Trauma


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Traumatic events include things that happen to you directly, or to someone you are close to. An event can be traumatic if you witnessed it happening to someone else, or if you were involved in the course of your work. For example:

if you were the first on the scene of a serious accident, or after a natural disaster
if you learnt that a friend or family member was involved in a life threatening event, was seriously injured, or died suddenly and unexpectedly

Effects of Trauma     In the first days and weeks after a traumatic event, people often experience strong feelings of fear, sadness, guilt, anger, or grief. As they begin to make sense of what has happened to them, these feelings usually begin to subside. Most people will recover quite quickly with the support of family and friends. For some people though, a traumatic event can lead to mental health issues such as posttraumatic stress disorder (PTSD), depression, anxiety, alcohol and drug use, as well as impacting on their relationships with family, friends, and at work.

PTSD

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After the experience of a traumatic event, a person suffering PTSD will experience four main types of problems.

1  Depression: a common reaction after trauma.

2  Anxiety: Many people experience extreme worry, fear and anxiety both during and after a traumatic event.

3  Alcohol and Substance Use: Alcohol and drugs may help block out painful emotions and memories in the short term, but they get in the way of recovery.

4  Life and Relationships: Mental health problems resulting from a traumatic event can have a significant impact on family, social and work life.


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Emotional and Psychological Trauma: Causes and Effects, Symptoms and Treatment

Psychological or Emotional Trauma is Much Broader Than Current Definitions of PTSD; it has many faces.

What is psychological or emotional trauma? | What causes emotional or psychological trauma? | What is the difference between stress and emotional or psychological trauma? | What causes psychological trauma? | Why can an event cause an emotionally traumatic response in one person and not in another? | What are the symptoms of emotional trauma? | What are the possible effects of emotional trauma? | What if symptoms don’t go away, or appear at a later time? | How is emotional trauma treated? | Online Resources for Emotional or Psychological Trauma

What is psychological or emotional trauma?

The ability to recognize emotional trauma has changed radically over the course of history. Until recently psychological trauma was noted only in men after catastrophic wars. The women’s movement in the sixties broadened the definition of emotional trauma to include physically and sexually abused women and children. Now, because of the discoveries made in the nineties – known as the decade of the brain – psychological trauma has further broadened its definition.

Recent research has revealed that emotional trauma can result from such common occurrences as an auto accident, the breakup of a significant relationship, a humiliating or deeply disappointing experience, the discovery of a life-threatening illness or disabling condition, or other similar situations. Traumatizing events can take a serious emotional toll on those involved, even if the event did not cause physical damage.

Regardless of its source, an emotional trauma contains three common elements:

• it was unexpected;
• the person was unprepared; and
• there was nothing the person could do to prevent it from happening.

It is not the event that determines whether something is traumatic to someone, but the individual’s experience of the event. And it is not predictable how a given person will react to a particular event. For someone who is used to being in control of emotions and events, it may be surprising – even embarrassing – to discover that something like an accident or job loss can be so debilitating.

What causes emotional or psychological trauma?

Our brains are structured into three main parts, long observed in autopsies:

• the cortex (the outer surface, where higher thinking skills arise; includes the frontal cortex, the most recently evolved portion of the brain)
• the limbic system (the center of the brain, where emotions evolve)
• the brain stem (the reptilian brain that controls basic survival functions)

Because of the development of brain scan technology, scientists can now observe the brain in action, without waiting for an autopsy. These scans reveal that trauma actually changes the structure and function of the brain, at the point where the frontal cortex, the emotional brain and the survival brain converge. A significant finding is that brain scans of people with relationship or developmental problems, learning problems, and social problems related to emotional intelligence reveal similar structural and functional irregularities as is the case resulting from PTSD.

What is the difference between stress and emotional or psychological trauma?

Trauma is stress run amuck. Stress dis-regulates our nervous systems – but for only a relatively short period of time. Within a few days or weeks, our nervous systems calm down and we revert to a normal state of equilibrium. This return to normalcy is not the case when we have been traumatized. One way to tell the difference between stress and emotional trauma is by looking at the outcome – how much residual effect an upsetting event is having on our lives, relationships, and overall functioning. Traumatic distress can be distinguished from routine stress by assessing the following:

• how quickly upset is triggered
• how frequently upset is triggered
• how intensely threatening the source of upset is
• how long upset lasts
• how long it takes to calm down

If we can communicate our distress to people who care about us and can respond adequately, and if we return to a state of equilibrium following a stressful event, we are in the realm of stress. If we become frozen in a state of active emotional intensity, we are experiencing an emotional trauma – even though sometimes we may not be consciously aware of the level of distress we are experiencing

What causes psychological trauma?

