Adolescent Cognitive Development After Trauma Raquel A. Figueroa Liberty University
COUN 620-B02

Abstract
In a generation of hopelessness, adolescents seek a purpose for their existence. They seek refugee from violence, abuse and maltreatment. The overwhelming pressure opens the door for instant gratification in drugs, alcohol, sexual activity, and fail to make appropriate adjustments in compromising circumstances. There is a correlation between traumatic experiences and adolescent cognitive development. A traumatic experience can alter an adolescent’s neural system and adversely affect the latter stages of brain development. Working with survivors of traumatic events requires an understanding of maladaptive behaviors, reactions and coping skills. Behavioral patterns emerge and become part of an adolescent’s personality. This paper will highlight the impact of traumatic experiences on adolescent cognitive development and their ability to foster an intrinsic knowledge of self.

Maltreatment of adolescents has reached epidemic proportions within the United States. According to Bright (2008), “One in four children/adolescents experience at least one traumatic event before age 16” (p. 11). A study commissioned by Finkelhor, Ormrod, & Turner (2005) concluded the exposure to “physical abuse, sexual abuse, witnessing domestic violence, community violence, and natural disasters is a common occurrence among children in the U.S.” (p. 314). Reports of abused and neglected children overwhelm Child Protective Services hotline and the lack of manpower hinders response time, case management, and post-care services.
Research has shown adolescent traumatic experiences are most likely perpetuated by an adolescent’s parent or “caregiving system” (van der Kolk, 2005. p. 402). According to van der Kolk (2005), “Most trauma begins at home; the vast majority of people (about 80%) responsible for child maltreatment are children’s own parents” (p. 402). In early childhood development the first few years of a child’s life a caregiver(s) provides an infant with his or her essential needs. An infant communicates his or her needs through crying, the caregiver(s) responds and the infant counter responds establishing an attachment (Feldman, 2008). The continuous stimulation and interaction between infant and caregiver(s) “help pave the way for the development of relationships between children, their parents and the rest of the social world” (Feldman, 2008, p. 193). According to Lubit, Maldonado-Duran and Helmig Bram (2009), “the nature of this relationship colors the person’s relationship for the rest of his or her life” (p. 1). In homes where domestic violence occurs, adolescents are at high-risk for suffering physical, emotional and mental abuse. Regardless of whether adolescents are physically, emotionally or mentally abused the witnessing of violence is similar to experiencing the actual abuse. Bright (2008) says, “Four in 10 children report witnessing violence” (p. 11).
According to Bright (2008) traumatic stress is categorized in three levels of severity. Acute trauma is categorized as a single event that result in “frightening feelings, thoughts and physical reaction” (Bright, 2008, p. 8). A traumatic event such a sudden death, assault or community violence can perpetuate overwhelming feelings (Bright, 2008). Chronic trauma is categorized as a continuous sequence of negative events that enhance the previous event (Bright, 2008). Complex trauma is categorized as “exposure to chronic trauma and the impact of such exposure” (Bright, 2008,p. 10) has detrimental consequences on adolescent development. Research shows chronic or complex trauma will take longer to recuperate from than an acute experience. According to Malchiodi (2009), “The Complex Trauma Taskforce of the National Child Traumatic Stress Network (NCTSN) undertook a significant step in identifying and resolving the problems associated with diagnosing complex trauma in children” (p. 1). Adolescents diagnosed with complex trauma are more likely to engage in “maladaptive attempts at self-soothing” (van der Kolk & Pynoos, 2009, p. 11) that is expressed in high-risk behavior, chemical or substance dependency or aggressiveness toward others.
Adolescents exposed to a traumatic event are predisposed to high-risk behaviors that range from “serious mental and physical health problems” (Bright, 2008, p. 18). Substance and chemical dependency, sexual activity, severe despondency, and suicide are just a few examples of maladaptive coping skills adolescents discover as a means of managing overwhelming emotions (Bright, 2008). Evidence suggests adolescents who think about how the trauma could have been prevented may suffer from extreme guilt. Untreated maladaptive behavior can become lethal toward others or themself.
