t
 5 million people suffer from PTSD in the US
 Women are twice as likely as men to develop PTSD
 Half of the individuals who use outpatient mental
health services have been found to suffer from
PTSD
 Not being present at a traumatic event does not
guarantee that one cannot suffer from traumatic
stress leading to PTSD. Ex. 2001 terrorist attacks
Statistics con’t
 5 million people suffer from PTSD in the US
 Women are twice as likely as men to develop PTSD
 Half of the individuals who use outpatient mental
health services have been found to suffer from
PTSD
 Not being present at a traumatic event does not
guarantee that one cannot suffer from traumatic
stress leading to PTSD. Ex. 2001 terrorist attacks
Rates of PTSD in Children
 Research done at Duke University:
 68% of children had direct or indirect exposure to a
traumatic event by the age of 16
 Witnessing a traumatic event (23%)
 Learning about a traumatic event (21.4%)
 Violent death of a sibling or peer (14.5%)
 Being involved in a serious accident (?)
Rates of PTSD in children
 Being exposed to a natural disaster (11.1%)
 Being diagnosed with a physical illness (11%)
 Experience of sexual abuse (10.9%)
 30% of children experienced only one traumatic
event while 37% had experienced multiple event
 Of this study group, only 0.5% of children had a
diagnosis of PTSD
Risk for PTSD Symptoms
 Factors that increase the likelihood that a child
develops PTSD after a traumatic event:
 Age (being older)
 Having another anxiety disorder
 Multiple traumatic experiences
Other Negative Consequences of
Childhood Trauma
 These children had twice the number of other
psychiatric disorders including:
 Depression
 Generalized anxiety disorder
 Social anxiety disorder
PTSD DSM-IV Diagnosis &
Criteria
 A. The person has been exposed to a traumatic
event in which both of the following have been
present:
 (1) An extreme traumatic stressor involving direct
personal experience of an event that involves actual
or threatened death or serious injury
 A threat to one’s physical integrity
 Witnessing an event that involves death, injury or a
threat to the physical integrity of another person
 Learning about unexpected or violent death, serious
harm by a family member or close associate
PTSD DSM-IV con’t
 (2) The person’s response to the event must involve
intense fear, helplessness, or horror
 B. The traumatic event is persistently re experienced
in one (or more) of the following ways:
 (1) Recurrent and distressing recollections of the
event (In young children, repetitive play may occur
with themes or aspects of the trauma are expressed)
 (2) Recurrent distressing dreams of the event
PTSD DSMV IV con’t
 (3) Acting or feeling as if the traumatic event were
recurring (a sense of reliving the experience,
illusions, hallucinations, flashbacks.)
 (4) Intense psychological distress at exposure to
internal or external cues that symbolize an aspect of
the event
 (5) Physiological reactivity on exposure to cues from
the event
PTSD DSMV IV con’t
 C. Persistent avoidance of stimuli associated with
the trauma and numbing of general responsiveness
as indicated by three or more of the following:
 (1) Efforts to avoid thoughts, feelings, or
conversations associated with the trauma
 (2) Effort to avoid activities, places or people that
arouse recollections of the event
 (3) Inability to recall an important aspect of the
trauma
PTSD DSMV IV con’t
 (4) Markedly diminished interest or participation in
significant activities
 (5) Feeling of detachment or estrangement from
others
 (6) Restricted range of affect (e.g. unable to have
love feelings
 (7) Sense of foreshortened future (e.g., does not
expect to have a career, marriage, children or
normal life span)
PTSD DSMV IV con’t
 D. Persistent symptoms of increased arousal as
indicated by two (or more) of the following:
