Department of Family and Community Medicine, Office of Community Engagement and Neighborhood Health Partnerships, University of Illinois Hospital and Health Sciences System, Chicago, Ill; Center for the Collaborative Study of Trauma, Health Equity, and Neurobiology, an educational program of the Hektoen Institute of Medicine, Chicago, Ill. ajstille@uic.edu
The author reported no potential conflict of interest relevant to this article.
SIDEBAR The lexicon of childhood adversity: Concepts and tools for care33-45
Adversity A state or instance of serious or continued difficulty or misfortune. 33
Attachment A special, enduring form of emotional relationship with a specific person involving soothing, pleasure, and comfort.34
Attunement The ability to read and respond to the cues of another.35
Eye-movement desensitization and reprocessing (EMDR) An evidence-based psychotherapy for posttraumatic stress disorder and other psychiatric disorders, mental health problems, and somatic symptoms. EMDR facilitates resumption of normal information processing and integration; the patient attends to emotionally disturbing material in brief sequential doses while simultaneously focusing on an external stimulus. EMDR targets past experience, current triggers, and future potential challenges, and results in alleviation of presenting symptoms; a decrease or elimination of distress from the disturbing memory; improved view of the self; relief from bodily disturbance; and resolution of present and future anticipated triggers.36
Historical trauma Cumulative emotional and psychological wounding, resulting from group traumatic experiences, transmitted across generations within a community.37
Neurofeedback Electroencephalographic biofeedback is a method for retraining brainwave patterns through operant conditioning; it is used to treat posttraumatic stress disorder, various mental health conditions, addiction, chronic pain, epilepsy, and other disorders.38
Neuromodulatory Having the capacity to alter nerve activity through targeted delivery of a stimulus, such as electrical stimulation or chemical agents, to specific neurological sites in the body to help restore function or relieve symptoms.39
Social determinants of health/adverse community experiences Conditions in which people are born, grow, live, work, and age and that are shaped by distribution of money, power, and resources at all levels.40,41
Trauma An event or circumstance experienced or observed by a person as physically or emotionally harmful or threatening and having lasting adverse effects on that person's functioning and well-being.42
Trauma-focused cognitive behavioral therapy An evidence-based trauma treatment for children 3 to 18 years and their parents comprising the elements of the acronym PRACTICE: Psychoeducation and parenting; Relaxation methods; Affective expression and regulation skills; Cognitive coping skills and processing; Trauma narrative and processing; In vivo exposure; Conjoint parent-child therapy sessions; and Enhancing personal safety and growth.43
Trauma-informed approach This "4-R" approach can be implemented in any type of service setting, organization, or program that: Realizes the widespread impact of trauma and understands potential paths for recovery; recognizes signs and symptoms of trauma in clients, families, staff, and others involved with the system; responds by fully integrating knowledge about trauma into policies, procedures, and practices; and seeks to actively resist re-traumatization.44
Use-dependent The organization and function of neurons, the neural system, and the brain depends on repetitive, patterned stimulation.45