Adolescents face a conundrum of developmental challenges as they navigate through traumatic experiences and make positive use of healthy coping skills. Self-awareness and self-regulation are two important skills traumatized adolescents can learn to control their emotions and self-talk. Counselors working with adolescents suffering or recovering from a traumatic experience must create a safe environment conducive to the therapeutic process and where he or she feels secure. Counselors cannot and should not reassure an adolescent that he or she will be immune to future traumatic experiences (Cohen, Mannarino & Deblinger, 2012). The therapeutic process should help cultivate the “relevant safety skills to enhance children’s sense of mastery and self-efficacy when faced with future stressors or tauma” (Cohen, Mannarino & Deblinger, 2012, p. 18). According to McAlister Groves (1999), “Therapy can provide a safe haven where children can express” (p. 128) verbally or nonverbally their emotions freely. Creating a bond between a counselor and adolescent “is an important component of successful therapy (McAlister Groves, 1999, p. 128). It is essential that a “counselor have impeccable character” (Clinton & Ohlschlager, 2002, p. 182) in order to gain credibility with an adolescent client. The primary function of a counselor is to help adolescents’ self-regulate overwhelming feelings and acknowledge the repercussions of trauma on his or her cognitive development, behavior, and relationships with others. According to Hahn (2008) “The reduction of psychological harm caused by exposure to traumatic events is thus a critical goal of public health” (p. 314).
The impact of a traumatic event is a combination of key factors and subjective to the victim or witness. It is impossible to predict how a traumatic event will affect an adolescent physically, mentally or emotionally. It is important, however, to note that not all adolescents who experience a traumatic event is traumatized nor suffer the same developmental deficiency. Therefore, victims of traumatic events require a treatment plan according to their needs assessment in order to effectively guide an adolescent toward a healthy emotional and mental recovery.
Working Definition of Developmental Trauma
A working definition of adolescent developmental trauma is the interruption of normal developmental processes, e.g. emotional, psychological, or cognitive. A traumatic experience refers to the physical and emotional reaction to an event that endangers an adolescent’s wellbeing. When traumatic experiences overwhelm an adolescent’s ability to effectively deal with compound feelings, it will impact how he or she perceives self and others. When that level of interruption or interference occurs on a regular basis maladaptive behaviors begin to manifest.
Traumatized adolescents are subjected to various responses as a means of coping. Some adolescents may demonstrate “behavior in an unconscious attempt to counter feelings of helplessness and importance” (Bright, 2008, p. 19). Whereas, other adolescents may demonstrate “cognitive delays or deficits in planning, organizing and exerting control over behavior” (Bright, 2008, p. 19). It is evident that trauma activates a stress response in the neural system in the brain (Ziegler, 2011). The implications of “trauma-induced alterations in biological stress” (Bright, 2008, p. 20) prevent the successful adolescent development of brain and cognitive skills.
Function of the Human Brain The brain is the most complex organ in the human body and is use dependent (Ziegler, 2011; Blaustein & Kinniburgh, 2010). Its functionality, e.g., ability to multitask, process and recall information, “sets man apart from even his closest animal peers” (Ziegler, 2011, p. 1). According to Ziegler (2011), “The size of the human brain in comparison to body size is largest among all other animal brains” (p. 1). The human brain has developed beyond innate survival instincts into a realm of “paradigms for understanding itself” (Ziegler, 2011, p. 1) and ability to “adapt and change in response to experience and maturation” (Blaustein & Kinniburgh, 2010, p. 10).
The human brain functions as a “human computer” (Ziegler, 2011, p. 2) because of its ability to process information and render a decision. According to Ziegler (2011), “No computer has been able to duplicate the variety or sophistication of the brain” (p. 2). The hardware consists of “physiological components of the main areas of the brain: the brainstem, the limbic system and the neocortex” (Ziegler, 2011, p. 4). The software component consists of data received “through the body’s sensory system” (Ziegler, 2011, p. 4) and processed through the neural system blueprint. The more triggers or stimulation the neural system receives the more it changes. Hence, when “specific changes happen in the brain in response to repeated input, or patterns” (Blaustein & Kinniburgh, 2010, p. 10) the information becomes imprinted. Based on the neural system blueprint, the information received will be processed in either an effective or ineffective manner (Ziegler, 2011). An ineffective neural system blueprint will hinder an individual’s ability to use information received in a utilitarian way. According to van der Kolk (2005) a traumatized adolescent’s trigger “pattern of repeated dysregulation” (p. 404) occurs by impulse “in presence of cues” (p. 404) or triggers.
