Trauma-related disorders (PTSD) in children and adolescents
- Bilonda Bukasa
- Mar 19
- 6 min read
Updated: Mar 28
Post-Traumatic Stress Disorder (PTSD) in Children: Long-Term Consequences and Differences from Adults
Post-traumatic stress disorder (PTSD) does not only affect adults—children, whose brains are still developing, are particularly vulnerable to the long-term consequences of trauma. They have lower stress resilience, struggle to contextualize events, and are often dependent on caregivers who may themselves be traumatized. Long-term effects include physical symptoms (e.g., sleep disorders), psychological symptoms (e.g., anxiety disorders), and dissociative phenomena (e.g., amnesia). Compared to adults, childhood trauma has a profound impact on brain development. Early intervention is crucial to prevent long-term damage and promote children's well-being.
Childhood and Adolescence: A Crucial Window for Trauma Processing
Long-Term Consequences and Differences from Adults
PTSD is not just a concern for adults—children and adolescents are particularly susceptible to the long-term effects of trauma. Their immature brains make them more vulnerable to psychological and physical consequences. But what specific factors play a role, and how do their symptoms differ from those of adults?
An Experiment
A study by Schaan et al. (2019) involving 66 young adults from Luxembourg and Germany examined the impact of early childhood trauma on interoceptive accuracy (IAc), which is the ability to perceive internal bodily signals, such as one's heartbeat, under stress. Participants immersed their hand in cold water while physiological responses (heart rate, cortisol levels) and interoceptive perception (heartbeat counting) were measured. The results showed that greater childhood trauma correlated with lower IAc—affected individuals had more difficulty perceiving their heartbeat after the stressor. However, this did not affect physiological responses, suggesting a specific impairment in body awareness (Schaan et al., 2019, p. 6).
Interoceptive accuracy (IAc) is the ability to perceive internal bodily signals, such as one's heartbeat, under stress.
Why Are Young Years Particularly Vulnerable?
Children and adolescents process stress differently from adults. Key factors include:
Children and adolescents process stress differently than adults. Key challenges include:
Foundation of Social-Emotional Development: The way a person interacts with their environment is shaped in the first three years through a complex social-emotional neural network.
Underdeveloped stress regulation: Children have not yet developed stable coping mechanisms.
Lack of experience in contextualizing events: They struggle to understand and process what has happened.
Low confidence in their coping abilities: They quickly feel overwhelmed and helpless.
Dependence on caregivers: If caregivers are also affected by trauma or act in a harmful way, the situation worsens.
Limited verbal expression: Young children often cannot articulate their experiences, making trauma processing more difficult.
Long-Term Physiological and Psychological Consequences
Chronic trauma exposure leads to profound changes on both physical and psychological levels:
Physical Symptoms
Dysfunction of the HPA axis: Imbalance in stress hormones (hyper-/hypocortisolism)
Neuroinflammation: Chronic low-grade inflammation in the brain
Autonomic dysregulation: Dominance of the sympathetic nervous system (“constant fight-or-flight mode”)
Increased risk of autoimmune and cardiovascular diseases
Bedwetting, sleep disturbances, eating disorders, and heightened startle reflex to name just a few.
Psychological Symptoms
Affective dysregulation: Difficulty managing emotions
Social withdrawal and relationship difficulties
Anxiety disorders and depressive symptoms
Developmental delays (e.g., learning difficulties)
Increased risk-taking behavior in adolescence (e.g., substance abuse, risky sexual activity)
Dissociative Symptoms
Dissociation is a psychological defense mechanism in which a person disconnects certain thoughts, feelings, memories, or even their awareness of the present reality. It often occurs in response to traumatic or overwhelming experiences and can take various forms, from brief moments of "spacing out" to severe dissociative disorders.
"Early trauma experiences can disrupt the rapid development of the right hemisphere of the brain, making children more vulnerable to future psychological and neurological disorders, such as depression or schizophrenia."
Traumatized children frequently experience:
Amnesia and memory gaps
Depersonalization (feeling detached from oneself)
Derealization (perceiving the world as unreal)
Dissociative bodily phenomena such as movement blockages or temporary sensory loss
These symptoms often lead to misdiagnoses, such as ADHD, dyslexia, or learning disabilities (Hanswille & Kissenbeck, 2008).
Differences Between PTSD in Children and Adults
A key difference is that childhood trauma profoundly impacts brain development. According to Schore (2001), the right hemisphere, which is crucial for stress regulation, undergoes rapid development in the first two years of life. Severe early stress experiences increase vulnerability to later psychological and neurological disorders, including depression, schizophrenia, Parkinson’s, and Alzheimer’s disease.