 (1) Difficulty falling asleep
 (2) Irritability or outbursts of anger
 (3) Difficulty concentrating
 (4) Hyper vigilance
 (5) Exaggerated startle response
PTSD DSMV IV con’t
 E. Duration of the disturbance (symptoms in
Criteria B, C and D) is more than one month
 F. The disturbance causes significant distress or
impairment in social, occupational, or other
important areas of functioning
 Specify if: Acute: if duration of symptoms is less than
3 months Chronic: if more than 3 months
 Specify if: With Delayed Onset: if at least 6 months
after the stressor
PTSD in Infants &
Toddlers (Birth to Age 1)
Because infants and toddlers have difficulty
communicating trauma they have experienced, the
following signs of distress may be exhibited:
 fussing more
 possible “loss” of developmental steps already
acquired
 possible failure to learn new and expected
developmental tasks
PTSD in Preschoolers
(Ages 2-5)
For preschoolers, whose language skills are weak and there is a
limited ability to verbalize their feelings of distress, the following
behaviours can be exhibited:
 anxiousness and clinging to the parent/caregiver; separation
difficulties
 taking a step backward in development by thumb sucking, bed
wetting, refusing to sleep or waking at night for fear of the dark
 being aggressive in their play
 speech difficulties
 expressing magical ideas about an event (e.g. “ Daddy left
because I was bad.”)
 decreases or increases in appetite
PTSD in Childhood
(Ages 6-12)
It would be important to watch for the following signs of
distress:
 sadness and crying
 poor concentration
 fear of personal harm
 bed wetting
 confusion
 physical complaints (e.g. headaches)
 regressive behaviours (e.g. clinging, whining)
PTSD in Childhood con’t
(Ages 6-12)
 aggressive behaviour at home or school
 withdrawal/social isolation
 attention-seeking behaviour
 school avoidance
 irritability
 sleep disturbances (e.g. nightmares)
 anxiety and fears
 eating difficulty
PTSD in Teenagers
(Ages 13-18)
 rebelliousness
 intrusive recollections
 anxiety and feelings of guilt
 sleep and eating disturbances
 antisocial behaviour (e.g. stealing)
 poor school performance
 increased substance abuse
PTSD in Teenagers con’t
(Ages 13-18)
 poor concentration and distractibility
 psychosomatic symptoms (e.g. headaches, bowel
problems)
 agitation or decrease in energy level (e.g. loss of interest
in activities)
 numbing
 aggressive behaviour
 depression
 peer problems
 Withdrawal
PTSD in Adults
(Ages 19 +)
 shock and disbelief
 feelings of detachment
 unwanted, intrusive recollections
 concentration difficulty
 psychosomatic complaints
 eating disturbance
 poor work performance
 emotional and mental fatigue
 irritability and low frustration tolerance
PTSD in Adults con’t
(Ages 19 +)
 loss of interest in activities once enjoyed
 denial
 depression
 anxiety
 hyper-vigilance
 withdrawal
 sleep difficulty
 emotional change
 marital discord
Appropriate Reactions to
crisis situations
 Shock
 Denial
 Dissociative behaviour
 Confusion
 Disorganization
 Difficulty making decisions
 Suggestibility
 It is crucial to give back a sense of control and to help
empower the individual
(Adapted from Crisis Response in Our Schools, 2003 Lerner, Volpe, Lindell)
The Effect of Trauma
 The effects of being traumatized are very
individual, and survivors are impacted physically,
emotionally, behaviourally, cognitively and
spiritually.
Physical
 Eating disturbances (more or less than usual)
 Sleep disturbances (more or less than usual)
 Pain in areas on the body that may have been
involved in the traumatic experience
 Low energy
 Chronic unexplained pain
 Headaches
 Anxiety/panic
Emotional
 Depression, spontaneous crying, despair and
hopelessness
 Anxiety
 Extreme vulnerability
 Panic attacks
 Fearfulness
 Compulsive and obsessive behaviours
