Complex Trauma

The term complex trauma describes the problem of children's exposure to multiple or prolonged traumatic
events and the impact of this exposure on their development. Typically, complex trauma exposure involves
the simultaneous or sequential occurrence of child maltreatmentincluding psychological maltreatment,
neglect, physical and sexual abuse, and domestic violencethat is chronic, begins in early childhood,
and occurs within the primary caregiving system. Exposure to these initial traumatic experiencesand the
resulting emotional dysregulation and the loss of safety, direction, and the ability to detect or respond to
danger cuesoften sets off a chain of events leading to subsequent or repeated trauma exposure in
adolescence and adulthood.

Domestic Violence

Domestic violencesometimes called intimate partner violence, domestic abuse, or batteringincludes

actual or threatened physical or sexual violence or emotional abuse between adults in an intimate
relationship. This clinical definition is broader than the legal definition, which may be restricted to acts of
physical harm. Domestic violence can be directed toward a current or former spouse or partner, whether
they are heterosexual or same-sex partners.

Anywhere from 3 to 10 million children are exposed to domestic violence in the United States every year.
Studies suggest that the majority of children who are exposed to domestic violence are young-under the
age of 8.

Early Childhood Trauma

Early childhood trauma generally refers to the traumatic experiences that occur to children aged 0-6.
These traumas can be the result of intentional violencesuch as child physical or sexual abuse, or
domestic violenceor the result of natural disaster, accidents, or war. Young children also may
experience traumatic stress in response to painful medical procedures or the sudden loss of a
parent/caregiver.

Medical Trauma

Pediatric medical traumatic stress refers to reactions that children and their families may have to pain,
injury, and serious illness; or to "invasive" medical procedures (such as surgery) or treatments (such as
burn care) that are sometimes frightening. Reactions can affect the mind as well as the body. For
example, children and their families may become anxious, irritable, or on edge. They may have unwanted
thoughts or nightmares about the illness, injury, or the hospital. Some people may avoid going to the
doctor or the hospital, or lose interest in being with friends and family and in things they used to enjoy. As
a result, they may not do well at school, work, or home. How children and families cope with these
changes is related to the person's own thoughts and feelings about the illness, injury, or the hospital;
reactions can vary, even within the same family.

Physical Abuse

Physical abuse means causing or attempting to cause physical pain or injury. It can result from punching,
beating, kicking, burning, or harming a child in other ways. Sometimes, an injury occurs when a
punishment is not appropriate for a child's age or condition. Physical abuse can consist of a single act or
several acts. In extreme cases, it can result in death.

Refugee Trauma

Refugee trauma include exposure to war, political violence, or torture. Refugee trauma can be the result
of living in a region affected by bombing, shooting, or looting, as well as forced displacement to a new
home due to political reasons. Some young refugees have served as soldiers, guerrillas, or other
combatants in their home countries, and their traumatic experiences may closely resemble those of
combat veterans.
Click here for more NCTSN resources on childhood and adolescent refugee trauma

School Violence

School violence includes fatal and nonfatal student or teacher victimization, threats to or injury of
students, fights at school, and students carrying weapons to school. Formal definitions of school violence
range from very narrow to very broad. The Center for the Prevention of School Violence, for example,
defines it broadly as "any behavior that violates a school's educational mission or climate of respect or
jeopardizes the intent of the school to be free of aggression against persons or property, drugs, weapons,
disruptions, and disorder." Click here for more information on community violence.

Sexual Abuse
Child sexual abuse includes a wide range of sexual behaviors that take place between a child and an
older person or alternatively between a child and another child/adolescent. Behaviors that are sexually
abusive often involve bodily contact, such as sexual kissing, touching, fondling of genitals, and
intercourse. However, behaviors may be sexually abusive even if they do not involve contact, such as of
genital exposure ("flashing"), verbal pressure for sex, and sexual exploitation for purposes of prostitution
or pornography.

terrorism

Terrorism is defined in a variety of formal, legal ways, but the essential element is the intent to inflict
psychological damage on an adversary. The US Department of Defense defines terrorism as "the
calculated use of violence or the threat of violence to inculcate fear, intended to coerce or to intimidate
governments or societies in the pursuit of goals that are generally political, religious, or ideological."
Terrorism includes attacks by individuals acting in isolation (for example, sniper attacks) as well as attacks
by groups or people acting for groups.