Psychological trauma can result from events we have long recognized as traumatic, including:

• natural disasters (earthquakes, fires, floods, hurricanes, etc.)
• physical assault, including rape, incest, molestation, domestic abuse
• serious bodily harm
• serious accidents such as automobile or other high-impact scenarios
• experiencing or witnessing horrific injury, carnage or fatalities

Other potential sources of psychological trauma are often overlooked including:

• falls or sports injuries
• surgery, particularly emergency, and especially in first 3 years of life
• serious illness, especially when accompanied by very high fever
• birth trauma
• hearing about violence to or sudden death of someone close

In addition, traumatic stress in childhood that influences the brain is caused by poor or inadequate relationship with a primary caretaker. Sources of this developmental or relational trauma include the following:

• Forced separation very early in life from primary caregiver;
• chronic mis-attunement of caregiver to child’s attachment signals (“mal-attachment”) or reasons such as physical or mental illness, depression or grief.

It is acknowledged that early life trauma creates a vulnerability for experiencing future traumatic responses.

For a fuller insights on the causes of psychological/emotional trauma see our adult trauma history questionnaire.

Why can an event cause an emotionally traumatic response in one person and not in another?

There is no clear answer to this question, but it is likely that one or more of these factors are involved:

• the severity of the event;
• the individual’s personal history (which may not even be recalled);
• the larger meaning the event represents for the individual (which may not be immediately evident);
• coping skills, values and beliefs held by the individual (some of which may have never been identified); and
• the reactions and support from family, friends, and/or professionals.

Anyone can become traumatized. Even professionals who work with trauma, or other people close to a traumatized person, can develop symptoms of “vicarious” or “secondary” traumatization. Developing symptoms is never a sign of weakness. Symptoms should be taken seriously and steps should be taken to heal, just as one would take action to heal from a physical ailment. And just as with a physical condition, the amount of time or assistance needed to recover from emotional trauma will vary from one person to another.

What are the symptoms of emotional trauma?

There are common effects or conditions that may occur following a traumatic event. Sometimes these responses can be delayed, for months or even years after the event. Often, people do not even initially associate their symptoms with the precipitating trauma. The following are symptoms that may result from a more commonplace, unresolved trauma, especially if there were earlier, overwhelming life experiences:

Physical
• Eating disturbances (more or less than usual)
• Sleep disturbances (more or less than usual)
• Sexual dysfunction
• Low energy
• Chronic, unexplained pain

Emotional
• Depression, spontaneous crying, despair and hopelessness
• Anxiety
• Panic attacks
• Fearfulness
• Compulsive and obsessive behaviors
• Feeling out of control
• Irritability, angry and resentment
• Emotional numbness
• Withdrawal from normal routine and relationships

Cognitive
• Memory lapses, especially about the trauma
• Difficulty making decisions
• Decreased ability to concentrate
• Feeling distracted
• ADHD symptoms

The following additional symptoms of emotional trauma are commonly associated with a severe precipitating event, such as a natural disaster, exposure to war, rape, assault, violent crime, major car or airplane crashes, or child abuse. Extreme symptoms can also occur as a delayed reaction to the traumatic event.

Re-experiencing the Trauma
• intrusive thoughts
• flashbacks or nightmares
• sudden floods of emotions or images related to the traumatic event

Emotional Numbing and Avoidance
• amnesia
• avoidance of situations that resemble the initial event
• detachment
• depression
• guilt feelings
• grief reactions
• an altered sense of time Increased Arousal
• hyper-vigilance, jumpiness, an extreme sense of being “on guard”
• overreactions, including sudden unprovoked anger
• general anxiety
• insomnia
• obsessions with death

What are the possible effects of emotional trauma?

Even when unrecognized, emotional trauma can create lasting difficulties in an individual’s life. One way to determine whether an emotional or psychological trauma has occurred, perhaps even early in life before language or conscious awareness were in place, is to look at the kinds of recurring problems one might be experiencing. These can serve as clues to an earlier situation that caused a dysregulation in the structure or function of the brain.