Emotional con’t
 Feeling out of control
 Irritability, anger and resentment
 Emotional numbness
 Frightening thoughts
 Difficulties in relationships
Behavioural
 Self-harm such as cutting
 Substance abuse
 Alcohol abuse
 Gambling
 Self-destructive behaviours
 Isolation
 Choosing friends that may be unhealthy
 Suicide attempts
Cognitive
 Memory lapses, especially about the trauma
 Loss of time
 Being flooded and overwhelmed with recollections
of the trauma
 Difficulty making decisions
 Decreased ability to concentrate
 Feeling distracted
 Withdrawal from normal routine
 Thoughts of suicide
Spiritual
 Guilt
 Shame and self-blame
 Self-hatred
 Feeling damaged
 Feeling like a “bad” person
 Questioning the presence of God
Spiritual con’t
 Questioning one’s purpose
 Thoughts of being evil, especially when abuse is
perpetuated by Clergy
 Turning away from the faith or obsessively
attending services and praying
 Feeling that as well as the individual, the whole race
or culture is bad
PTSD and its Effect
on the Brain
http://www.chordsforchange.org/2010/02/04/brainonmusic/
Factors Shown to Increase the
Likelihood of PTSD in Children
 The severity of the event
 Parental reaction to the event
 The child’s physical and /or emotional proximity
to the event
Helping the Child Survive
the Traumatic event
 Demaree (1995) states, “maintaining a safe
classroom environment is the cornerstone for
meeting the needs of children with PTSD” ( p. 33).
Teachers can individualize their programs when
they know and understand the differences and
special needs of children with PTSD. This can be
established by:
 setting clear, consistent limits
Helping the Child Survive
the Traumatic event
 providing a positive learning environment with
consistent daily routines and expectations
 reassuring their safety needs by showing empathy
and care
 model good stress management and problemsolving skills
 providing opportunities for personal control
 finding positive outlets for their release of
frustration and regulation of their own stress level
(i.e. relaxation techniques such as yoga, singing,
artwork or physical movement)
Helping the Child Survive
the Traumatic event
 reinforce the belief that conditions can and will
improve despite temporary setbacks
 maintaining a relationship with the child
 being positive and patient with the child
 incorporating more physical activity in the
classroom
 providing ample opportunities for students to
interact with one another
Associated Conditions
 Along with associated symptoms, there are a number of
co-occurring psychiatric disorders that are commonly
found in children and adolescents who have been
traumatized. They include:
 major depression
 substance abuse
 anxiety disorders such as separation anxiety, panic
disorder and generalized anxiety disorder
 attention-deficit/hyperactivity disorder
 oppositional defiant disorder
 conduct disorder
Associated Conditions con’t
 By co-occurring, we mean: one or more Mental
Health Disorders as well as one or more disorders
relating to substance and/or alcohol abuse
 It is estimated that 4 million people in the United States
have a co-occurring disorders.
 Co-occurring disorders are common with trauma
survivors. They should be expected rather than
seen as the exception.
Associated Conditions
con’t
 PTSD is a risk factor for substance abuse,
dependence, and addiction.
 The trauma survivor is often looking for a way to
numb feelings, emotions, pain and suffering in an
attempt to cope.
 Although not mentioned in the DSM IV, disruptive
behaviour disorders often co-occur in children with
PTSD.
 25% ADHD
 15.4% Conduct Disorder
 25% Oppositional Defiant Disorder
(Nickerson et al, 2009)
Resilience
A set of beliefs, feelings and behaviours that emerge at
a time of crisis and adversity.
 Protective Factors present in resilient children








