Stress Disorders in Children: Sign and Symptom Clusters W.E.Krill, Jr. M.S.P.C.

Re-experiencing:

Intrusive dreams, nightmares

Daytime intrusive memories

Physical agitation

Anger/rage

Severe upsets over apparently small issues

Enuresis, encopresis

Play reenactments

Hiding

Physically aggressive, combative

Complaints about wounds, pain, boo-boos that you can not see present

Talking about or relating details about the trauma

Avoidance, numbing, detachment:

Avoids discussing trauma or people associated

Lack of empathy or sympathy

Bullying/hurting others with no remorse

Lack of connectivity with others

Ignoring others’ feelings, statements, directives, conversation, assistance

Emotional numbing

Physical numbing

Self harm, disregard for danger or injuries

Lacks age appropriate play or activity

Cruelty to animals

Lack of focus

Overly submissive

Can not describe their emotions

Consistently misinterpreting what others are saying

Socially isolating

Can’t remember obvious time lines or events

Increased arousal:

Physical agitation, aggression

Trashing their toys, clothes, room

Door slamming

Screaming

Foul language not usually heard

Hyperactive

Hyper reactive

Jumpy, easily startles

Hyper vigilant

Fight or flight behaviors

Helpless

Frozen

Glassy eyes, dilated pupils, zombie like

Lack of focus/attention

Oppositional, defensive

Sexualized behaviors

Argumentative

Hiding behaviors (food, self, soiled clothes)

Easily brought to tears

Rushing through work, schoolwork, doing a poor job

Can not seem to calm down for hours upon hours, or even days

Psychological alterations:

Age regressed behaviors

Heightened vulnerability

Emotional cycling

Memory difficulties

Chronic fatigue, physical complaints

Risk taking

Heightened impulsivity

Statements of despair

Can’t seem to comfort self

Relational:

Mistrust

Heightened accusations against others

Secretive

Guarded

Self defeating interactions

Child like or precocious

Worried about being abandoned or left behind

Increased boundary problems

Inconsistent approach, friendliness, affect in relating

Seems to try to hard to fit in

Makes complaints about being excluded by others

Argumentative for no apparent reason

Bossy, parentified

Clingy, seeking attention

Excessive seeking out of nurturing/comfort

“Push-pull” feeling of intimacy and care

Refusal of assistance, help, care, affection.

Calls older relatives by first name

Ego structure:

Attributes traumatic events to their fault

Self harm verbalizations

Seems to “fall apart” very easily

Shame, guilt. Low self esteem statements

Has multiple names either given to them or for themselves

Alteration between very stubborn and excessively vulnerable

1