Common personal and behavioral effects of emotional trauma:
• substance abuse
• compulsive behavior patterns
• self-destructive and impulsive behavior
• uncontrollable reactive thoughts
• inability to make healthy professional or lifestyle choices
• dissociative symptoms (“splitting off” parts of the self)
• feelings of ineffectiveness, shame, despair, hopelessness
• feeling permanently damaged
• a loss of previously sustained beliefs

Common effects of emotional trauma on interpersonal relationships:
• inability to maintain close relationships or choose appropriate friends and mates
• sexual problems
• hostility
• arguments with family members, employers or co-workers
• social withdrawal
• feeling constantly threatened


What are the symptoms of psychological trauma?

Many people have strong emotional or physical reactions following experience of a traumatic event. For most, these reactions subside over a few days or weeks. For some, the symptoms may last longer and be more severe. This may be due to several factors such as the nature of the traumatic event, the level of available support, previous and current life stress, personality, and coping resources.

Symptoms of trauma can be described as physical, cognitive (thinking), behavioural (things we do) and emotional.

Physical

Excessive alertness, on the look-out for signs of danger
Easily startled
Fatigue/exhaustion
Disturbed sleep
General aches and pains

Cognitive (thinking)

Intrusive thoughts and memories of the event
Visual images of the event
Nightmares
Poor concentration and memory
Disorientation
Confusion

Behavioural

Avoidance of places or activities that are reminders of the event
Social withdrawal and isolation
Loss of interest in normal activities

Emotional

Fear
Numbness and detachment
Depression
Guilt
Anger and irritability
Anxiety and panic


what is a potentially traumatic event?

Potentially traumatic events are powerful and upsetting incidents that intrude into daily life. They are usually defined as experiences which are life threatening, or where there is a significant threat to one’s physical or psychological wellbeing.

The same event may have little impact on one person but cause severe distress in another individual. The impact that an event has may be related to the person’s mental and physical health, level of available support at the time of the event, and past experience and coping skills.

Situations and events that can lead a person to experience psychological trauma include:

Acts of violence such as an armed robbery, war or terrorism
Natural disasters such as bushfire, earthquake or floods
Interpersonal violence such as rape, child abuse, or suicide of a family member or friend
Involvement in a serious motor vehicle or workplace accident.

Other less severe but still stressful situations can also trigger traumatic reactions in some people.


list of traumas

• Community Violence
• Complex Trauma
• Domestic Violence
• Early Childhood Trauma
• Medical Trauma
• Natural Disasters
• Neglect
• Physical Abuse
• Refugee Trauma
• School Violence
• Sexual Abuse
• Terrorism
• Traumatic Grief

Community Violence

Community violence includes predatory violence (robbery, for example) and violence that comes from personal conflicts between people who are not family members. It may include brutal acts such as shootings, rapes, stabbings, and beatings. Children may experience trauma as victims, witnesses, or perpetrators.

Complex Trauma

The term complex trauma describes the problem of children’s exposure to multiple or prolonged traumatic events and the impact of this exposure on their development. Typically, complex trauma exposure involves the simultaneous or sequential occurrence of child maltreatment—including psychological maltreatment, neglect, physical and sexual abuse, and domestic violence—that is chronic, begins in early childhood, and occurs within the primary caregiving system. Exposure to these initial traumatic experiences—and the resulting emotional dysregulation and the loss of safety, direction, and the ability to detect or respond to danger cues—often sets off a chain of events leading to subsequent or repeated trauma exposure in adolescence and adulthood.

Domestic Violence

Domestic violence—sometimes called intimate partner violence, domestic abuse, or battering—includes actual or threatened physical or sexual violence or emotional abuse between adults in an intimate relationship. This clinical definition is broader than the legal definition, which may be restricted to acts of physical harm. Domestic violence can be directed toward a current or former spouse or partner, whether they are heterosexual or same-sex partners.
Anywhere from 3 to 10 million children are exposed to domestic violence in the United States every year. Studies suggest that the majority of children who are exposed to domestic violence are young-under the age of 8.