Persistence
Goal-orientation
Adaptability
Optimism
Willingness to approach novel events
High Self-esteem
Intelligence
Good social skills
(Adapted from PTSD in Childhood, 2010, Chapman, Stefanation and Sukhan, Winnipeg)
Resiliency,
What can we do?
 Refer to the individual as a trauma survivor not as a
victim. This reduces the sense of powerlessness.
 Validate the individuals resilience and protective
factors.
 Build new skills and better adaptations as past
coping behaviours may no longer be needed and/or
acceptable.
 Work from a resilience-minded perspective.
 Help the trauma survivor to realizes/he has the
skills from within to heal and recover.
The Support System
 School
 Classroom Teachers
 Preschool and Elementary School Age Children
 Adolescents
 Adult Students
 School Guidance Counselor
 School Psychologist
 Therapies provided by outside agencies
General role of the support
system
 Provide for safety and security
 Help the child regain control over parts of his/her
life.
 Listen
 Don’t minimize the child’s perception of the crisis and/or
traumatic event.
 Allow the child to share his/her feelings at his/her
own pace.
 Recognize that physical ailments and illness can be
linked to PTSD.
 Understand co-occurring disorders.
 Collaborate with everyone involved.
Debriefing
 Is a structure for listening and
talking to the trauma survivor.
 It is a way for adults to provide an
environment in which children can
safely express their emotions and
reactions
 It is not counseling
Goal of Debriefing
 normalize the child’s responses
 aid in the recovery process
 allow a venue for venting
 teach coping skills
 help the child to understand what
occurred
Debriefing Method

