We Are Survivors 

This blog is dedicated to the tens of millions of adult survivors of child abuse and neglect who get up every day and try to work and function in a world that seems to not care about us.

Diagnoses for Children with Multiple Traumas

At this time, there is no single diagnosis for children who have experienced multiple traumas and who struggle with self-regulation. They could be a child abuse victim who has also experienced a death in the family. There are any number of debilitating problems a child might be experiencing with a corresponding multitude of diagnoses that are used to treat the child. Listed below are some of the diagnoses currently used and some of their shortfalls.[1]

  • Pervasive Developmental Disorders (PDD) capture some of the problems children have with attachment and information processing but involve more severe problems with reality orientation, communication and stereotypic behaviors. In addition, PDDs do not usually involve the child’s pronounced anxiety and depressed mood.
  • Oppositional Defiant Disorder and Conduct Disorder involves intense anger, distrust and conflict in relationships, as well as distorted beliefs about people and the world. But they don’t include the guilt, shame, anxiety, dissociation and depressed mood seen in children.
  • Reactive Attachment Disorder is limited to early childhood and must occur in the context of “pathogenic care” such as neglect or abandonment.
  • Affective Disorders, including Posttraumatic Stress Disorder (PTSD), capture the fearfulness, worry and avoidance behaviors but not the intensely changeable emotional states, negative self-beliefs and disorganized attachment feelings.
  • Borderline Personality Disorder captures the changeable emotional states and disturbed relationships of dysregulation and attachment problems, but it is an adult diagnosis that is not appropriate for children whose personalities are still forming. It also does not address these children’s dissociation, physical complaints or extreme dysregulation in response to trauma reminders or memories.

 


[1] “Monitor on Psychology,” T. DeAngelis, American Psychological Association, Volume 38, No. 32, March 2007.

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