Early Childhood Trauma

Early childhood trauma generally refers to the traumatic experiences that occur to children aged 0-6. These traumas can be the result of intentional violence—such as child physical or sexual abuse, or domestic violence—or the result of natural disaster, accidents, or war. Young children also may experience traumatic stress in response to painful medical procedures or the sudden loss of a parent/caregiver.

Medical Trauma

Pediatric medical traumatic stress refers to reactions that children and their families may have to pain, injury, and serious illness; or to “invasive” medical procedures (such as surgery) or treatments (such as burn care) that are sometimes frightening. Reactions can affect the mind as well as the body. For example, children and their families may become anxious, irritable, or on edge. They may have unwanted thoughts or nightmares about the illness, injury, or the hospital. Some people may avoid going to the doctor or the hospital, or lose interest in being with friends and family and in things they used to enjoy. As a result, they may not do well at school, work, or home. How children and families cope with these changes is related to the person’s own thoughts and feelings about the illness, injury, or the hospital; reactions can vary, even within the same family.

Natural Disasters

A disaster is any natural catastrophe (for example, tornadoes, hurricanes, and earthquakes) or any fire, flood, or explosion that causes enough damage that local, state, or federal agencies and disaster relief organizations are called into action. Disasters can result from a man-made event (such as a nuclear reactor explosion), but if the damage is caused intentionally, it is classified as an act of terrorism.

Neglect

Child neglect occurs when a parent or caregiver does not give a child the care he or she needs according to its age, even though that adult can afford to give that care or is offered help to give that care. Neglect can mean not giving food, clothing, and shelter. It can mean that a parent or caregiver is not providing a child with medical or mental health treatment or not giving prescribed medicines the child needs. Neglect can also mean neglecting the child’s education. Keeping a child from school or from special education can be neglect. Neglect also includes exposing a child to dangerous environments. It can mean poor supervision for a child, including putting the child in the care of someone incapable of caring for children. It can also mean abandoning a child or expelling it from home. Neglect is the most common form of abuse reported to child welfare authorities.

Physical Abuse

Physical abuse means causing or attempting to cause physical pain or injury. It can result from punching, beating, kicking, burning, or harming a child in other ways. Sometimes, an injury occurs when a punishment is not appropriate for a child’s age or condition. Physical abuse can consist of a single act or several acts. In extreme cases, it can result in death.

Refugee Trauma

Refugee trauma include exposure to war, political violence, or torture. Refugee trauma can be the result of living in a region affected by bombing, shooting, or looting, as well as forced displacement to a new home due to political reasons. Some young refugees have served as soldiers, guerrillas, or other combatants in their home countries, and their traumatic experiences may closely resemble those of combat veterans.

School Violence

School violence includes fatal and nonfatal student or teacher victimization, threats to or injury of students, fights at school, and students carrying weapons to school. Formal definitions of school violence range from very narrow to very broad. The Center for the Prevention of School Violence, for example, defines it broadly as “any behavior that violates a school’s educational mission or climate of respect or jeopardizes the intent of the school to be free of aggression against persons or property, drugs, weapons, disruptions, and disorder.”

Sexual Abuse

Child sexual abuse includes a wide range of sexual behaviors that take place between a child and an older person or alternatively between a child and another child/adolescent. Behaviors that are sexually abusive often involve bodily contact, such as sexual kissing, touching, fondling of genitals, and intercourse. However, behaviors may be sexually abusive even if they do not involve contact, such as of genital exposure (“flashing”), verbal pressure for sex, and sexual exploitation for purposes of prostitution or pornography.

Terrorism

Terrorism is defined in a variety of formal, legal ways, but the essential element is the intent to inflict psychological damage on an adversary. The US Department of Defense defines terrorism as “the calculated use of violence or the threat of violence to inculcate fear, intended to coerce or to intimidate governments or societies in the pursuit of goals that are generally political, religious, or ideological.” Terrorism includes attacks by individuals acting in isolation

Traumatic Grief

Childhood traumatic grief may occur following a death of someone important to the child when the child perceives the experience as traumatic. The death may have been sudden and unexpected (e.g., through violence or an accident), or anticipated (e.g., illness or other natural causes).
The distinguishing feature of childhood traumatic grief is that the trauma symptoms interfere with the child’s ability to go through the typical process of bereavement. The child experiences a combination of trauma and grief symptoms so severe that any thoughts or reminders, even happy ones, about the person who died can lead to frightening thoughts, images, and/or memories of how the person died.


