Abstract
A review of childhood secondary trauma is presented. Secondary trauma involves the transfer and acquisition of negative affective and dysfunctional cognitive states due to prolonged and extended contact with others, such as family members, who have been traumatized. As such, secondary trauma refers to a spread of trauma reactions from the victim to those who have close contact with the traumatized individual. Assessment devices are reviewed and most of these appear to be designed to assess secondary or vicarious traumatization in therapists rather than in the general population of adults. The majority of scales lack cutoff scores and this is a significant weakness. The modified Stroop procedure is presented as non-paper and pencil method of assessing secondary trauma reactions. The evaluation of the efficacy of therapeutic interventions for secondary traumatization is virtually non-existent. Systematic studies of secondary trauma are in their infancy and a good deal of further research is needed.
TopBackground
Those experiencing secondary trauma have not directly experienced a traumatic event but have acquired trauma symptoms vicariously, often through close contact with trauma victims (Figley, 1995; McCann & Pearlman, 1990). One might conceive of secondary trauma as a “spread of effect” of trauma from the impacted person or situation to those who have close involvement with the traumatized person. Hearing about or witnessing trauma situations, and an inclination to identify with those in the trauma situation, can also result in secondary trauma reactions, especially if these vicarious experiences evoke fear reactions in the witness (e.g., Marshall & Galea, 2004; Propper, Stickgold, Keeley, & Christman, 2007). The range of secondary trauma symptoms can include anger, anxiety, depression, low self-esteem, emotional exhaustion, difficulty concentrating, body aches, sleep problems changes in eating habits, startle responses, increase in addictive behaviors, and withdrawing from others. Not only is the study of secondary trauma is in its infancy and comparatively lacking in empirical studies, but systematic, controlled research on secondary trauma in children is almost non-existent.
Secondary trauma or vicarious trauma, are terms that have been used in somewhat different contexts. Secondary trauma, or secondary traumatic stress, parallel the diagnostic categories that are presented for posttraumatic stress disorder (PTSD) and acute stress disorder in the Diagnostic and Statistical Manual of Mental Disorders(4th ed., text rev.; DSM-IV-TR; American Psychiatric Association [APA], 2000). Vicarious trauma refers more specifically to the alteration of cognitive schemas and core beliefs. For example, therapists who have extensive contact with children who have undergone traumatic experiences may acquire the negative emotional states of these children. In vicarious traumatization the focus is the alteration of one’s cognitions and basic life assumptions such as beliefs in environmental stability, safety, and a secure sense of self. However, it is increasingly recognized that vicarious trauma and secondary trauma are not entirely distinct concepts (Bober & Regehr, 2006; Jenkins & Baird, 2002) in that they both involve the transfer of trauma symptoms to others. For this reason the terms “secondary trauma” and “vicarious trauma” will be used synonymously in this review. The overarching issue between the terms is the disturbance of one’s emotions and/or cognitions as a result of experiencing the impact of trauma on others.
Key Terms in this Chapter
Secondary Traumatization: The process of acquiring secondary trauma responses.
Vicarious Trauma: Is another term commonly used in the literature to describe secondary trauma. It is often used for the spread of trauma between clients and therapists.
Modeling: Enacting the behavior of another simply through observation.
Observational Learning: That form of learning that takes place simply through viewing another’s behavior and not through a process of instruction.
Stroop Procedure: A testing procedure developed by J.R. Stroop that examines the delay in naming the color of printed words when those words describe colors that are not congruent with the actual ink color in which the words are printed.
Secondary Trauma Scale: As scale developed specifically for assessing secondary trauma. It emphasizes the degree to which another person’s trauma responses produce similar responses in the recipient, although the latter has not been traumatized.
Secondary Trauma: The spread of the negative emotional states due to trauma to others who have not been traumatized.
Emotional Stroop: Similar to the Stroop Procedure but rather than using the names of colors, emotion evoking words are used. The delay in naming the color of these words, as opposed to emotionally neutral words, reveals their emotional impact.