The impact, psychological sequelae and management of trauma affecting children

Purpose of review This review covers recent research findings (published during 2003) on various aspects of the impact of trauma on children's mental health, including epidemiology, diagnostic and measurement issues, aetiological mechanisms, interventions and services. Recent findings The association between trauma and child psychopathology has been well established, but there is less knowledge on the underlying mechanisms and mediating factors, particularly among children facing interlinked trauma and environmental adversities (war conflict, migration, community and domestic violence). A number of measures have been developed and validated. Evaluated interventions mainly consist of group cognitive-behavioural therapy, with initial promising findings. These target either child populations exposed to trauma (universal), and are linked to local non-statutory services, or traumatized children with mental health problems of clinical significance, who are often provided by, or seen in association with, specialist mental health services for children. There is a striking absence of child-based evidence across all research topics. Summary Acute and chronic trauma constitute high risk factors for a range of mental health problems, although these should be distinguished from ‘normal’ emotional responses. The impact of trauma is compounded by different parental, family and environmental factors. Consequently, these need to be taken into consideration in the setting up of services that can provide multi-level interventions for different levels of need.