Trauma

Traumas are often thought of as difficult-to-manage events that are psychologically devastating for the individuals who experience them. (Briere and Scott, 2006; Straussner and Calnan, 2014). For post-traumatic stress disorder (PTSD) and acute stress disorder, she identified the causative factors for the traumatic event as: actual or threatened death, exposure to or witnessing sexual abuse through serious injury or direct experience, such an event from a close friend or family member. repeated exposure to distressing details about learning or traumatic events (not through electronic media, television, movies, or pictures unless work-related). DSM-5 (American Psychiatric Association, 2013), Individuals’ reactions to traumatic stressors vary; some develop severe trauma reactions and PTSD from the experience, while others have little reaction when exposed to the same event. Various factors such as the pre-traumatic characteristics and experiences of the individual, the nature and severity of the traumatic event, individual perceptions and post-traumatic experiences interact and contribute to the development of the trauma response (Straussner & Calnan, 2014). In fact, most individuals experience a traumatic stressor during their lifetime (56%), and few (8%) develop PTSD (Kessler et al., 1995). Individuals experiencing traumatic stressors may experience chronic and pathological or delayed responses. Apart from this, after being exposed to a potentially traumatic event, these individuals can display resilience and continue their lives in a healthy way (Bonanno, 2004). Individuals may experience acute stress disorder that resolves within a month, develop more severe PTSD, or develop other disorders and symptoms such as depression, anxiety, dissociation, and substance use (Kolk, 2005; Wiechelt, 2014; Wiechelt & Gryczynski, 2012). It is possible to say that childhood traumas are associated with substance disorders (Zhang et al., 2020) and behavioral addictions such as gambling (Horak et al., 2020), internet use disorder (Grajewski and Dragan, 2020; Kircaburun et al., 2019). (Dalbudak et al., 2014; Evren et al., 2019).

DEPENDENCE

TDK explained addiction as a state of being dependent. Another definition for addiction was made by the Who as “a set of psychological, behavioral and cognitive phenomena in which a substance or type of substance takes precedence over its previously valuable behaviors” (2018). Addiction is considered as a brain disease and includes concepts such as “tolerance, withdrawal, unsuccessful quit attempts, continuing to use despite harm, desire to use, spending most of the time, loss of control” (Ögel, 2017), (Hollander, 2012) . Although taking substances from the outside is the most common thought that comes to mind for addiction, behavioral disorders such as gambling, sex and the internet are among the factors that cause addiction by affecting the reward mechanism system (Greenfiel, 1999), (Ögel, 2017), (Griffiths, 2000).

CHAPTER 2

2.1. SECTIONS AFFECTED BY TRAUMA

2.1.1. COGNITIVE IMPACTS

He evaluated how the child made sense of traumatic experiences by looking at the child’s awareness in the cognitive developmental stage. He believes that Piaget’s understanding of egocentrism is the biggest factor in translating the child’s causality of events. Therefore, children are likely to blame themselves for their victimization, and distressing events may cause them to fear a repeat of these events. Victims may develop defenses against traumatic memories and thoughts. Children and adolescents can use various defensive functions to avoid thinking about a traumatic event and gain dominance or control over the event. This can also cause memory impairment. This, in turn, can affect intellectual functioning or the ability to perform in the present or think about the future (Mowbray, 1988). Traumatized children may experience intolerable, intrusive thoughts or images. Generally, while avoiding situations, people or objects that remind them of a particular event, they consciously try to suppress them (Pynoos and ARK., 1987; Terr, 1984). Using a variety of defenses to forget the event or avoid reminders can help guard against the overwhelming feelings of helplessness that are often the core experience of traumatic situations (Van der Kolk, 1987). She recorded the defenses of internalizing anger and identifying with aggressors in the case of traumatized boys (Pynoos & Eth, 1984); he observed that girls internalize hopelessness and helplessness and identify with the victims (Green, 1985; Terr; 1985; Wohl & Kaufman, 1985).

2.1.2. SENSORY EFFECTS

Most researchers agree that children respond to stress in one of two ways after trauma: either in an overreactive mode with anxiety and hyperactivity, or in an overreacting and withdrawing mode, both socially and emotionally (Horowitz, 1976; van der Kolk, 1988; Zimrin, 1986). For example, traumatized children have been observed to exhibit emotional lability (Nurcombe, 1986; Simonds & Glenn, 1976); These children are more likely to express feelings of anger and irritability (Pynoos & Nader, 1988; Pynoos et al., 1987); and “their ability to regulate emotions is reduced” (van der Kolk, 1987). Similarly, it has been observed that they restrict their emotions or show an inability to express and experience their emotions (Doyle & Bauer, 1988; Green, 1985; Holaday, Armsworth, Swank, & Vincent, 1992).

