It Is Not Always About PTSD

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This is the second in a series of articles regarding Trauma-Informed Psychological Evaluations.
Part 1 here  |  
Part 3 here

By Dr. Julianne Ludlam

​Although disorders like PTSD are considered synonymous with trauma, a history of trauma can lead to a variety of other psychological disorders and physical problems – issues that are not always considered unless a careful assessment is conducted. As was abundantly shown in the Adverse Childhood Experiences (ACE) studies, there appears to be a direct link between childhood trauma and a myriad of negative outcomes (Felitti et al., 1998; Felitti et al., 2018; Gilbert et al., 2010). These negative outcomes include an increased risk for psychiatric conditions (including depression, anxiety disorders, bipolar disorder and schizophrenia, addictive disorders, eating disorders, dissociative disorders, and personality disorders) as well as chronic diseases and health problems (including chronic bronchitis, hepatitis, skeletal fractures, heart disease, cancer, and lung disease). Adverse childhood experiences were also linked to problematic health-related behaviors starting in childhood and adolescence, including smoking, sexual activity, drug use, adolescent pregnancy, and suicide attempts. The ACE Studies have demonstrated clear evidence of a dose-response model – the more adverse experiences, the higher the likelihood of negative outcomes (Felitti et al., 1998; Felitti et al., 2018; Edwards, Holden, Anda, & Felitti, 2003), and this direct relationship has been shown for all types of trauma (e.g., Follette, Polusney, Bechtle, & Naugle, 1996).

What is a trauma-informed psychological evaluation?
​Trauma-informed psychological evaluations (also referred to as trauma-informed mental health assessments) can address the complexities of misdiagnosed or unrecognized trauma, disproportionate adverse experiences, and other possible psychological and physical impacts. A trauma-informed evaluation is a comprehensive process conducted by a trained clinician to determine whether clinical symptoms related to traumatic stress are present and to characterize the severity of symptoms and impact on an individual’s functioning (Conradi, Wherry, & Kisiel, 2011; National Child Traumatic Stress Network, n.d.). Like all comprehensive psychological evaluations, multiple domains are assessed, including broader mental health symptoms, individual/family needs or difficulties, environmental or psychosocial issues, and resources and strengths, but there is an emphasis on trauma and developmental history and traumatic stress symptoms. Like forensic psychological evaluations, multiple methods of data collection are employed, including clinical interviews, psychological testing, and behavioral observations, and data is typically gathered from multiple parties, including collateral contacts. When the goal is to attribute symptoms to a specific event, careful attention is given to the selection of measures and to the client’s recent and remote trauma history, particularly when symptoms are complex or pervasive (Briere & Spinazzola, 2005).

Interested in talking about if a Trauma-Informed Psychological Evaluation is right for your client or case? Contact Dr. Ludlam: drjulianne@kkjpsych.com or call 919-493-1975.

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Julianne Ludlam

I conduct forensic and psychological evaluations for KKJ, and I have two overarching goals in this work. First, I strive for accuracy, honesty, and fairness in all evaluations. Second, it is important to me to demonstrate respect and appreciation for differences between individuals and groups.