Developmental Factors
Chronic early trauma — starting when the individual’s personality is forming — shapes a child’s (and later adult’s) perceptions and beliefs about everything.

Severe trauma can have a major impact on the course of life. Childhood trauma can cause the disruption of basic developmental tasks. The developmental tasks being learned at the time the trauma happens can help determine what the impact will be. For example, survivors of childhood trauma can have mild to severe deficits in abilities such as:
1. self-soothing
2. seeing the world as a safe place
3. trusting others
4. organized thinking for decision-making
5. avoiding exploitation
Disruption of these tasks in childhood can result in adaptive behavior, which may be interpreted in the mental health system as “symptoms.” For example :
1. disrupted self-soothing can be labeled as agitation
2. the disrupted ability to see the world as a safe place looks like paranoia
3. distrust of others can be interepreted as paranoia (even when based on experience)
4. disruptions in organized thinking for decision-making appears as psychosis
5. avoiding/preempting exploitation is called self-sabotage
Psychological effects are likely to be most severe if the trauma is:
1. Human caused
2. Repeated
3. Unpredictable
4. Multifaceted
5. Sadistic
6. Undergone in childhood
7. And perpetrated by a caregiver
• Rape
• Domestic violence
• Natural disasters
• Severe illness or injury
• The death of a loved one
• Witnessing an act of violence

Emotional and psychological trauma can be caused by:
• One-time events, such as an accident, injury, natural disaster, or violent attack
• Ongoing, relentless stress, such as living in a crime-ridden neighborhood or battling a life-threatening illness
• Commonly overlooked causes, such as surgery (especially in the first 3 years of life), the sudden death of someone close, the breakup of a significant relationship, or a humiliating or deeply disappointing experience

An event will most likely lead to emotional or psychological trauma if:
• It happened unexpectedly.
• You were unprepared for it.
• You felt powerless to prevent it.
• It happened repeatedly.
• Someone was intentionally cruel.
• It happened in childhood.

Emotional and psychological symptoms of trauma:
• Shock, denial, or disbelief
• Anger, irritability, mood swings
• Guilt, shame, self-blame
• Feeling sad or hopeless
• Confusion, difficulty concentrating
• Anxiety and fear
• Withdrawing from others
• Feeling disconnected or numb
Physical symptoms of trauma:
• Insomnia or nightmares
• Being startled easily
• Racing heartbeat
• Aches and pains
• Fatigue
• Difficulty concentrating
• Edginess and agitation
• Muscle tension

psychic




SYMPTOMS OF TRAUMA

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The behaviors caused by trauma sometimes depend on a child’s age when the symptoms appear. However, some symptoms can affect all children, including:
* Major changes in eating or sleeping
* Nightmares
* Anger or rage
* Unreasonable fear
* Unusually strong startle reactions

SYMPTOMS OF TRAUMA: BIRTH – 2

http://recognizetrauma.bmobilized.com/?task=get&ihash=70f8e24828&url=http%3A%2F%2Fwww.recognizetrauma.org%2Fsymptoms0-2.php

All infants and toddlers become angry or have tantrums at times. The following symptoms might indicate the child has experienced a traumatic event if they are excessive or interfere with the child’s or family’s lives.
* Unusually high level of anger
* Tantrums that do not stop within a few minutes
* Inability to be soothed or comforted
* Agitation
* Heightened startle response (easily startled)
* Terrified responses to sights, sounds, etc., that remind the child of the trauma
* New fears
* Loss of skills such as use of the toilet and/or speech (children at this age may quit speaking)
* Aggression towards family and others
* Fear of adults who remind them of the trauma
* Fear of being separated from parent or caregiver
* Eating problems such as loss of appetite, low weight or digestion issues
* Nightmares
* Sleeplessness
* Irritability
* Listlessness
* Withdrawal from previously trusted adults
* Avoidance of eye contact and/or physical contact

SYMPTOMS OF TRAUMA: AGES 3-5

http://recognizetrauma.bmobilized.com/?task=get&ihash=f4df7faf94&url=http%3A%2F%2Fwww.recognizetrauma.org%2Fsymptoms3-5.php

