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| Posttraumatic Stress Disorder (PTSD) |
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| Posttraumatic Stress Disorder (PTSD) is defined as "the development of characteristic symptoms following exposure to an extreme traumatic stressor involving direct personal experience of an event that involves actual or threatened death or serious injury, or other threat to one' physical integrity" (American Psychiatric Association, 2000 p. 463). Their have been few studies completed that offer the prevalence of PTSD in children but it is known children and adolescents are susceptible to developing PTSD, and that PTSD has different age-specific features. |
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| PTSD is common in children and adolescents and the incidence rates and lifetime prevalence is reported to be rising. Children are increasingly exposed to violence that increases the risk of traumatization. It varies depending on the type of trauma exposure. Children exposed to interpersonal trauma such as; abuse, rape, and/or violence are more likely to result in PTSD than a child exposed to a natural disaster. Children with certain vulnerability factors have a greater chance of developing PTSD if faced with trauma. Children with a history of mental illness in their family and children living in poverty have a greater likelihood of developing PTSD (Costello, Erkanli, Fairbank, & Angold, April 2002) (Deykin, July/August 1999). Symptoms vary with each developmental stage. The onset of PTSD during a child's developmental stages could have profound impact on the child's appraisal of threat, meaning, coping abilities (emotional and cognitive), and reaction to the situation (Amaya-Jackson, 1995). Three factors have been found that indicate the development of PTSD symptoms in children: severity of exposure, parental/ caregiver reaction, and child's proximity to traumatic event (Foy, Madvig, Pynoos, & Camilleri, 1996). |
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| Typical reactions for children 5 years of age and younger may not present with PTSD symptoms. This may be because most of the symptoms require a verbal expression to ones feelings and experiences (Scheeringa, Zeanah, Drell, & Larrieua, 1995). Young children may express more generalized feelings that may include a fear of being separated from their parent(s), episodes of crying, whimpering, screaming, trembling, and excessive clinging, and frightened facial expressions. Parents may also notice children regressing to previous childhood behaviors, such as sucking their thumb, wetting their bed, or fearing the dark. Children in this age range tend to be sensitive to, and strongly affected by, their parent's reactions to the experienced trauma. |
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| Children ages 6 to 11 years old may demonstrate "time skew" and "omen formation". Time skew refers to a child missequencing trauma related events when recalling the memory. Omen formation is a belief that there were warning signs that predicted the trauma. These children may exhibit extreme withdrawal, disruptive behaviors, and an inability to pay attention. Regressive behaviors, nightmares, sleep difficulties, irrational fears, anger outbursts, refusal to attend school and fighting is common to traumatized children of this age. Some children may complain of headaches or stomach distress, or other bodily symptoms for which no medical basis can be found. A decline in academic performance is highly likely, as well as depression, anxiety, or a notable emotional flatness.
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| Adolescents, 12-17, may exhibit responses to trauma similar to those of adults, including nightmares, flashbacks, depression, alcohol or drug abuse and difficulties with peers or co-workers. Also common to this age group are feelings of withdrawal and isolation, thoughts of suicide, avoidance of school, decline in academic performance, sleep disturbances, and anti-social behavior or may exhibit impulsive and aggressive behaviors. Adolescents may also feel extreme guilt over their failure to prevent injury or loss of life to others, particularly if the victims were family members or peers (e.g., school shootings). (Journal of the American Academy of Child & Adolescent Psychiatry Oct. 1998). |
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| Although some children show a natural remission in PTSD symptoms over a period of a few months, there are a significant number of children for whom PTSD persists for years if untreated. There is treatment available for PTSD in children and adolescents. For more information you can contact Hammond Henry Hospital social work service department at 944-9170. |
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