Trauma and Complex Trauma Disorder by Prof Jayashri Kulkarni
Prof Jayashri Kulkarni, Professor of Psychiatry and Director of Monash Alfred Psychiatry Research Centre discusses the epidemic of antenatal domestic violence, early sexualisation of girls and its consequences on children. Prof Kulkarni further discusses Complex Trauma Disorder (CTD).
- Despite our hope that pregnant women are seen as ‘special’ there is an increase of violence against women during the antenatal stage.
The behavioural problems were quite profound in the children and we think that this is obviously because of the impact of Cortisol and the Corticotropin releasing factor (CRF) on fetal neurons, but also the profound impact of maternal depression on the baby.
We’ve got the gene environment link going on here – so we’ve got violence in the environment which actually then can lead to factors such as altering the serotonin transport gene in the foetus in utero.
Premature sexualisation is linked with serious mental health problems like eating disorder, low self-esteem and depression.
- Prof. Kulkarni emphasises the above statement with images from children participating in beauty pageants – clearly, the events unfolding within society are contributing greatly to problems in the mental health industry.
Complex Trauma Disorder (CTD):
- Highly associated with trauma. Assessment of trauma is often missed. This should be sensitively done over time.
- The Zanarini Rating Scale is a good scale to use in clinical practice to assess the severity and change in Borderline Personality Disorder (Complex Trauma Disorder) symptoms.
Treatment of CTD
It is important that we treat the depression with a soft medication that is not going to create more side effects than we intended
SNRI’s can create a sort of jarring with the nor-adrenergic effects and the agitation can be quite significant for these patients.
- Prof. Kulkarni discusses further treatment options such as psychotherapy, education, support for family and friends and ‘re-training’ about relationship and suicidal thoughts.
- Watch for reappearance in menopause. Can occur with other presentations such as alcohol misuse.
Prevention of abuse is clearly something our community needs to get behind.