Researchers show a correlation between the “reduced size of the cortex” (Bright, 2008, p. 21) and childhood traumatic experience. According to Ziegler (2011), “This is an issue we will see in traumatized brains and the way they function” (p. 4). Although the human brain is more sophisticated than a computer and “it is living and organic rather than mechanical” (Ziegler, 2011, p. 2), thus has the proficiency to develop schemes. Piaget (Feldman, 2008) believed schemes are homogenous to computer software because of its ability to “direct and determine how data” (p. 151) from environmental interactions are viewed, evaluated and acted upon. At birth, the human brain has close to 100 billion brain cells that “communicate with each other to form 1,000 trillion synaptic connections by three years of age” (Ziegler, 2011, p. 2). According to Feldman (2008) Piaget theorized “children pass through a series of four universal stages in a fixed order from birth through adolescence: sensorimotor, preoperational, concrete operational and formal operational” (p. 151). The interference or interruption of the four stages of cognitive development will manifest itself in the behavior, communication skills and academic success.
Effects of Trauma on Adolescent Brain Development Adolescents exposed to a chronic or complex traumatic event may experience different emotions “than those who may have experienced an acute, single incident of trauma or loss” (Malchiodi, 2009, p. 1). Van der Kolk (Malchiodi, 2009) presents empirical evidence suggesting children exposed to chronic or complex trauma face adverse development. The “proposed developmental trauma disorder (DTD)” (Malchiodi, 2009, p. 1) diagnosis offers a more suitable description and treatment plan to adolescents with developmental adversities. Years of repeated exposure to violence, sexual and physical abuse perpetuates “feelings of rage, fear, shame, defeat and withdrawal” (Malchiodi, 2009, pp. 1-2), which can hinder an adolescent’s social skills. Van der Kolk and Pynoos (2009) suggest:
That an alternative diagnosis was necessary to capture the spectrum of coherent symptoms of children exposed to interpersonal violence and disruptions in caregiving, van der Kolk (2005) proposed the creation of a Developmental Trauma Disorder diagnosis and described the broad domains of impairment and distress that characterize these children and adolescents (p. 5).
Adolescents experiencing chronic traumatic events are taught how to behave by activating a stress response system in the brain that will keep him or her in constant “fight, flight, freeze or fright” (Krantwitz & Miller, 2005, p. 71) mode. Early exposure to trauma compromises “the development of the brain regions that would normally help children manage fears, aggression, and control impulse” (Bright, 2008, 22). This alteration obstructs an adolescent’s self-awareness and self-regulation of emotions.
All adolescents experience a form of positive or negative stress; however, the manner in which stress is dealt with is a key factor in their development. The emotional stress perpetuates a complex combination of perception of events, experience, memory, and body chemistry (Rhoton, 2011). Severe or complex stress prevents the brain from returning to a relaxed state or baseline. Therefore, when the next traumatic event occurs the adolescent’s stress level begins at a higher range because it never retuned to its original baseline. This alteration in response will influence how an adolescent reacts to future events and will have implications on their “long term health” (Bright, 2008, p. 20). According to van der Kolk (2005) explains the impact of “persistently altered attributions and expectancies” (p. 404) of developmental trauma as “negative self-attribution, distrust of protective caretaker, loss of expectancy of protection by others and inevitability of future victimization” (p. 404). For example an adolescent raised in a home of constant screaming and arguing will interpret the behavior as normal interaction with others. The brain is being taught to respond to those types of stimulants. Adolescents with poor communication skills are not effective in responding to feedback or making behavioral changes based on feedback. An after product of emotional abandonment is a maladaptive coping skill using self-talk to control his or her behavior and direct future actions. This process requires taking an event apart, analyzing the components and reconstructing the event with a different outcome.
Perpetuating Factors in Adolescent Trauma
Various factors contribute and perpetuate the interference and interruption of adolescent development (Rhoton, 2010). The impact of a traumatic event is contingent upon the adolescent’s age and cognitive developmental stage, perception, role, “relationship to victim or perpetrator, past experience and availability of supportive adults” (Bright, 2008, p. 13). Adolescents with parents or caregivers that are emotionally unavailable perpetuate disconnection and rejection (Rhoton, 2010). McAlister Groves (1999) explains the vital role parents partake in their adolescent’s trauma when she states:
Children exposed to community- based violence, or trauma caused by an accident, often have access to one or both parent(s) for psychological support. By contrast, children who witness domestic violence may not have such emotional refuge—the perpetrating parent is unsafe and the battered parent may be emotionally unavailable because of her own trauma (p. 128).
