Psychological Consequences of Human Trafficking: Complex Posttraumatic Stress Disorder in Trafficked Children.

Trafficked children are frequently exposed to multiple traumatic events, including during their recruitment, transit, and exploitation. It has been hypothesized that such exposures can lead to the development of Complex Posttraumatic Stress Disorder (PTSD). Complex PTSD includes (in addition to the core PTSD symptoms of re-experiencing, avoidance, and hyperarousal) disturbances in affect regulation, dissociation, self-concept, interpersonal relationships, somatization, and systems of meaning. This historical cohort study aimed to investigate Complex PTSD in trafficked children with a diagnosis of PTSD and compare these with nontrafficked controls exposed to single or multiple trauma. Trafficked children were identified by keyword searches of the electronic health records of more than 250,000 mental health service users; a matched cohort of nontrafficked children was randomly selected. Regression models compared the number of Complex PTSD symptoms in trafficked children and non-trafficked children who had experienced multiple or single trauma. Fifty-one trafficked children were identified: eleven with a diagnosis of PTSD (22%). A high proportion of trafficked children with PTSD had Complex PTSD symptoms. Trafficked and non-trafficked children with PTSD who had been exposed to multiple trauma showed a greater number of Complex PTSD symptoms compared to nontrafficked children with PTSD exposed to single-event traumas. Somatic symptoms were noted for almost two-thirds of the trafficked children but only 10%-11% of the nontrafficked children. Child trafficking and multiple trauma exposure are associated with more complex posttraumatic presentations. A thorough clinical assessment at intake is crucial to ensure additional symptoms can be meaningfully incorporated into treatment plans.