Trauma in Childhood

Copeland et al¹ found that more than two-thirds of children in western North Carolina are victims of trauma before their 16th birthday. Yet less than 0.5% developed posttraumatic stress disorder (PTSD).

The striking discrepancy between the prevalence of trauma and the prevalence of PTSD is partly explained by conceptual bracket creep in the definition of trauma. The broader the concept of trauma, the lower the rate of PTSD is likely to be. Indeed, no longer need one be directly exposed to a potentially fatal event to qualify as a victim of trauma. People who merely learn about the serious misfortunes of others now qualify as trauma survivors themselves. As Copeland et al observed, such indirect experiences account for many cases of exposure in their study.

The shockingly high rate of trauma in the Copeland et al study notwithstanding, many studies indicate that crimes against children have been plummeting since the early 1990s.² The decline has been dramatic, ranging from 40% to 70%, depending on the crime. Substantiated cases of sexual abuse dropped by 49% between 1990 through 2004 after having steadily risen during the previous 15 years. Documented cases of physical abuse of children and sexual assaults of teenagers dropped by 43% and 67%, respectively. Domestic violence declined by 49%, implying diminished exposure to vicarious trauma for children.

After ruling out artifactual explanations for these positive findings, Finkelhor and Jones² concluded that the good news is genuine. “The era of continually rising numbers of child maltreatment and crime victimization is probably over,”^{2 (p709)} they stated. As Finkelhor and Jones emphasized, we now need to identify the variables causing these massive improvements so that we can foster policies that accelerate these favorable trends.

Correspondence: Dr McNally, Department of Psychology, Harvard University, 33 Kirkland St, Cambridge, MA 02138 (rjm@wjh.harvard.edu).

Financial Disclosure: None reported.