Traumatic Grief

Childhood traumatic grief may occur following a death of someone important to the child when the child
perceives the experience as traumatic. The death may have been sudden and unexpected (e.g., through
violence or an accident), or anticipated (e.g., illness or other natural causes).

The distinguishing feature of childhood traumatic grief is that the trauma symptoms interfere with the
child's ability to go through the typical process of bereavement. The child experiences a combination of
trauma and grief symptoms so severe that any thoughts or reminders, even happy ones, about the person
who died can lead to frightening thoughts, images, and/or memories of how the person died.

Scope of the Problem

Young children are exposed to traumatic stressors at rates similar to those of older children. In one study
of children aged 2-5, more than half (52.5 percent) had experienced a severe stressor in their lifetime
(Egger & Angold, 2004).
The most common traumatic stressors for young children include: accidents, physical trauma, abuse,
neglect, and exposure to domestic and community violence.

Child Accidents and Physical Trauma

Children aged 05 are hospitalized or die from drowning, burns, falls, choking, and poisoning
more frequently than do children in any other age group (Grossman, 2000).
One in three children aged 06 have injuries severe enough to warrant medical attention (Beach
& McCormick, 1997).
Child Abuse and Neglect
Young children have the highest rate of abuse and neglect, and are more likely to die because of their
injuries.
Victims 03 constituted 27.3 percent of all maltreatment vicitims reported to authoraties in 2013
(U.S. Department of Health and Human Services, 2013) taken from U.S.Department of Health
and Human Services, Administration for Children and Families, Administration on Children, Youth
and Families, Childrens Bureau. (2015). Child maltreatment 2013.
Infants are the fastest growing category of children entering foster care in the United States
(Dicker, Gordon, & Knitzer, 2001). Infants removed from their homes and placed in foster care
are more likely than are older children to experience further maltreatment and to be in out-of-
home care longer (Wulczyn, Hislop, & Jones, 2002).
Child Exposure to Domestic or Community Violence
In a survey of parents in three SAMHSA-funded community mental health partnerships, 23
percent of parents reported that their children had seen or heard a family member bring
threatened with physical harm (Crusto et al., 2009).
Nearly two-thirds of young children attending a Head Start program had either witnessed or been
victimized by community violence, according to parent reports (Shahinfar, Fox, & Leavitt, 2000).
In a survey of parents of children aged 06 in an outpatient pediatric setting, one in ten children
had witnessed a knifing or shooting; half the reported violence occurred in the home (Taylor,
Zuckerman, Harik, & Groves, 1992).
in 2002 the NCTSN Complex Trauma Task Force conducted a clinician survey on trauma exposure for
children who were receiving assessment and/or intervention services. Among the findings, published in a
white paper Complex Trauma in Children and Adolescents (2003) (PDF) was that 78 percent of
children had experienced more than one trauma type and that the initial exposure on average occurred at
age 5. Additional data from more than 10,000 cases of children receiving trauma-focused services from
sites in the NCTSN reveal that in this cohort, one-fifth of children are aged 0-6. The traumas these
children most often received services for were exposure to domestic violence, sexual abuse, neglect, and
traumatic loss/bereavement (NCTSN, 2009).

Medical Trauma
Pediatric medical traumatic stress refers to a set of psychological and physiological responses of children
and their families to pain, injury, serious illness, medical procedures, and invasive or frightening treatment
experiences. These responses may include symptoms of arousal, re-experiencing, and / or avoidance.
They may vary in intensity, are related to the subjective experience of the event, and can become
disruptive to functioning.

Pediatric Medical Traumatic Stress Toolkit for Health Care Providers

This toolkit was produced by the Medical Traumatic Stress Working Group of the National Child Traumatic
Stress Network to

raise awareness among health care providers about traumatic stress associated with
pediatric medical events and medical treatment, and
promote trauma-informed practice of pediatric health care in hospital settings across the
continuum of care and in a variety of settings within the hospital.

