Psych Vivas · Child and adolescent psychiatry — childhood trauma and maltreatment
Childhood trauma and maltreatment — structured clinical viva
Fellowship viva covering maltreatment types, ACE graded risk, reporting duty, TF-CBT, safety-first sequencing, and trauma-informed systems.
On this page & tools
Target exams
Interpretation
Reveal interpretation
Exposure vs diagnosis. Physical and emotional abuse are maltreatment exposures; map polyvictimisation and ACE domains for cumulative risk, then diagnose psychiatric sequelae (e.g. PTSD, depression) separately from the protection plan.[1][2]
Assessment. Trauma-informed private child interview, non-leading questions, verbatim documentation, school collateral, suicide/self-harm and sibling risk. Reasonable suspicion → statutory notification. Do not invent section numbers; state principle and multi-agency action.[4]
Mechanisms (brief). Toxic stress / biological embedding and ecophenotype concept (earlier, more severe, more comorbid courses within diagnoses) as group-level framing — not MRI diagnosis of abuse.[6]
Treatment. Safety first. TF-CBT with PRACTICE components once a safe non-offending caregiver and environment allow; RCT evidence for TF-CBT in abuse-related PTSD. Trauma-informed care principles across the system. Medication only as adjunct for comorbidity with monitoring.[3][4][5]
Key points
References
- [1]Felitti VJ, Anda RF, Nordenberg D, et al. Relationship of childhood abuse and household dysfunction to many of the leading causes of death in adults. The Adverse Childhood Experiences (ACE) Study Am J Prev Med, 1998.PMID 9635069
- [2]Gilbert R, Widom CS, Browne K, et al. Burden and consequences of child maltreatment in high-income countries Lancet, 2009.PMID 19056114
- [3]Cohen JA, Deblinger E, Mannarino AP, Steer RA A multisite, randomized controlled trial for children with sexual abuse-related PTSD symptoms J Am Acad Child Adolesc Psychiatry, 2004.PMID 15187799
- [4]Cohen JA, Bukstein O, Walter H, et al. Practice parameter for the assessment and treatment of children and adolescents with posttraumatic stress disorder J Am Acad Child Adolesc Psychiatry, 2010.PMID 20410735
- [5]Harris M, Fallot RD Designing trauma-informed addictions services New Dir Ment Health Serv, 2001.PMID 11291263
- [6]Teicher MH, Samson JA Childhood maltreatment and psychopathology: A case for ecophenotypic variants as clinically and neurobiologically distinct subtypes Am J Psychiatry, 2013.PMID 23982148