Psychiatric Quarterly [psaq] ph077-psaq-361314 March 13, 2002 19:58 Style ﬁle version Nov. 19th, 1999
Psychiatric Quarterly, Vol. 73, No. 2, Summer 2002 (
THE TRAUMA OF PROFOUND
CHILDHOOD LOSS: A PERSONAL
AND PROFESSIONAL PERSPECTIVE
Francine Cournos, M.D.
Profound loss in childhood as a precipitant for symptoms of posttraumatic
stress disorder has been a largely neglected subject. There is now some litera-
ture to suggest that severe loss and the absence of care may be as predictive of
psychological distress in children as events that are more frequently studied,
such as exposure to natural disasters and physical or sexual abuse. This paper
combines the author’s personal experience as an orphaned child who was placed
in foster care with a discussion of this emerging literature to examine the
relationship between childhood loss and trauma symptoms. An awareness of
the traumatic nature of severe losses in childhood could help caregivers and
mental health professionals deal more effectively with such children.
KEY WORDS: childhood trauma; childhood loss; childhood bereavement; foster care.
Trauma in general, and posttraumatic stress disorder in particular,
presents a unique mental health problem. The symptoms associated
with trauma skirt the boundaries of, and may be comorbid with, many
The author is Professor of Clinical Psychiatry, Columbia University, and Director,
Washington Heights Community Service, New York State Psychiatric Institute.
Address correspondence to Francine Cournos, M.D., New York State Psychiatric
Institute, 1051 Riverside Drive, Unit 112, New York, NY 10032.
2002 Human Sciences Press, Inc.