ABSTRACT
Understanding the effects of trauma for children is a complex process. Children's reactions, including posttraumatic stress disorder (PTSD), may evolve or change over time or may appear years or months after an event (Fletcher, 2003; Greenwald, 2002; Yule et al., 2000). More importantly, the symptoms that follow childhood traumatic experiences may have cascading as well as direct effects (Ford, 2002). In addition to DSM-IV PTSD symptoms, a disruption to normal development and changes in patterns of thinking and behaving can affect each subsequent phase of development. Such alterations in functioning can have a cumulative effect on the youth's interactions with others, the interdependent relations among multiple levels of risk and protective factors, and the transactions between child and environment (Nader, in press; Yates, Egeland, & Sroufe, 2003). Trauma and its symptoms may exacerbate pre-existing symptoms or disorders, may be amplified by or create vulnerabilities, and may completely derail a youth from a personal life trajectory. Researchers and clinicians are beginning to look beyond DSM PTSD to examine, in addition, the deeper wound created by traumatic experiences: the damage to self and self-concept; the distortion of or interruption in a trajectory toward a meaningful purpose, career, relationships, and personal evolvement; as well as changes in how the psyche responds inwardly—the wound to the spirit, essence, or true self of the child (Kalsched, 1996; Nader, in press).