A parent that arrives home from work and sits in front of a computer until everyone is asleep fail to share an emotional connection is defined as emotional abandonment. This instability in behavior makes it difficult to predict when it would be an appropriate time to approach a parent or caregiver or know with certainty who can be trusted. McAlister Groves (1999) states:
Typically, children turn to their parents for protection in times of stress or fear. Research indicates that if children have access to a parent, they are more resilient in response to trauma than are children who do not (p. 128).
Parents or caregivers that consistently interfere with an adolescent’s ability to operate independently and successfully are perpetuating impaired autonomy and performance (Rhoton, 2010). An adolescent believes that without their parent or caregiver he or she is unable to live without their provider, operate independently or succeed (Rhoton, 2010) and learn to become codependent.
Treatment
According to Hahn (2008) adolescents suffering or recovering from a traumatic event can benefit from “psycho-education and trauma-focused therapy, including cognitive behavioral techniques” (p. 314). Cognitive-behavioral therapy has been found to be “safe and effective to use with” (Hahn, 2008, p. 314) adolescents suffering or recovering from a traumatic event. This approach has received support from the American Academy of Child and Adolescent Psychiatry and The National Center for Post-Traumatic Stress Disorder (Hahn, 2008). According to Cohen, Mannarino, & Deblinger (2012), “Cognitive coping is the component that lays the groundwork for helping children and parents understand the connections between their thoughts, feelings and behaviors” (p. 14). In addition, The National Institute of Mental Health suggests art therapy can be beneficial to adolescents because he or she may be unable to verbally express their emotions (Hahn, 2008). McAlister Groves (1999) states:
These approaches share several goals: promoting open discussion about children’s experiences with domestic violence, helping children to deal with the emotions and consequences that follow such exposure, reducing the problematic symptoms children experience, strengthening children’s relationships with their nonabusive caregivers, and helping children and their families to create and maintain relationships and living situations that are free from violence and abuse (p. 122).
The involvement and support of a strong family unit is vital in the treatment and recovery process. This support can help facilitate the challenges an adolescent will encounter as he or she begins to make sense of their emotions. After a traumatic event, it is important for the family to seek a professional mental health provider or encourage their adolescent to speak with someone capable of providing assistance, e.g., a school guidance counselor or pastor. An assessment will help identify high-risk behaviors and “help determine interventions that will reduce risk” (Bright, 2008, p. 35). The purpose of the assessment it to contextualize behaviors associated with the traumatic event and explore family histories.
Family history is important for understanding family psychodynamic and highlighting patterns. Underlying factors and family history are essential to behavioral and communication patterns. Adolescents assume a role within their family unit and are preconditioned to assume identical behavior as their parent or caregiver. The role can be beneficial or detrimental to an adolescent’s development. Thus the destructive behavioral patterns will significantly impact how an adolescent perceives the world, self and others.
High-risk behaviors and a past traumatic experiences is indicative of an unhealthy combination of factors that if left unresolved or untreated can become detrimental to the adolescent’s physical, mental and emotional health.. Based on the assessment, the health care professional is able to develop a treatment plan with realistic goals “designed to reduce negative effects of trauma” (Bright, 2008, p. 25). This allows the adolescent an opportunity to discuss the traumatic event, his or her emotions, and future preventative measure. After a traumatic event, an adolescent is thinking about how to prevent the same or similar event from reoccurring, which can cause additional stress and trauma. A beneficial treatment plan will conclude improving communication and listening skills, improving problem-solving and non-violence conflict resolution skills and enhancing emotional honesty.