Another critical issue is attachment disorganization: When a caregiver is both a source of security and a threat, the child experiences deep inner conflict. This can lead to personality disorders and severe trauma-related conditions in adulthood (van der Kolk et al., 2005).
Children and adolescents process stress differently from adults, making them more vulnerable to long-term trauma effects. Their developing brains and underdeveloped coping mechanisms amplify their susceptibility to psychological and physical consequences.
"War causes destruction not only on the battlefield but also leaves immeasurable psychological scars. We cannot afford wars, not only because of the immense healing costs we cannot pay, but also because there are not enough therapists to heal the emotional wounds of the survivors."
Therapeutic Opportunities and Conclusion
While the long-term effects of trauma can be severe, childhood is also a period of high neuroplasticity—early intervention is key. Trauma therapy for children should not only focus on individual coping mechanisms but also incorporate attachment, social support, and neurobiological insights.
The transactional coping model by Lazarus and Folkman (1984) provides a valuable foundation but must be expanded to include neurobiological and cultural perspectives. This model states that trauma recovery depends on the traumatic event itself, the individual's response, and their surrounding context and support system.
What Can Help? How Can I Help?
The body-oriented psychological work that is possible with the individual begins at the body-mind interface. The intervention, therapy, and healing process consist of changing the neurobiological state.
The body-mind is a powerful influence on both psychological and physical health.
We therapists can only change society if we help individuals achieve their healing and satisfaction. The body-mind is a powerful influence on both psychological and physical health. Bottom-up interventions are those that start with the body. Through the body, body awareness, and self-regulation, new attitudes, perspectives, evaluations, and decisions can be made. These, in turn, empower individuals—both in feeling and in reality.
Based on the expanded interactional model, preventive, intervening, and integrative body-oriented psychological methods as well as body-psychotherapy approaches can be effectively used to treat trauma-related disorders. Experiences and studies show that processing trauma through body-centered approaches is particularly effective because the body stores the trauma, and the brain needs to form new connections that are triggered by a sense of psychological and emotional safety, physical relaxation, and reduced inflammation.
Based on the extended interactional model, preventive, interventional, and integrative body-centered psychological and psychotherapeutic methods can be highly effective in treating trauma-related disorders. Research and experience have shown that processing trauma through the body is particularly beneficial.
I am pleased to welcome Dr. Boshra Varastengani to my network. She is an expert in Nutrigenetics and Functional Medicine, an innovative field that provides personalized medical nutrition recommendations based on DNA analysis. When combined with functional medicine, this approach offers a holistic, individualized health care strategy. Instead of merely treating symptoms, it focuses on identifying and addressing the root causes of diseases.
Even psychological disorders such as depression or persistent depressive moods can be effectively addressed with this method. As a valuable addition to body-centered psychological treatment, targeted nutritional management provides a strong foundation for both physical and mental well-being.
Inspirational Greetings
MSc. Body Psychology und Body Psychotherapy i.e. (London)
Referenzen:
Brückl, T. M., & Binder, E. B. (2017). Folgen früher Traumatisierung aus neurobiologischer Sicht. Forensische Psychiatrie, Psychologie, Kriminologie, 11(2), 118–132. https://doi.org/10.1007/s11757-017-0412-9
Council of the European Union. (2021). Mental health and well-being in the EU.Available at: https://www.consilium.europa.eu/en/policies/mental-health/
D'Andrea, W., Ford, J., Stolbach, B., Spinazzola, J., & van der Kolk, B. A. (2012). Understanding interpersonal trauma in children: Why we need a developmentally appropriate trauma diagnosis. American Journal of Orthopsychiatry, 82(2), 187–200. https://doi.org/10.1111/j.1939-0025.2012.01154.x
Hanswille, R., & Kissenbeck, A. (2008). Systemische Traumatherapie. Konzepte und Methoden für die Praxis.
National Library of Medicine. (2021). The global burden of mental health disorders: Economic implications. PMC.Available at: https://pmc.ncbi.nlm.nih.gov/articles/PMC9525140/
Nichols, M. (2022). Effects of Nurture versus Trauma on Infant and Early Childhood Psychological and Social Development. BU Journal of Graduate Studies in Education, 14. https://eric.ed.gov/?id=EJ1397717
Schore, A. N. (2001). The effects of early relational trauma on right brain development, affect regulation, and infant mental health. Infant Mental Health Journal, 22(1–2), 201–269.
Schaan, V. K., Schulz, A., Rubel, J. A., Bernstein, M., Domes, G., Schächinger, H., & Vögele, C. (2019). Childhood trauma affects stress-related interoceptive accuracy. Frontiers in Psychiatry, 10, 750-750. https://doi.org/10.3389/fpsyt.2019.00750
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