Brooks & Siegel (1996) in their book, The Scared
Child, lay out a four-step method for helping
children through a traumatic experience.
1.
2.
3.
4.
Preparing the Self
Having the Child Tell his/her Story
Sharing the Child’s Reactions
Survival and Recovery
Preparing the Self
Do your research.
 www.wsd1.org
 Departments and Services
 Library Support Services
 Pathfinders
Prepare yourself psychologically /emotionally.
Screening & Referral
Handout, Nickerson et al, (2009) Identifying, Assessing
& Treating PTSD at School
Preschool and elementary
school aged children
 Play using clay or blocks
 Painting
 Drawing feelings and memories
 Journal writing/scribing
 Writing letters/cards
 Reading and discussing stories
 Create a memory board about the crisis
 Memory box/scrapbooking happy thoughts
(Adapted from Crisis Response in Our Schools, 2003, Lerner, Volpe, Lindell)
Adolescents
 Journal, poetry and story writing
 Writing cards/letters
 Art
 Relaxation techniques
 Exercise
 Problem Solving Strategies
 Listening to music
 Small group discussions
(Adapted from Crisis Response in Our Schools, 2003 Lerner, Volpe, Lindell)
Adult students
 Temporarily altered work schedule
 Writing
 Relaxation/meditation strategies
 Exercise
 Listening to music
 Social support
(Adapted from Crisis Response in Our Schools, 2003 Lerner, Volpe, Lindell)
Programs/Resources
 Kelso
www.kelsoschoice.com
 Five Point Scale
www.fivepointscale.com
 Teen Friendly site
www.kidshelpphone.ca
 Resource Documents
www.anxietybc.com
 American Red Cross, Masters of Disasters
Curriculum
http://www.redcross.org/preparedness/educators
module/ed-cd-main-menu-1.html
The School Guidance
Counselor
 Individual and small group counseling
 Support groups
 Crisis Intervention
 The goal of Crisis Intervention is to help
restore the trauma survivor to previous levels
of functioning.
 cessation of emergency reactions.
 understanding and expressing feelings and
emotions around the trauma.
 short-term goals, practical considerations and
concrete plans of action
(Johnson, 1989)
The School Psychologist
 Individual counseling
 Assessment
Therapy provided by
outside agencies
 Short term treatment, focused on the acute-stage
interventions. Helping restore the trauma survivor
to previous levels of functioning.
 Long term treatment, focused on resolution of
psychological and behavioral issues following the
traumatic experience.
 Play Therapy
 Art Therapy
 Family therapy
 Psychiatric Treatments
Trauma Recovery
 Normalize the experience and the symptoms for the
trauma survivor
 Assist the trauma survivor in connecting with
services critical to recovery
 Health and Mental Health services
 Help the trauma survivor to define recovery
 Facilitate connects with family, friends, the
community, and culture
(Adapted from Trauma-informed, 2008)
Recovery and School
Reintegration
 The memories of the traumatic experience will always
remain for the trauma survivor.
 The individual must incorporate the event into his/her
life experiences.
 Creating a reintegration plan that includes goals,
guidelines and contacts.
 Pre-scheduled preventative sessions to address highstress circumstances such as anniversaries could help the
trauma survivor.
 Monitoring
Examining the Effects of
Trauma Causality
 “Unlike the minor crises that are part if the normal
travails of life, trauma are situations that are outside
the range of expected experience” (Brooks & Siegel
3.)
 Does the different causality of trauma in turn mean
a particular manifestation or unique exhibition of
Posttraumatic Stress Disorder?
Examining the Effects of
Trauma Causality
 This section will investigate the characteristics (i.e.:
behavioral, cognitive, emotional, physical) of the
effects of different types of trauma which could
develop into Posttraumatic Stress Disorder—
especially in children.
 “An experience that is only moderately difficult for
one person may be unbearable and traumatic to
another” (Johnson 34.)
Examining the Effects of
Trauma Causality
 It is important to note that any significant
trauma can develop into PTSD, and what is
traumatic to one may not entirely be
traumatic to another; because frame-ofreference, cognitive ability, abstract
understanding, emotional resilience, mental
fortitude,—much of which is dependent
upon stages of Human Development—a
similar stimuli may be received as a mild
disruption to one while being an impacting
nuance to shatter the psyche of another.
Examining the Effects of
Trauma Causality
 To better discuss the possible trauma
responsible for an individual’s PTSD, the
different types of trauma discussed will be
both limited in numbers and categorized
into traumatic experience triggers.
Examining the Effects of
Trauma Causality
 The manner in which the cause/trigger of the traumatic event
will be categorized will be
 Intimate or Direct Trigger—somehow trauma has been
experienced by an individual as by his own senses or person,
including imagined trauma; the trigger is the trauma.
 Consequential or Reactionary Trigger—somehow trauma has
been experienced by an individual which is the response of
another to trauma he has experienced which can be perceived as
a global/shared experience and may not have a rationality
behind it; this inflicting of trauma is a perpetuating of the
experience that may not be in synch with the initial trauma.
 One person’s direct trigger of trauma is another’s reactionary
trigger to his own trauma.
Examples of Intimate/Direct
Trauma
 Death of a Loved One
 Divorce
 Domestic Violence (or Abuse: Physical, Psychological,
Sexual)
 Illness & Injury
 Natural Disaster
 Trauma by Proxy
 Warfare
Examples of General
Consequential/Reactionary
Trauma Triggers