Medical Events & Traumatic Stress in Children and Families (PDF)

This presentation covers

statistics on medical stress among children and adolescents,

the impact of traumatic medical events on children, parents, and healthcare providers,
definitions and key concepts in traumatic stress after medical events,
cancer and traumatic stress,
injury and traumatic stress, and
pediatric intensive care units and traumatic stress.

Consult a NCTSN reading list of research on medical traumatic stress.

andrews & Bonta, 1998 offered four general definitions of criminal behavior that will fit all the types of it.
These four areas include the following types of act:

1. Prohibited by law and are punished by the state

2. Considered to be violation moral or religious code and is believed to be punishable by a Supreme

Spiritual being such as God

3. Violate norms of society or traditions and are believed to be punishable by community

4. Acts causing serious psychological stress or mental damage to a victim, but is somewhat
affordable for offender (referred as Psychological criminal behavior ).
Causes of criminal behavior
The reasons behind criminal behavior can vary a lot in each particular case, but still they can be grouped
in two main categories genetics and environment.

When in the mid 19th century the question about the causes of criminal behavior was raised, a lot of
psychologists were insisting that the only reason is genetics. They even considered that a persons
inclination to criminal could be measured according to the parents mental condition, i.e. if they had some
even minor mental problems theirs son/daughter was more likely to become a criminal. The scientists had
their versions of solving a problem, but is it fair if the people with higher risk of committing a crime would
not be allowed by the state and society to live normally and have children?

As the time passed more and more researches and experiments were held and modern approach to this
question is that of course genetics is really important reason behind criminal behaviour, but the
environment is also as important as it. This includes the family the child is born and raised in, the example
parents and family can give them, the social status they have, education, etc.

Nowadays the psychologists and criminalists agree that what drives a person to criminal behavior is really
complex and complicated mechanism, involving a lot of factors. We can imagine a child, who was born in
a criminal family (mother is schizopreniac, father is rapist and murderer) but after he got an education
and a job there is nothing antisocial in his behaviors. It proves that solely genetics cant determine ones
inclination to the criminal.

So, it is impossible to predict a persons criminality according to some specific factors, but we can still
highlight some circumstances and apply a person to a relatively higher criminal risk group.

Financial problems, or starvation this is especially common problem in third world countries.
When a person has to struggle every day just to get food to survive, the probability that they
become thieves is high.

Low social status when one is bullied because of it, they may easily become aggressors and
fight back against the whole society.

Genetics some genetical mental disorders, itself, includes increased aggression.

Etc.

Theories of criminal behavior

In order to find the best ways to handle and prevent crime, examining why do people commit crime is
very important. Many theories have appeared and are appearing since beginning of this study seeking to
find the best solutions for this problem. Those theories are continuing and will always influence
forensic/criminal psychologists work. I will write a brief review of basic and other more or less popular
theories of criminal behavior. Though these theories are eventually modified, I will try to be as accurate as
possible.

Three broad models of criminal behaviors are the following: psychological, sociological and biological
models. Actually, it is difficult to completely separate them and it is generally accepted, that all of them
play a role in the interpretation of behavior. Though psychological principles can be applied across all the
three models, they all have some specific ones, which would help in implementing across different crime
control policies.

Psychological Approaches
There are several fundamental assumptions, that are common for all the psychological approaches to
criminal behavior. These are the following:

The individual is the primary unit of analysis. (Individual human being is considered to be
responsible for acts he/she conducted)

Personality drives behavior within individuals, because it is the major motivational element.

Crimes can result from abnormal, dysfunctional or inappropriate mental processes within the
individuals personality.

An individual may have purpose of criminal behavior if it addresses certain felt needs.

Normality is generally defined by social consensus, that is, what is considered as typical,
normal, or acceptable by the majority of individuals in a certain social group.

Defective or abnormal, mental processes may be caused by a variety of factors such as diseased
mind, inappropriate learning or improper conditioning, the emulation of inappropriate role models,
and adjustment to inner conflicts.

