Socially well-supported children deal better with trauma

Mr Landolt, you treat children and young people who suffer from trauma-related disorders. How do these manifest themselves?

Children and adolescents can react differently to trauma. Common symptoms include intrusive memories, so-called flashbacks, nightmares, emotional numbness or avoidance of triggers that bring the trauma to mind. In young children, these symptoms can become visible through regressive behaviour such as bedwetting or separation anxiety or through changes in play and nightmares. Younger children often also show behavioural abnormalities - they become aggressive, overly clingy or anxious.

Adolescents tend to react to trauma with self-harm and irritability.

Adolescents are prone to mood swings, irritability, self-harming behaviour or substance abuse. Some develop long-term disorders such as post-traumatic stress disorder, which is characterised by re-experiencing the trauma, avoidance and overexcitement. The severity varies according to the type and duration of the trauma and also depends on whether there are protective factors such as family and social support.

Does it make a difference to the success of treatment whether a trauma was caused by a one-off event such as an accident or by repeated experiences, for example sexual violence over a longer period of time?

Yes, there are significant differences in therapeutic treatment: a one-off trauma such as a road traffic accident can often be treated more effectively and quickly, as the disorder is usually less complex and contains clearly defined symptoms of post-traumatic stress disorder (PTSD).

Abuse over a longer period of time often leads to complex disorders.

Methods such as trauma-focused cognitive behavioural therapy (TF-CBT) can bring rapid progress here. Repeated traumatic experiences such as abuse over a longer period of time often lead to more complex trauma-related disorders. In addition to the symptoms of PTSD, those affected often suffer from disorders of affect regulation as well as attachment, relationship and self-esteem problems. Treatment in such cases takes longer and often requires a combination of stabilising measures, processing trauma memories and promoting self-esteem and social skills.

Why can some people survive traumatic experiences such as flight or war seemingly unscathed, while others struggle with them for a long time?

It is true that even in childhood and adolescence, the majority of those affected by many potentially traumatic events do not develop any negative long-term psychological consequences. Resilience to traumatic experiences varies greatly between individuals and depends on a variety of factors. Characteristics of the trauma, the individual and the social environment as well as cognitive judgements play an important role. Protective factors include genetic dispositions, certain personality styles, positive early childhood bonding experiences and, in particular, the availability of family and social support. Children and adolescents with good social and family support and well-developed coping strategies are generally better able to deal with traumatic experiences. Cognitive patterns such as a sense of control or meaning can also increase resilience.