Complicated kids…teasing out the effects of trauma from mental illness

shutterstock_65290903Welcome to the eighth installment of our Fall 2013 blog series: Trauma and Kids…A Primer for Pastors, Church Staff and Parents. Today, we’ll look at some of the challenges clinicians face in separating the effects of trauma from the signs and symptoms of mental illness in children and teens.

One of the challenges we face in treating kids with trauma is sorting out the extent to which the symptoms leading to referral are trauma-related, or associated with some other mental health disorder in which the symptoms are totally unrelated to the trauma.

Kids with trauma histories frequently present with marked dysregulation of affect, mood and behavior…not surprising, when one considers the impact of trauma on brain development discussed earlier in this series. Children of parents with chronic mental illness are more likely to live in the types of chronically dysfunctional environments in which traumatic events are more likely to occur.

Some of the conditions that can mimic symptoms associated with trauma/PTSD include…

  • ADHD: Kids will often present with agitation, restlessness, decreased concentration, hyperactivity, hyperarousal and difficulty with sleep.
  • Oppositional Defiant Disorder: Some kids may manifest PTSD primarily through angry outbursts and/or irritability.
  • Panic Disorder: Kids and teens can manifest symptoms that mimic panic attacks when they encounter reminders that trigger distressing memories of traumatic events.
  • Social Anxiety Disorder: avoidance and social withdrawal are common coping mechanisms among children and teens who have experienced trauma.
  • Depression: Affective numbing associated with trauma, in conjunction with sleep disturbances, avoidance of people, self-injurious behavior can frequently be misdiagnosed as depression.
  • Bipolar Disorder/Disruptive Mood Dysregulation Disorder: Irritability and mood lability in in kids following traumatic events, in addition to hypersexualized behavior in kids exposed to sexual trauma may lead to a misdiagnosis of a mood disorder.

There was some discussion around the development of the DSM-5 regarding a condition referred to as chronic PTSD in kids and teens with exposure to early, severe or interpersonal trauma…or complex PTSD…a condition occurring in conjunction with other DSM conditions.

I find it helpful when kids appear to manifest symptoms of other psychiatric disorders following a traumatic event(s) to ascertain whether the. symptoms of other mental health disorders preceded the trauma. When possible, we would seek to treat the comorbid conditions in an integrated manner that helps “kill two birds with one stone.” I’ll address treatment specifically in our next two posts.


600817_10200479396001791_905419060_nConfused about all the changes in diagnostic terminology for kids with mental heath disorders? Key Ministry has a resource page summarizing our recent blog series examining the impact of the DSM-5 on kids with mental health disorders. Click this link for summary articles describing the changes in diagnostic criteria for conditions common among children and teens, along with links to other helpful resources!

About Dr. G

Dr. Stephen Grcevich serves as President and Founder of Key Ministry, a non-profit organization providing free training, consultation, resources and support to help churches serve families of children with disabilities. Dr. Grcevich is a graduate of Northeastern Ohio Medical University (NEOMED), trained in General Psychiatry at the Cleveland Clinic Foundation and in Child and Adolescent Psychiatry at University Hospitals of Cleveland/Case Western Reserve University. He is a faculty member in Child and Adolescent Psychiatry at two medical schools, leads a group practice in suburban Cleveland (Family Center by the Falls), and continues to be involved in research evaluating the safety and effectiveness of medications prescribed to children for ADHD, anxiety and depression. He is a past recipient of the Exemplary Psychiatrist Award from the National Alliance on Mental Illness (NAMI). Dr. Grcevich was recently recognized by Sharecare as one of the top ten online influencers in children’s mental health. His blog for Key Ministry, was ranked fourth among the top 100 children's ministry blogs in 2015 by Ministry to Children.
This entry was posted in Hidden Disabilities, Key Ministry, Mental Health, PTSD and tagged , , , , , , . Bookmark the permalink.

1 Response to Complicated kids…teasing out the effects of trauma from mental illness

  1. Ann Holmes says:

    Thanks, Steve! Very helpful reminder of distinction! You are such an incredible resource!


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