Every preschooler becomes angry or distracted at times. The following symptoms might indicate the child has experienced a traumatic event if they are excessive or interfere with the child’s or family’s lives.
* Unusually high level of anger/excessive temper
* Tantrums that do not stop within a few minutes
* Inability to be soothed or comforted
* Aggression towards family and others
* Verbal abuse towards others
* Overly bossy or controlling
* Disruptive (may be expelled from preschool due to behaviors)
* Agitation
* Difficulty focusing or learning
* Development of learning disabilities
* Poor skills development
* Loss of skills, such as speech, use of the toilet
* Bedwetting
* Acting out in social situations
* Fear of adults who remind them of the trauma
* Fear of being separated from parent or caregiver
* Withdrawal from family and friends
* Avoidance of eye contact and/or physical contact
* Inability to trust others or make friends
* Imitating the traumatic event
* Heightened startle response (easily startled)
* Terrified responses to sights, sounds, etc., that remind the child of the trauma
* Eating problems such as loss of appetite, low weight or digestion issues
* Lack of self confidence
* Stomach aches and headaches
* Loneliness
* Confusion
* Unusual clinginess
* Overly obedient (fear of punishment for not obeying)
* Wild eyed, especially when stressed
* Nightmares
* Sleeplessness
* Irritability
*

SYMPTOMS OF TRAUMA: AGES 6-12

http://recognizetrauma.bmobilized.com/?task=get&ihash=fb2c65b5d8&url=http%3A%2F%2Fwww.recognizetrauma.org%2Fsymptoms6-11.php

Every child has difficulty concentrating or gets angry sometimes. The following symptoms might indicate the child has experienced a traumatic event if they are excessive or interfere with the child’s or family’s lives.
* Unusually high level of anger/excessive temper
* Aggression towards family and others
* Verbal abuse towards others
* Overly bossy or controlling
* School problems
* Difficulty concentrating
* Suicidal thoughts or actions
* Stomachaches, headaches and other physical complaints
* Withdrawal from friends and family
* Fear of being separated from caregiver
* Acting out in social situations
* Imitating the traumatic event
* Fear of adults who remind them of the trauma
* Eating problems such as loss of appetite, low weight or digestion issues
* Nightmares
* Sleeplessness
* Irritability
* Inability to trust others or make friends
* Lack of self confidence
* Loneliness
* Confusion
* Drug or alcohol use
* Clinginess
* Sexual knowledge beyond the child’s age
* Overreaction to situations
* Re-creation of the traumatic event during play
* Hoarding of food

SYMPTOMS OF TRAUMA: AGES 13-18

http://recognizetrauma.bmobilized.com/?task=get&ihash=b49d91e894&url=http%3A%2F%2Fwww.recognizetrauma.org%2Fsymptoms12-18.php

Every adolescent has problems at school or gets angry sometimes. The following symptoms indicate the child has experienced a traumatic event if they are excessive or interfere with the child’s or family’s lives.
* Unusually high level of anger
* Aggression towards family and others
* Verbal abuse towards others
* Overly controlling
* School problems
* Difficulty concentrating
* Suicidal thoughts or actions
* Drug or alcohol use
* Associating with negative peers or adults
* Risky behaviors, including sexual behaviors
* Unhealthy romantic relationships
* Self harm
* Panic attacks
* Shame
* Flashbacks
* Hostility
* Hoarding of food
* Overly self-reliant
* Running away
* Starting fights
* Trouble relating to peers
* Defiant
* Mistrustful
* Inability to see a future (expects to die young)
* Alienated
* Stomachaches, headaches and other physical complaints
* Withdrawal from friends and family
* Acting out in social situations
* Avoidance of situations that remind the child of the trauma
* Eating problems
* Nightmares
* Sleeplessness
* Irritability
* Inability to trust others or make friends
* Poor self esteem
* Loneliness

trauma

Experiencing trauma in childhood can have a severe and long-lasting effect. When childhood trauma is not resolved, a sense of fear and helplessness carries over into adulthood, setting the stage for further trauma.

Childhood trauma results from anything that disrupts a child’s sense of safety, including:
• An unstable or unsafe environment
• Separation from a parent
• Serious illness
• Intrusive medical procedures
• Sexual, physical, or verbal abuse
• Domestic violence
• Neglect
• Bullying


 

 

 

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