In short, crime control policy based on psychological principles targets individuals and tries to prevent
criminal behavior from this point. Any policy aimed at preventing crime by targeting persons such as
training, education, promotion of self-awareness, rehabilitation, resocialization or identification risks of
criminal behavior are psychological in nature. In addition, psychologists have long recognized that the
best predictor of future behavior is past behavior of the individual (Mischel, W. 1968).

Sociological Approaches
In this approach scientists are examining criminal behavior from a sociological point of view. The majority
of sociological theories believe, that the criminal behavior mainly is influenced by combination of social
surrounding, political and economic factors.
Offenders are not necessarily viewed as bad people, these theories trend to look at social context of a
persons situation, examining his race, neighborhood, intelligence, education, family, political and media
influence, income level, job and career, childhood history to determine why did he/she become
criminal.There are many different theories seeking to explain criminal behavior such as: Social Structure
Theory (which itself consists of Social disorganization, Strain and Cultural deviance theories) differential
association, theory of anomie, neutralization theory, Social Control Theory and many others.

The key idea of Differential association theory, created by Edwin H. Sutherland is, that criminal behavior
is learned through communication with other people. Though that interaction Values, techniques and
attitude to things is learned, that motivates future behavior and in the following case it is criminal act.
Indeed, the more a person sees delinquent acts, which are not criticized by the surrounding community,
the higher is the chance of him/her committing such act.

According to social control theory, if social bounds of a person is weak, he/she will more likely conduct a
criminal act, because people care what others thinks of them and try to conform with social expectations
because of their attachment to others.

Biological Approaches
Biological theories purport, that criminal behavior is caused by some flaw in individuals biological
makeup. According to Raine Study, the causes may be Heredity, Neurotransmitter dysfunction and brain
abnormalities, which could be caused either by the first two or trauma. Many theories are sharing
biological approaches such as: Trait and psychodynamic trait theories, Lombrosos Theory, Y
Chromosome Theory and others.

There are several types of crime control, which involve artificial interference in human biology such as
Psychosurgery, chemical methods of control, brain stimulation and others.

Psychodynamic therapy was developed by Sigmund Freud in the late 1800s and has then become a
significant theory in the history of criminality (Siegel, 2005). Freud believed, that every individual carries
residue of the most significant emotional attachments of our childhood, which then guides our future
interpersonal relationships (Siegel, 2005) The theory is a three-part structure consisting of the id, the ego
and the super ego. The id is considered the underdeveloped of primitive part of our markup. It controls
our need for food, sleep and other basic instinct. This part is purely focused on instant gratification. The
ego controls the id by setting up boundaries. The superego is the change of judging the situation through
morality (Siegel, 2005)

Psychodynamic theorists believe that personality of offenders is id-dominated. Which means, that when
they lose control of the ago their id of instant gratification takes over. Other problems causing control of
the ego are poor social skills, excessive dependence on others, immaturity, etc.

Others believe, that offenders are moved by unconscious need to be punished by their previous sins.
Consequently, crime is a manifestation of feelings of oppression and peoples inability to develop the
proper psychological defense and rationales to keep these feelings under control (Siegel).
Structural Strain Theory

American sociologist Robert K. Merton developed structural strain theory as an extension of the
functionalist perspective on deviance. This theory traces the origins of deviance to the tensions that are
caused by the gap between cultural goals and the means people have available to achieve those goals.

According to this theory, societies are composed of both culture and social structure. Culture establishes
goals for people in society while social structure provides (or fails to provide) the means for people to
achieve those goals. In a well-integrated society, people use accepted and appropriate means to achieve
the goals that society establishes.

In this case, the goals and the means of the society are in balance. It is when the goals and means are
not in balance with each other that deviance is likely to occur. This imbalance between cultural goals and
structurally available means can actually encourage deviance.