Nurturing an Adolescent’s Spiritual Character
When a parent fails to stay committed to God’s plan, it will be impossible to lead their adolescent. God commanded the Israelites to teach their children “so that the next generation would know them… and would put their trust in God and would keep his commands” (Psalm 78:6-7, NIV). Parents play a vital role in the spiritual growth of their adolescent. It is through healthy spiritual development adolescents are influenced to worship and practice their faith within their community. Ratcliff and Ratcliff (2010) says, “churches need families and families need churches”. Likewise the church needs adolescents and adolescents need church. Adolescents “are not the church of the future; they are very much the church today” (Ratcliff & Ratcliff, 2010, p. 5). Just as Christian parents glorify God in church by praising, singing, and ministering Scripture, their adolescent can see and experience their parent’s relationship with God. Pack (2009) postulates “to produce a happy, moral, emotionally mature and productive adult- including a strong relationship with the true God- parents must swim against a swirling ocean of powerful currents represented by the trends, pulls and overwhelming pressures of modern age” (p. 13). Spiritual development is based on the maturity of an adolescent and will occur in two stages (Ratcliff & Ratcliff, 2010). Ratcliff and Ratcliff (2010) postulate:
The maturing of the brain influences this aspect of development a great deal. The second kind of change, spiritual growth, is the more global development that the Bible generally describes, in which an adult can be a spiritual infant and -in contrast- a small child may be very sensitive and responsive to God. This kind of growth is fairly independent of brain maturing (p. 5)
When a parent instructs their adolescent with true knowledge, it will reveal their dependency of God. An adolescent’s confidence in God is the ultimate goal of Christian parents because it externalizes the obedience and submission to God. When adolescents are confident in God, they will follow His commandments. Outward obedience will not be conformity to external pressures and expectations. It will be the fruit of internal confidence that comes from God. Proverbs 14:26-27 (NIV) says, “In fear of the Lord there is strong confidence, and His children will have a place of refuge. The fear of the Lord is a fountain of life, to turn one away from the snares of death.” When parents are truly faithful to God, it will not be an intricate process to instruct their children in the way of the Lord. Adolescent’s are not in bondage to trauma but the lies they believe as a result of the trauma. Eliminating the influence of evil (Colossians 2:15) and seeking the serenity of God’s presence can bestow an adolescent’s single-focused mindset and heart. The root of physiological conflict, e.g. fear, anxiety, distrust, addiction, high-risk behavior, etc., is a belief that is not based on truth (Clinton, Olhschlager, & Hart, 2005). These false beliefs must be rooted out with the power of the Holy Spirit and replaced with God’s truth. An adolescent suffering or recovering from a traumatic event must be committed to work out a plan of responsible behavior and carry out the plan of action with faith in Jesus Christ. According to Hinson (1996), “Faith is so important that it is mentioned more than three hundred times in the Bible” (p.15). When an adolescent elects “the truth as revealed in God’s Word” (Anderson, 2003, p.198) something amazing transpires. The adolescent becomes receptive to God’s voice and His fellowship. Curtis and Eldredge (1997) state: This longing is the most powerful part of any human personality. It fuels our search for meaning, for wholeness, for a sense of being truly alive. However we may describe this deep desire, it is the most important thing about us, our heart of hearts, the passion of our lives. And the voice that calls us in this place is none other than the voice of God (p.7).
The counselor’s responsibility to discern the heart of the adolescent within the realm of the Scripture can shed light on the pain and conflict that require attention. It is the responsibility of the counselor to guide a traumatized adolescent to the root of emotional pain, psychological and spiritual conflict. Anderson (2003) says, “Consequently, the root issue often remains uncovered and unresolved.” (p.148). A traumatized adolescent may be unaware of a root issue, pattern developed, and what implications a traumatic event has on his or her life. Subsequently, there is almost always a cause and effect relationship that potentially hinders an adolescent’s ability to foster meaningful relationships with self and others and attain spiritual growth.
Adolescents recovering from a traumatic event are encouraged to establish a goal that reflects God’s purpose for their life and is not dependent upon others or circumstances beyond their control. Discipleship counseling offers traumatized adolescents with psychological and emotional conflict an opportunity to resolve their issues by identifying themselves in Christ and displaying His character in the midst of their conflict.
Conclusion
Adolescent trauma can interfere or interrupt brain development processes than can have lasting affects on cognitive development and hinder his or her ability to cultivate nurturing relationships. The overwhelming pressure adolescents face in this generation and lack of parental support perpetuates instant gratification in high-risk behavior. According to Beth Moore (2009) “Whether we seek to have our cup filled through approval, affirmation, control, success, or immediate gratification, we are miserable until something is in it” (p. 91). Adolescents with maladaptive behaviors fail to self-regulate their feelings and self-sooth in unhealthy behaviors. Recovering from a traumatic event varies from one adolescent to another and is contingent upon extenuating factors. Exposure to a traumatic event or events predisposes an adolescent to adverse cognitive development. Research demonstrates early childhood exposure not only affects the brain but also an adolescent’s emotional and physical health. Adolescents exposed to an acute, chronic or complex traumatic events need the assistance of a mental health professional in addition to a support system, e.g. family or community. Research show the importance of parental or caregiver involvement within the therapeutic process. According to Desforges and Abouchaar (2003), “good parenting in the home, including provision of secure and stable environment, intellectual stimulation and good models of constructive social values” (p. 4) perpetuate healthy adolescent development. A combination of a strong support system and therapeutic intervention can facilitate a healthy recovery from an adolescent traumatic experience.

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