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and that exposure to traumatic experiences increases may be required as children, especially teenagers,
the risk of learning and behavioural problems, may present themselves as having no difficulties in
obesity and psychotic symptoms in childhood and their lives until more specific questions are asked.
23
24
beyond. Neurobehavioural developmental research
also indicates the long-lasting neurological impact It should also be noted that, when diagnosing
of traumatic experiences on children at various ages children’s mental health, it is important to differentiate
from pre-verbal stages to late adolescence. In terms between behaviour, cognition and emotion that are
of psychological conditions and diagnoses, some are typical to the child’s developmental stage and age
similar to those used in adults, such as post-traumatic and those that are cause for concern. Furthermore,
stress disorder, depression, anxiety and phobias, behaviour and other indicators need to be considered
while others are specific to children, such as elective within the child’s cultural and psychosocial context.
mutism, reactive attachment disorder of childhood
and disinhibited attachment disorder of childhood,
conduct disorder, oppositional conduct disorder V. Lesbian, gay, bisexual and
and disruptive mood dysregulation disorder. See transgender children and young
paragraphs 581–594 above for a detailed account persons
of conditions and diagnoses that may be observed
in children who have been tortured or ill-treated. Lesbian, gay, bisexual and transgender children
and young persons are likely to experience abuse
It should be noted that, while the same diagnoses can by adults and peers, and the risk increases with the
be found in both children and adults, children manifest decrease or absence of social and legal protections.
25
symptoms differently and clinicians need to rely more Research demonstrates that experiences of persecution
26
on observing the child’s behaviour (e.g. monotonous, and abuse may severely affect their mental health.
repetitive play) and somatic reactions (e.g. loss of When documenting torture in lesbian, gay, bisexual
control of bowel movements), and consider the use of and transgender children and young persons, it
appropriate questionnaires in order to make accurate is important to consider the specific risk factors
diagnoses. The clinician therefore may need to rely and acknowledge their potential impact. As for
on a child’s behaviour and reports from others rather adults, it is essential to provide a safe and respectful
than predominantly on narratives provided by the setting and not to pathologize gender identities and
child. A range of psychological diagnostic techniques sexual orientations (see paras. 599–601 above).

23 Burke and others, “The Impact of adverse childhood experiences”.
24 Louise Arseneault and others, “Childhood trauma and children’s emerging psychotic symptoms: a genetically sensitive longitudinal cohort study”, American Journal of
Psychiatry, vol. 168, No. 1 (2011), pp. 65–72.
25 Edward J. Alessi, Sarilee Kahn and Sangeeta Chatterji, “‘The darkest times of my life’: recollections of child abuse among forced migrants persecuted because of their sexual
orientation and gender identity”, Child Abuse & Neglect, vol. 51 (2016), pp. 93–105.
26 Ibid.; and Rebecca A. Hopkinson and others, “Persecution experiences and mental health of LGBT asylum seekers”, Journal of Homosexuality, vol. 64, No. 12 (2017),
pp. 1650–1666.

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