Labeling Theory

Labeling theory is one of the most important approaches to understanding deviant and criminal behavior
within sociology. It begins with the assumption that no act is intrinsically criminal. Instead, definitions of
criminality are established by those in power through the formulation of laws and the interpretation of
those laws by police, courts, and correctional institutions. Deviance is therefore not a set of characteristics
of individuals or groups, but rather it is a process of interaction between deviants and non-deviants and
the context in which criminality is defined.

Those who represent forces of law and order and those who enforce the boundaries of proper behavior,
such as the police, court officials, experts, and school authorities, provide the main source of labeling. By
applying labels to people, and in the process creating categories of deviance, these people reinforce the
power structure and hierarchies of society. Typically it is those who hold more power over others, on the
basis of race, class, gender, or overall social status, who impose rules and labels on others in society.
Social Control Theory

Social control theory, developed by Travis Hirschi, is a type of functionalist theory that suggests that
deviance occurs when a persons or groups attachment to social bonds is weakened. According to this
view, people care about what others think of them and conform to social expectations because of their
attachments to others and what others expect of them. Socialization is important in producing conformity
to social rules, and it is when this conformity is broken that deviance occurs.

Social control theory focuses on how deviants are attached, or not, to common value systems and what
situations break peoples commitment to these values. This theory also suggests that most people
probably feel some impulse towards deviant behavior at some time, but their attachment to social
norms prevents them from actually participating in deviant behavior.

Theory of Differential Association

The theory of differential association is a learning theory that focuses on the processes by which
individuals come to commit deviant or criminal acts. According to the theory, created by Edwin H.
Sutherland, criminal behavior is learned through interactions with other people. Through this interaction
and communication, people learn the values, attitudes, techniques, and motives for criminal behavior.

Differential association theory emphasizes the interaction people have with their peers and others in their
environment. Those who associate with delinquents, deviants, or criminals learn to value deviance. The
greater the frequency, duration, and intensity of their immersion in deviant environments, the more likely it
is that they will become deviant.
Sociology of Deviance and Crime

By Ashley Crossman,Sociology
Expert

Updated December 10, 2016.

Sociologists who study deviance and crime examine cultural norms, how they change over time, how they are
enforced, and what happens to individuals and societies when norms are broken. Deviance and social norms vary
among societies, communities, and times, and often sociologists are interested in why these differences exist and

impact the individuals and groups in those areas.

Overview
Sociologists define deviance as behavior that is recognized as violating expected rules and norms. It is simply more
than nonconformity, however; it is behavior that departs significantly from social expectations. In the sociological
perspective on deviance, there is subtlety that distinguishes it from our commonsense understanding of the same
behavior. Sociologists stress social context, not just individual behavior. That is, deviance is looked at in terms of
group processes, definitions, and judgments, and not just as unusual individual acts.

Sociologists also recognize that not all behaviors are judged similarly by all groups. What is deviant to one group may
not be considered deviant to another. Further, sociologists recognize that established rules and norms are socially
created, not just morally decided or individually imposed. That is, deviance lies not just in the behavior itself, but in the
social responses of groups to behavior by others.

Sociologists often use their understanding of deviance to help explain otherwise ordinary events, such as tattooing or
body piercing, eating disorders, or drug and alcohol use. Many of the kinds of questions asked by sociologists who
study deviance deal with the social context in which behaviors are committed. For example, are there conditions
under which suicide is an acceptable behavior? Would one who commits suicide in the face of a terminal illness be
judged differently from a despondent person who jumps from a window?
Four Theoretical

Approaches

Within the sociology of deviance and crime there are four key theoretical perspectives from which researchers
study why people violate laws or norms, and how society reacts to such acts. We'll review them briefly here.

Structural strain theory was developed by American sociologist Robert K. Merton, and suggests that deviant
behavior is the result of strain an individual may experience when the community or society in which they live does not
provide the necessary means to achieve culturally valued goals. Merton reasoned that when society fails people in
this way, they engage in deviant or criminal acts in order to achieve those goals (like economic success, for example).

Some sociologists approach the study of deviance and crime from a structural functionalist standpoint. They
would argue that deviance is a necessary part of the process by which social order is achieved and maintained. From
this standpoint, deviant behavior serves to remind the majority of the socially agreed upon rules, norms, and taboos,
which reinforces their value and thus social order.

