Post-Traumatic Play in Child Victims of Adverse Childhood Experiences: A Pilot Study with the MCAST-Manchester Child Attachment Story Task and the Coding of PTCP Markers

Play is among the most frequently observed distorted behaviors in victims of Adverse Childhood Experiences (ACEs). Terr's (1981) studies helped to describe this behavioral distortion as post-traumatic child's play (PTCP). This study aimed to evaluate whether child victims of Adverse Childhood Experiences (ACEs) engaging in semi-structured play present the markers of post-traumatic child's play (PTCP) during the administration of the Manchester Child Attachment Story Task (MCAST), whose playful stories activate the attachment system. The sample comprised 17 child victims of ACEs (mean age = 6.76). Children were evaluated using the Manchester Child Attachment Story Task. The analysis of the play clearly revealed the presence of markers associated with the characteristics of the post-traumatic play described by Terr (1981), namely, repetition, revisiting, hyperarousal, and danger. In particular, the intrusiveness dimension was observed, which can be identified in the post-traumatic play by the presence of recurrent memories, dreams, and dissociative symptoms. Post-traumatic play is characterized by repetition, containing aspects, scenes, or sequences of the traumatic event, expressed explicitly or symbolically.