Guest blog post from Jessica M., public health undergraduate intern with the Center for Pediatric Traumatic Stress



“Childhood trauma does not come in one single package.”

Tirumalai S. Srivatsan


Trauma is redefined in the fifth volume of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). In the DSM’s earlier volumes, it is clearly stated that trauma could occur from primary or secondary exposure of a traumatic event. However, a majority of the studies on trauma widely focused on Primary Traumatic Stress. In this fifth volume the concept of Secondary Traumatic Stress is greatly discussed and explored. Secondary Traumatic Stress (STS) occurs through exposure of a traumatic event by narrative, witnessing or a firsthand account. Upon reading the term in its simplest form one could infer that STS refers to the adoption of Post-Traumatic Stress Disorder (PTSD) symptoms that victims are suffering. But, the question then arises… How?


Secondary Traumatic Stress (STS) often affects those closest to the one suffering, in this case, the sick child. When a child is sick a whole network is affected. This network includes friends, family and healthcare professionals. In the same way, when a child has become a victim to medical trauma, the network is affected as well. All of these individuals are susceptible to STS. 


Secondary Traumatic Stress (STS) is not to be compared to a cold or flu. It is not contagious. While the negative mental behaviors may be adopted while in close proximity to the ailing child, these symptoms are not appeased with a simple cough syrup or vaccine. The impact does not take place on a physical, microbial level, but on psychological transfer of emotions. For a parent or family member, caring for a sick child can be incredible taxing. Family members offer a certain level of empathy that makes them even more vulnerable to adopt this condition. They may begin to take on the symptoms of the suffering child. The symptoms mirror those of Traumatic Stress on a primary exposure level. These include, but are not limited to, distressing memories, intrusive thoughts, sudden mood changes, dissociation and avoidance. Healthcare Professionals, who are consistently exposed to childhood medical trauma, may become affected by STS as well. Upon caring for this traumatized child and hearing the account of what occurred, as well as seeing the physical injury, providers may experience an inability to cope. They may also begin to experience symptoms that mirror PTSD. If this condition goes untreated it may lead to burnout.           


Secondary Traumatic Stress

(Image source:Aging Life Care Journal)


Whether it is the child, the parent or the health provider, screening is the absolute best first step in assessing and treating Traumatic Stress.  Look for the signs and symptoms mentioned above, as well as those featured in the Self-Care portion of the HealthCareToolbox. Be mindful & proactive regarding your own mental health and that of your patient.


“We don’t heal in isolation, but in community.”

S. Kelley Harrell


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Aging Life Care Journal


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Psychiatric Times