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We completed some diagnostic measures and a clinical interview and decided that complex post-traumatic stress disorder (C-PTSD) was a better explanation for her difficulties than BPD. The difficulty she had with relationships involved avoidance and fear of being judged, not the intense swings between idealisation (“I love you”) and devaluation (“I hate you”) typical of BPD. In fact, she had a strong negative sense of self and a critical inner voice. While Cathy had some of the traits of BPD (emotional regulation difficulties, self-harm and thoughts of death), she did not have difficulties with a lack of identity – a key characteristic of BPD. We spoke about her diagnosis of BPD and realised that it did not encapsulate all the difficulties she had. We initially focused on building a collaborative formulation of Cathy’s difficulties. However, she still felt very sad at times, and continued to struggle with social anxiety and loneliness, as well as recurrent flashbacks to the sexual assault and childhood events. DBT helped her build distress tolerance skills so she could reduce self-harm and manage her mood better. She was preoccupied by thoughts that she was a failure, that she would never get better and that she was going “crazy”.Ĭathy had tried dialectical behaviour therapy in the past, a first-line treatment for BPD focused on helping people learn to regulate emotions, manage distress and create better relationships. She didn’t know how to manage tough emotions and used alcohol and self-harm to numb herself, eventually being diagnosed with BPD. Research into the effects of adverse childhood experiences (ACEs), begun with a study conducted at Kaiser Permanente with the Centers for Disease Control in the 1990s and subsequently expanded with additional data, has shown a direct relationship between ACEs and a wide range of negative outcomes later in life.In adulthood, she experienced episodic bouts of depression. This category is used for those cases.Ĭhildhood stress and trauma can have health and life impacts beyond these five types of emotional disorders. Some emotional and behavioral reactions to trauma do not fit in the diagnostic categories above. Unclassified and unspecified trauma disorders. They may wander off with strangers without checking with their parent or caregiver. They can be over-eager to form attachments with others, walking up to and even hugging strangers. Children with DSED are unusually open to interactions with strangers. They may not seem to care when toy is taken away from them.ĭisinhibited social engagement disorder (DSED). Children with RAD may not appear to want or need comfort from caregivers. This might show in a lack of remorse after bad behavior or a lack of response to positive or negative emotional triggers. Children with RAD show limited emotional responses in situations where those are ordinarily expected. These reactions can be emotional, such as a depressed mood or nervousness, or behavioral, such as misconduct or violating the rights of others. Adjustment disorders are unhealthy or unhelpful reactions to stressful events or changes in a child’s life. Prompt treatment and appropriate social support can reduce the risk of ASD developing into PTSD.Īdjustment disorders. The symptoms of ASD are similar to PTSD, but occur within the first month after exposure to trauma. Other symptoms may include jumpiness, sleep problems, problems in school, avoidance of certain places or situations, depression, headaches or stomach pains.Īcute stress disorder (ASD). Children and adolescents with PTSD have symptoms such as persistent, frightening thoughts and memories or flashbacks of a traumatic event or events. Trauma and stressor-related disorders include: Even a move or the birth of a sibling can be a stressor that can cause significant difficulties for some children. Stressors such as parental separation or divorce or even more severe stressors such as emotional or physical neglect can cause problems when they are prolonged or not addressed by caring adults. Observing a parent being treated violently, for example, can be a traumatic experience, as can being the victim of violence or abuse. These traumatic and stressful experiences can include exposure to physical or emotional violence or pain, including abuse, neglect or family conflict.
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Trauma and stressor-related disorders are a group of emotional and behavioral problems that may result from childhood traumatic and stressful experiences.