#Signs of trauma in adolescence series

These challenges have had the potential to exacerbate any number of individual traumas, including identity crises and family conflicts. Stressors occurring during this time include prolonged home confinement, school interruptions, worry for loved ones, unexpected illnesses and death, mental healthcare disruptions, and economic instability. The COVID-19 pandemic represents a collectively experienced potentially traumatic stress in adolescents and children akin to the trauma of a natural disaster.

Examples of individualized, interpersonal, and systemic racism afflicting trauma on a range of minority groups have persisted and continue to persist throughout this nation’s history. In the USA, racial-based traumatic stress (the mental, emotional, spiritual, and physical injury that occurs as the result of living within a racist system or experiencing racism) leaves Black, Indigenous People of Color (BIPOC) most vulnerable. In socio-economically disadvantaged communities, rates of trauma exposure have also been shown to be disproportionally higher. Transgender and gender diverse adolescence have the highest rates of mistreatment, harassment, and violence in their home life, school, occupations, and interpersonal relationships nearly half of these individuals have been sexually assaulted and 40% have attempted suicide in their lifetime. Roughly 90% of Americans have experienced at least one traumatic event in their lifetime, and 28.9% of youth have experienced at least one adverse childhood event (ACE). This definition encompasses individual traumas such as car accidents or the death of loved one interpersonal traumas such as interpersonal violence, discrimination, or abuse collective traumas such as natural disasters or pandemics and structural traumas such as racism and sexism.

#Signs of trauma in adolescence series

Trauma is “an event, series of events, or set of circumstances an individual experiences as physically or emotionally harmful that can have lasting adverse effects on the person’s functioning and mental, physical, emotional, or spiritual well-being”.

Importantly, we aim to equip readers with strategies to Realize how trauma can affect an adolescent patient and their family, Recognize the signs of trauma in this population, Respond to trauma while an adolescent is hospitalized, and Resist further traumatization within an inpatient setting (the four “R’s” of TIC). After reviewing the impacts of trauma in this population and introducing the principles of trauma-informed care (TIC), we will use cases to discuss applying skills to the care of hospitalized adolescents in varying stages of development. This paper will review how trauma influences adolescents during hospitalization and how inpatient providers can utilize an understanding of the prevalence and impact of trauma to provide therapeutic care. Any history of trauma may influence how these patients experience a hospitalization and can be compounded by trauma of the hospitalization itself. Adolescents in similar situations are currently well-represented in pediatric hospitals, with children’s mental health being a national emergency. Emmanuel is a 13-year-old struggling with a new diagnosis of type 1 diabetes. Haley is a 19-year-old admitted to the pediatric floor after telling their roommate, “I am at the end of my line and can’t keep going.” Ryan is a 16-year-old hospitalized with anorexia nervosa. This concept of the “trauma-informed approach” is still novel through examples and practice, providers can learn to universally apply the trauma-informed care framework to every patient encounter to address the harmful effects of trauma and promote recovery and resilience. Trauma-informed care promotes health, healing, and equity.

Increased hospitalizations and mental health diagnoses during the past two years signal toxic levels of stress affecting this group. Recent FindingsĪdolescents today are caught in the crosshairs of two syndemics-racism and other structural inequities and the COVID-19 pandemic. In this article, we use three case studies of hospitalized adolescents to illustrate the application of trauma-informed principles of care with this unique population. Exposure to trauma accelerates during the adolescence, and due to increased behavioral and psychiatric vulnerability during this developmental period, traumatic events during this time are more likely to cause a lasting impact.