Severe emotional trauma that occurs before age 8 and lasts for more than six months is akin to physical brain trauma, says Tatiana Falcone, MD, a child and adolescent psychiatrist at Cleveland Clinic.
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“S100 beta, a protein that is released whenever there’s a breach in the blood-brain barrier, is higher in the brains of people who experienced severe childhood trauma,” says Dr. Falcone. “These people also have a higher prevalence of depression, anxiety and post-traumatic stress disorder.”
Dr. Falcone reveals more about this protein — a potential biomarker for suicidality — in the newest episode of Cleveland Clinic’s Neuro Pathways podcast. She also discusses:
Click the podcast player above to listen to the episode now, or read on for a short edited excerpt. Check out more Neuro Pathways episodes at clevelandclinic.org/neuropodcast or wherever you get your podcasts.
Dr. Falcone: When you’re interviewing an adolescent, it’s very unlikely that they will report anything if the parent is in the room. We have to ask the guardian or parent to give them some space because a lot of people who have been traumatized feel like a victim and don’t want to share that with their parents. I think it’s very important to open this space for them. In general, it’s always important to give kids age 12 and older 10 minutes of their appointment in which you’re talking with them one on one.
Podcast host Glen Stevens, DO, PhD: What if the parent doesn’t want to leave the room?
Dr. Falcone: You slowly start teaching the parent why it is important and how it can be helpful. Parents warm up to the concept.
I also do consults in the hospital for kids who have neurologic disorders. I would say 30% of parents feel comfortable leaving their kid to interview alone. I think the more you talk to parents and explain that it’s very unlikely the kid will be open if parents are here, then you’re building rapport and trust, and they end up agreeing to leave the room.
Now that we’re seeing a lot of patients virtually, that’s one important consideration when asking sensitive questions. We have to ask the parent to please give the patient some privacy. Often I see that the parent might move the computer and move the camera away from their face, but they’re still sitting next to the patient. So I ask the patient to take the computer or phone to a different room. One of the most important parts of the visit is the 10 minutes alone with the patient, when I can openly ask and they can openly respond without being worried about what their parent will think.