Coping with the Loss of/Unfamiliar Family Roles…………… Residential Schools

Culture Influence/Dissonance………………………………… Newcomers; Immigrants

Gang affiliations………………………………………………. Hyper-Violent Existence

Literal/Cultural Genocide……………………………………... Holocaust

Relocation—Forced, Necessary, Required……………………. Newcomers; Refugees

Socio-economic Background………………………………….. Inner-city; Single/young
Parent
Examining Effects of
Trauma Causality
 “An argument can be made that historic
generational trauma strongly influences Aboriginal
people’s locus of personal and social control. It
engenders a sense of fatalism and reactivity to
historical and colonial forces, and this adversely
influences their social relations” (Keith 22.)
 It is not apt, however, to simplify the relationship of
the series of traumatic experiences along a single
generational thread; it is too superficial a
representation, and it is too difficult to accurately
discover/portray the entirety of this social
phenomenon too commonly occurring amongst
marginalized peoples and populations.
Intimate/Direct Trauma:
Death of a Loved One
“Children believe that their world is
stable, that the people who are in it
today will be in it tomorrow and
forever,” (Brooks & Siegel 4.)
Intimate/Direct Trauma:
Death of a Loved One
 Children and adolescents do not mourn
as their older counterparts.
 “The mourning process is not linear in
children as it is in adults. For children,
there is no beginning, middle, and end.
Rather, the process is repeated as the
child grows older and understands the
death from a more mature perspective”
(Brooks & Siegel 47.)
Intimate/Direct Trauma:
Divorce
Though it is not uncommon, divorce
is traumatic just the same, especially
for children; it is the breaking of
what was believed to be
unbreakable, compounded by the
fact that it is those whom were to
maintain it forever taking it apart.
Intimate/Direct Trauma:
Divorce
 Children “are the powerless victims in the
divorce. They have no say in the decision, they
are pushed around psychologically, and in
some cases they are even used as pawns by
irresponsible parents” (Brooks & Siegel 84.)
 “Children of divorce were likely to be afraid to
trust relationships and hesitant about making a
commitment to a specific person” (Brooks &
Siegel 84.)
Intimate/Direct Trauma:
Divorce
 Divorce is not a simple action; it is
an on-going process which has three
stages:
 Crisis Stage
 The Short Term
 The Long Term
Intimate/Direct Trauma:
Divorce
 Age, gender, and stage of divorce affect a child’s
reaction to divorce.
 Ironically, it is the older children which are more
likely to have a worse reaction to divorce than
younger children; this reason is the concept which
most would think would make it easier, but in fact it
is quite the contrary; their understanding of the
situation as well as their more solidified
concept/identity of family makes for worse injury
by divorce than the damage of divorce accompanied
by ignorance and malleable sense of self & family of
youth.
Intimate/Direct Trauma:
Domestic Violence
 Domestic violence includes physical abuse, sexual
abuse, psychological abuse, and abuse of property
and pets” (Lerner 55), either experienced or
witnessed (as in respect to spousal abuse.)
 “If a child has been abused physically,
[psychologically,] or sexually, or if a child has been
witness to spousal abuse, it is likely that the child
will experience posttraumatic acute-stress reactions.
If the abuse has been going on for a long time, the
child is likely to experience the symptoms of PTSD”
(Brooks & Siegel 62.)
Intimate/Direct Trauma:
Domestic Violence
 Children whom have experienced domestic
abuse are at significant risk for delinquency,
substance abuse, school drop-out, and
difficulties in their own relationships, as well
as exhibit symptoms of PTSD.
 How children react to domestic violence is
largely affected by the type of abuse being
experienced/witnessed and the age/cognitivepsychological ability of the child.
Intimate/Direct Trauma:
Illness & Injury
 The trauma of illness & injury is not always in
the actual ailment, but rather the circumstance
around it:
 Absent parents
 Absent family
 Unfamiliar or uncomfortable surroundings
 Financial concerns
Intimate/Direct Trauma:
Illness & Injury
 “Illness and injury, [themselves,] are
traumatic because they are usually
unexpected” (Brooks & Siegel 6.)
 “Because the terrible event happened
during a normal part of life, children
can become uncomfortable with
ordinary life” (Brooks & Siegel 6.)
Intimate/Direct Trauma:
Natural disaster
“Unlike other traumas, which mostly
affect one person or one family or at
most a few families, natural
disasters usually traumatize whole