2.1.2. EMOTIONAL REACTIONS

Numerous emotional responses have been reported from studies of children experiencing various forms of trauma. It has been observed that traumatized children generally show a high sense of vulnerability and sensitivity to environmental threat. That is, they tend to re-experience events emotionally, both from reminders of the event and from intervening thoughts or images of the event (Rosenheck & Nathan, 1985; van der Kolk, 1987b). They found that these children and adolescents have lower tolerance for stress and may feel more overwhelmed overall (Holaday et al., 1992). The child’s level of development at the time of trauma appears to be an important factor in determining the emotional response. For example, children who were abused before the age of two showed anger and sadness until the age of six; children aged four to six years exhibited irritability, anxiety, strain, and withdrawal when abuse occurred (Erickson & Egeland, 1987; Howes & Espinosa, 1985). However, as discussed in the following section, the diversity of responses to trauma in general is similar regardless of the triggering event. In these children, reactions such as depressive reactions, excessive crying, grief and anhedonia were detected (Milgram et al., 1988).

2.1.3. CRIME AND SHAME

Terr (1984) and Zimrin (1986) found that the children they studied experienced extreme guilt and shame from experiencing difficulties that others did not experience. In addition, traumatized children evaluated their behavior in these situations harshly and experienced shame and self-blame (Holaday et al., 1992; Terr, 1984; Zimrin, 1986). These children have experienced feelings of distress, helplessness, and powerlessness. When analyzing the drawings of traumatized children, they stated that the drawings “reflect feelings of helplessness, powerlessness, fragmentation, depression, anger and anxiety”. It has been observed that these children avoid social isolation symptoms, lack of confidence, and general fear of interpersonal contact. (Wohl & Kaufman, 1985), Other researchers (Milgram et al., 1988; Pynoos et al., 1987; Zimrin, 1986) stated that frightening thoughts about the event can immediately reveal feelings of anxiety, inability to relax, helplessness, hopelessness, and fear. . Holaday et al. (1992) stated that passivity in decision-making may result from a sense of powerlessness to affect the lives of traumatized children.

2.1.3. SELF PERCEPTIONS

Many studies have documented changes in self-perceptions or feelings towards self among traumatized children and adolescents. These include low self-esteem, poor self-concept, and negative body image (Kinard, 1980; Oates et al., 1985; Tong et al., 1987). Lack of self-confidence has also been documented in various trauma groups (Armsworth & Turboff, 1990; Holaday et al., 1992). Other research has found that traumatized children feel worthless and believe they deserve their destiny (Doyle & Bauer, 1988; Terr, 1988; Zimrin, 1986). It has been observed that traumatized children develop an extreme sense of vulnerability and sensitivity to environmental threat. It has been stated that these feelings arise from internalized thoughts and images as well as physical reminders. (Rosenheck and Nathan, 1985; van der Kolk 1987). Feelings of apathy, withdrawal, and low motivation have also been reported in these children, which may be evidence of resignation to a perceived inability to control events (Eth & Pynoos, 1984; Mowbray, 1988). Fears and feelings of vulnerability are not limited to children’s personal safety. Extreme fear and concern for the safety of family members has been documented by Pynoos et al. (1987). Many behavioral response patterns following traumatic events have been documented. It has been observed that traumatized children are more likely to display aggression towards their peers (Burke et al., 1982; George & Main, 1979; Hoffman-Plotkin & Twentyman, 1984), parents, teachers, and authority figures. (Friedrich, 1987; Kinard, 1980); These children may be violent towards animals (Friedrich et al., 1988; Friedrich and Reams, 1987). In addition, they have a tendency to harm themselves more than their peers (Green, 1983; Zimrin, 1986) and may show extreme adjustment difficulties (Farber & Joseph, 1985). They are more likely to become chemically dependent (Cavaiola & Schiff, 1988); they are likely to engage in antisocial or criminal activities (Frederick, 1985; McCormack et al., 1986; Shore, Tatum et al., 1986); exhibiting intergenerational abuse (Gelardo & Sanford, 1987); and prostitution (James & Meyerding, 1977) and illegal behavior (Rimza & Berg, 1988).

2.1.4. PHYSIOLOGICAL-SOMATIC EFFECTS

Van der Kolk (1988) stated that trauma affects both the psyche and the body, and most PTSD symptoms are caused by physiological and neurochemical changes. According to Van der Kolk (1987b), traumatized people are afraid to “get into their own minds” to cope with the memories, fears, terror, or effects of the traumatic event, and may therefore experience the bodily manifestations of these traumas as a means of protection. This, in turn, results in multiple bodily outputs triggered by physiological or neurochemical changes in the brain (van der Kolk, 1984).

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