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Dr. Cook is director of evaluation, Dr. Spinazzola is executive director, and Dr. Blaustein is director of training and education, The Trauma Center, Justice Resource Institute, and National Center on Family Homelessness, Boston, MA. Dr. Ford is associate professor, Department of Psychiatry, University of Connecticut Health Center, Farmington CT, and research and evaluation director, Yale/University of Connecticut Child Violent Trauma Center. Dr. Lanktree is director, Miller Children's Abuse and Violence Intervention Center, Long Beach, CA. Dr. Cloitre is director, New York University Child Study Center Institute for Urban Trauma & Stress, New York, NY. Dr. DeRosa is associate director, North Shore University Hospital Adolescent Trauma Treatment Development Center, Manhasset, NY. Ms. Hubbard is child trauma specialist, Directions for Mental Health, Clearwater, FL. Dr. Liautaud is clinical adminstrator, Heartland Health Outreach: International FACES, Chicago, IL. Dr. Olafson is director, Child Abuse Trauma Treatment Replication Center, Cincinnati Children's Hospital, Cincinnati, OH. Dr. Kagan is director, Parsons Child Trauma Study Center, Albany, NY. Dr. Mallah is director, Family Trauma Treatment Program, Mental Health Center of Denver, Denver, CO. Dr. van der Kolk is professor of psychiatry, Boston University Medical School, Boston, MA; clinical director, The Trauma Center at Justice Resource Institute, Brookline, MA; and co-director, National Child Traumatic Stress Network Community Program, Boston.
The authors have no industry relationships to disclose.
This article is a condensation of the Complex Trauma White Paper of the National Child Traumatic Stress Network (NCTSN) Workgroup on Complex Trauma. A full version of the report is available at <ext-link ext-link-type="uri" xlink:href="http://www.traumacenter.org" xlink:type="simple">http://www.traumacenter.org</ext-link>. This project was supported by SAMHSA grants U79 SM 54587, 54284, 54254, 54251, 54318, 54314, 54272, 54282, 54292, 54276, and 54300; as well as by SAMHSA grant UD1 SM56111.
The immediate and long-term consequences of children's exposure to maltreatment and other traumatic experiences are multifaceted. Emotional abuse and neglect, sexual abuse, and physical abuse, as well as witnessing domestic violence, ethnic cleansing, or war, can interfere with the development of a secure attachment within the caregiving system.
Complex trauma exposure results in a loss of core capacities for self-regulation and interpersonal relatedness. Children exposed to complex trauma often experience lifelong problems that place them at risk for additional trauma exposure and cumulative impairment (eg, psychiatric and addictive disorders; chronic medical illness;...