Whereas I find the various disorders in the DSM IV to be highly subjective, they are mainly a listing of certain behavioral traits manifested by certain individuals. It is my proposition that behind all of these behavioral traits lies traumatic experience, and that based on age of the time of trauma, the nature of the trauma, and environmental factors will have a role in what reaction occurs and what behaviors are displayed.

Trauma appears to be the main causation of the majority of what are termed 'disorders' in children and adolescents. Hammersley, et al. (2003) found in his study, "Childhood trauma and hallucinations in bipolar affective disorder" that there was a highly significant association of those experiencing hallucinations and the behaviors that are labeled bipolar disorder and those experiencing childhood traumas, particularly childhood sexual abuse.

McKenzie (1998) noted that a symptom defining trauma prior to 18 months could lead to the development of psychotic features once a symptom-precipitating trauma occurred later in life. McKenzie (1998) also proposed that trauma between 18 and 24 months would lead to what would be term as 'schizoaffective' traits, and that trauma between 24 and 34 months would manifest later as 'major depression.'

I propose that trauma within during later childhood (approximately age 6-10) can lead to the development of behaviors in children that would be labeled as "Conduct Disorder". James (1989) states that trauma violates basic trust and disrupts one's ability to have empathy. During the age between 6-10 is also the period where a child begins to develop a sense of justice, a delineation between what is 'right' and 'wrong'. If a trauma should occur during this period of formation, then the outcome would be the manifestation later of serious conduct. Chemtob, Novaco, Hamada, Gross, & Smith (1997) report that trauma canlead toan individual acting out by violent means.

If a child experiences significant abuse and neglect within the first year of life can develop what is termed as 'reactive attachment disorder'. The child has difficulty forging appropriate relational bonds. They are inherently distrustful. Highes (2003) has developed dyadic developmental psychotherapy which focuses on building the caregiver's bond as well as encouraging the use of "PACE" (Playfulness, Acceptance, Curiousity, Empathy) as well as the incorporation of some cognitive approaches. The child who would fall into the categorization of "reactive attachment' must be differentiated from those with pervasive developmental disorder, as whereas those with developmental challenges may manifest difficulty in relational bonds, there is a differing causation.

With autism and pervasive developmental disorders, trauma is also a factor, however the trauma is not resultant of any action of the parent in regards to abuse or neglect. Rather, the trauma is beyond the control of the parents and is usually resultant from trauma in utero or as a neo-nate. In addition, there may be some role in regards to exposure to toxicity in relation to developmental delays. Waseem and Switzer (2005) report that the earlier the onset of severe trauma the greater propensity for dissociation. Those children who begin to dissociate are those where the trauma is not a single isolated event but a pervasive and recurrent event in the child's life.

Trauma which occurs that is less intense and can be more readily resolved would fall into the classification of what is labeled, "Adjustment Disorders". Lochner, et. al (2002) in the study, "Childhood trauma and obsessive compulsive disorders' found a significant higher level of childhood trauma, particularly emotional neglect in adults who later manifested obsessive-compulsive disorder (OCD). In OCD, the trauma occurs in childhood and the environment is one that is chaotic, and the child begins to feel the need to have a semblance of control. It is through the obsessive-compulsive rituals that the child then begins to feel that they are able to take control over some aspect of their lives. Anxiety and panic concerns can also be seen to be trauma related. Exposure to a fear invoking event or 'flashbacks' to a traumatic event through a new precipitating trigger can evoke the panic response. Being that the the various psychological 'disorders' are connected to trauma, it is logical that this is the factor that must be addressed and the use of psychotropic drugs in 'treatment' would only be subduing behaviors and numbing the impact of the trauma without truly ever addressing the core issue which has led to the psychological distress. Therefore, it is important that clinician's begin to truly examine the experience of children and adolescents and begin to understand the role and impact of traumatic experience in their lives. It is necessary for the adults in the life of the child to begin to address the factors in the environment which may perpetuate distress and to aid the child in development of adaptive coping responses and the ability to resolve the inner conflicts arising from the traumatic experiences.

Dr. Edmunds received his Doctorate of Education in Pastoral Community Counseling from the University of Sarasota. He is a critic of the bio-psychiatric paradigm and is a proponent of drug free relationship based approaches towards addressing emotional and developmental challenges. His website can be found at www.danedmunds.com

Dan Edmunds - EzineArticles Expert Author

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