communities” (Brooks & Siegel 73.)
Long term disruptions in all aspects
of life occur—few are left unscathed
by the event.
Intimate/Direct Trauma:
Natural disaster
The most significant feelings of bereavement to
individuals whom experience natural disasters
as noted from Barbara Brooks, Ph.D. & Paula
M. Siegel’s book, The Scared Child: Helping
Kids Overcome Traumatic Events, are:
 Lost sense of security
 Loss of familiar surroundings
 Loss of personal possessions
Intimate/Direct Trauma:
Natural disaster
Children experience and express
differently than adults; trivial losses
to adults may be gross detriments to
children, and granted vice versa;
however, both suffer equally as well
as deeply.
Intimate/Direct Trauma:
Trauma by Proxy
Not all traumas need to be experienced firsthand; some
traumatic experiences are had through exposure to
real events through another medium:
 Media (Television, Newsprint, Music,
Artistry/Digital Artistry, Internet)
 Gossip amongst primary/secondary/tertiary/etc.
social group
 Identification to
Narrator/Subject/Character/Antagonist/Etc.
Intimate/Direct Trauma:
Trauma by Proxy
Why this trauma is predominantly found in
children is their perception and inability to
separate/ability to identify themselves with
those falling victim to circumstance.
 “Trauma by proxy is filtered through a child’s
perception of the world. Youngsters in varying
age groups have different understandings and
reactions to catastrophic events that they hear
about or see in the media” (Brooks & Siegel
127.)
Intimate/Direct Trauma:
Trauma by Proxy
“Children are more vulnerable than
adults to being traumatized by
distant events. Kids are particularly
at risk of developing posttraumatic
symptoms after being exposed to
events in which they identify with
the victim” (Brook & Siegel 125.)
Intimate/Direct Trauma:
Warfare
 “Refugees and immigrants coming from war-torn
countries or repressive regimes have often
experienced considerable trauma” (Unknown 24.)
 “There is a great variability in the physical and
psychological effects of war and torture trauma, as
well as tremendous variability in how survivors
present themselves and their stories. There is also a
high variability in ability to remember what
happened and put into words. Many war and
torture traumas are considered ‘unspeakable acts.’”
(Unknown 31.)
Intimate/Direct Trauma:
Warfare
“Children showed a significantly
higher incidence of behavior
problems and problems with
psychosocial competence, but
significantly lower levels of
depression. There were no
significant differences [for children]
in anxiety. Neither age nor gender
was related to any of the outcomes”
(Flores 8-9).
Intimate/Direct Trauma:
Warfare
 “Features that might contribute to the
development of long-lasting anxiety and
trauma:
 the subjection of daily life to pervasive tension
and fear;
 the ubiquitous use of deadly weapons
including land minds; and
 the targeting of violence against civilians and
combatants in a hateful brutal manner”
(Flores 9).
Conclusion
Though the messages from individuals
suffering trauma from different
causalities maybe similar, there are
nuances within their messages and
specifics within their actions which are
particular; all express anxiety, conflict,
pain… but each individual burdened
from a unique trauma have a distinct
identifiable source of his ailing, which
can or cannot develop into
posttraumatic stress disorder.
Conclusion
Overall, PTSD looks familiar amongst
those whom have been diagnosed
with it; however, the trauma that
offset the individual psyches express
characteristics in the signs and
symptoms displayed—each case is
marked by its origin and cause like a
sort of identifiable traumatic
features.
References

Brooks, Barbara, Ph. D. & Siegel, Paula M, (1996). The Scared Child: Helping
Kids Overcome Traumatic Events. New York: John Wiley & Sons, Inc.

Flores, Joaquin E. (1999). “Schooling, Family, and Individual Factors
Mitigating Psychological Effects of War on Children.” Current Issues in
Comparative Education, 2(1)—November 15. Teachers College, Columbia
University.

Johnson, Kendall, Ph. D. (1989). Trauma in the Lives of Children. Alameda:
Hunter House Inc.

Keith, Anita L. (2006). For Our Children Our Sacred Beings: Understanding
the Impact of Generational Trauma on our Aboriginal Youth. Delta: Healing
the Land Publishing.

Lerner, Mark D., Volpe, Joseph S., & Lindell, Brad. (2003). A Practical Guide
for Crisis Response in Our Schools (5th Edition). Commack, NY: The
American Academy of Experts in Traumatic Stress.
 Nickerson, A., Reeves, M., Brock, S., & Jimerson, S. (2009). Identifying,
assessing and treating ptsd at school. New York, NY: Springer