Conflict theory is also used as theoretical foundation for the sociological study of deviance and crime. This approach
frames deviant behavior and crime as the result of social, political, economic, and material conflicts in society. It can
be used to explain why some people resort to criminal trades simply in order to survive in an economically unequal
society.

Finally, labeling theory serves as an important frame for those who study deviance and crime. Sociologists who
follow this school of thought would argue that there is a process of labeling by which deviance comes to be
recognized as such. From this standpoint, the societal reaction to deviant behavior suggests that social groups
actually create deviance by making the rules whose infraction constitutes deviance, and by applying those rules to
particular people and labeling them as outsiders. This theory further suggests that people engage in deviant acts
because they have been labeled as deviant by society, because of their race, or class, or the intersection of the two,
for example.

Pshycojology explanation
Deviant behavior is any behavior that is contrary to the dominant norms of society. There are many
different theories on what causes a person to perform deviant behavior, including biological explanations,
psychological explanations, and sociological explanations. Following are some of the major psychological
explanations for deviant behavior.
There are several fundamental assumptions that all psychological theories on deviance have in common.
First, the individual is the primary unit of analysis in psychological theories of deviance. That is, individual
human beings are solely responsible for their criminal or deviant acts. Second, an individuals personality
is the major motivational element that derives behavior within individuals. Third, criminals and deviants
are seen as suffering from personality deficiencies. Thus, crimes result from abnormal, dysfunctional, or
inappropriate mental processes within the personality of the individual.

Finally, these defective or abnormal mental processes could be caused from a variety of things, including
a diseased mind, inappropriate learning, improper conditioning, and the absence of appropriate role
models or the strong presence of inappropriate role models.

Psychoanalytic Theory
Psychoanalytic theory, which was developed by Sigmund Freud, states that all humans have natural
drives and urges that are repressed in the unconscious. Additionally, all humans have criminal tendencies.
These tendencies are curbed, however, through the process of socialization. A child that is improperly
socialized, then, could develop a personality disturbance that causes him or her to direct antisocial
impulses either inward or outward. Those who direct them inward become neurotic while those that direct
them outward become criminal.
Cognitive Development Theory
According to the cognitive development theory, criminal and deviant behavior results from the way in
which individuals organize their thoughts around morality and the law. Lawrence Kohlberg, a
developmental psychologist, theorized that there are three levels of moral reasoning. During the first
stage, called the preconventional stage, which is reached during middle childhood, moral reasoning is
based on obedience and avoiding punishment. The second level is called the conventional level and is
reached at the end of middle childhood. During this stage, moral reasoning is based on the expectations
that the childs family and significant others have for him or her. The third level of moral reasoning, the
postconventional level, is reached during early adulthood at which point individuals are able to go beyond
social conventions. That is, they value the laws of the social system. People who do not progress through
these stages may become stuck in their moral development and as a result become deviants or criminals.
Learning Theory
Learning theory is based on the principles of behavioral psychology, which
hypothesizes that a persons behavior is learned and maintained by its
consequences or rewards. Individuals thus learn deviant and criminal
behavior by observing other people and witnessing the rewards or
consequences that their behavior receives. For example, an individual who
observes a friend shoplifting an item and not getting caught sees that the
friend is not being punished for their actions and they are rewarded by
getting to keep the item he or she stole. That individual might be more likely
to shoplift, then, if they believe he or she will be rewarded with the same
outcome. According to this theory, if this is how deviant behavior is
developed, then taking away the reward value of the behavior can eliminate
deviant behavior.
References
BarCharts, Inc. (2000). Sociology: The Basic Principles of Sociology for Introductory Courses. Boca
Raton, FL: Bar Charts, Inc.
Freud, S. (1961). The Complete Works of Sigmund Freud (Vol. 19). London: Hogarth.
Cole, M. and Cole S.R. (1993). The Development of Children. New York: W.H. Freeman and
Company.
Bandura, A. (1973). Aggression: A social learning analysis. Engle-wood Cliffs, NJ: Prentice Hall.