Scared Sick: The Relationship Between Trauma and Disease

1. Scared Sick: The Relationship Between Trauma and Disease Susan E. Craig, Ph.D. craigsus@juno.com Visit my blog at http://meltdownstomastery.wordpress.com

2. Child Abuse in the United States • Trauma is a public health problem estimated to effect 26% of all children in the United States (SAMHSA, 2011). • Family violence is the #1 cause of childhood trauma. • Just under five children in the United States die every day as a result of child abuse.

3. Child Well-being in the United States • 1 in 100 infants each year is born with Fetal Alcohol Syndrome, a preventable cause of mental retardation and learning disabilities. • ¼ of the children insured by Medco took prescription drugs to manage a chronic disease. • 13% of children ages eight to fifteen have had a diagnosable mental illness within the last year.

4. Adult Well-being in the United States • 26% of adults in the United States over eighteen have a diagnosable mental disorder(NIMH, 2010). • ¼ of American adults over eighteen meet the criteria for a substance abuse disorder. • 18% of adults in the United States over eighteen have an anxiety disorder.

5. What’s the Connection? The Adverse Childhood Experiences (ACE) Study “The most important public health study that you have never heard of.”

7. ACEs Too HighAdults Continue to affect adult health and behavior • Accounts for intergenerational transmission of violence, poverty, and neglect • Reduces the ability of adults to provide children with a “modulated nervous system to help them regulate their physical and emotional being”.

9. Childhood Experiences and Adult Alcoholism 4+ 3 2 1 0

11. Adverse Childhood Experiences andHistory of STD

12. ACEs Too HighChildren • Traumatize Children – Overwhelm Their Capacity to Cope • Trauma Alters Brain Development in Predictable Ways • Changes in Brain Interfere with Academic and Social Competence, Increase Risk of Disease • Children w/ ACE Score of 4+ are 47 time more likely than peers to be depressed, 12 times more likely to commit suicide

13. Trauma and the Brain“the young mind is as driven to obliterate the chronic pain of loss and rejection as it is to escape physical pain.” • Survival Brain • Emotional Brain • Logical Brain

14. Trauma and Children’s Health • Asthma- Risk more than doubled in predisposed children exposed to marital strife or maternal depression • ADHD – Often associated with low birth weight and maternal depression • Obesity and chronic inflammation - biomarkers in blood-C-reactive protein and interleukin-6 that show inflammation in the body.

15. Yet the Silence Continues “They do not want to hear what their children suffer. They’ve made the telling of the suffering itself taboo” From Possessing the Secret of Joy, Alice Walker From ACE Study Slides: Vincent Felitti

16. Criminal Justice Problems and Unaddressed Sexual/Physical Abuse • More than 75% of girls in juvenile justice system Calhoun et al, 1993 • 80% of women in prison and jails Smith, 1998 • 100% of men on death row Freedman, Hemenway, 2000 • Boys who commit violence van der Kolk, 1998

17. What to Do • Recognize that trauma causes children to carry RELENTLESS needs for safety and survival into classrooms and everyday experiences. • The presence of caring adults can restore safety and mitigate effects • High incidence calls for trauma-sensitive schools

18. Trauma-sensitive Supports • Trauma-sensitive Interviews, Case Histories • Collaboration w/ Parents • Collaboration w/Staff • Screening

19. Trauma-sensitive Supports • Know How to Manage the “Double Struggle” • Know How to “Find the Fear” • Know How to Collaborate • Work as a Team