Post-Traumatic Stress Disorder
Potential sources of Trauma
Children and adolescents are more at risk of exposure to violence at home or on the streets than in school. One million children are confirmed victims of child abuse each year. Eighty-seven percent of inner-city elementary school-aged boys have seen someone arrested; 84 percent have heard guns being fired; 25 percent have seen someone get killed.
Learn More:
Radio Segment
Steve Muething, MD, associate director of clinical services in the Division of General and Community Pediatrics, can now be heard weekly "The Health Show," distributed by WAMC/Northeast Public Radio. On March 18, 2004, he spoke about Kids and Stress. Listen to this segment:
What is post-traumatic stress disorder?
Post-traumatic stress disorder (PTSD) is a debilitating condition that often follows a terrifying physical or emotional event that is beyond an expected life event- causing the person who survived the event to have persistent, frightening thoughts and memories, or flashbacks, of the ordeal. Persons with PTSD often feel chronically, emotionally numb. PTSD in children and adolescents can becomes a chronic disorder.
What causes post-traumatic stress disorder?
The event(s) that may trigger PTSD may be:
- something that occurred in the person's life
- something that occurred in the life of someone close to him/her
- something the person witnessed
A child's/adolescent's risk for developing PTSD is often affected by the child's or adolescent's proximity and relationship to the trauma, the severity of the trauma, the duration of the traumatic event, the recurrence of the traumatic event, the resiliency of the child, the coping skills of the child and the support resources available to the child from the family and community following the event(s).
The following are some examples of catastrophic, life-threatening events that may cause PTSD if experienced or witnessed as a child or adolescent:
- serious accidents (such as car or train collisions)
- natural disasters (such as floods or earthquakes)
- man-made tragedies (such as bombings, a plane accident)
- violent personal attacks (such as a mugging, rape, torture, being held captive, or kidnapping)
- physical abuse
- sexual molestation or assault
- emotional abuse
Who is affected by post-traumatic stress disorder?
Traumatic experiences are not common in the lives of most children and adolescents. However, approximately 3,000,000 children each year are diagnosed with PTSD. No studies have examined the general population incidence of PTSD specifically in children and adolescents. However, it is estimated to be as high as 40 percent in violence-ridden neighborhoods.
What are the symptoms of post-traumatic stress disorder?
The following are the most common symptoms of PTSD. However, each child or adolescent may experience PTSD in different manners, and may have some or all of the listed symptoms.
Children and adolescents with PTSD experience extreme emotional, mental and physical distress when exposed to situations that remind them of the traumatic event. Some may repeatedly experience the trauma in the form of nightmares and disturbing recollections during the day and may also experience any, or all, of the following:
- sleep disturbances
- depression
- being hypervigilant
- being easily startled
- loss of interest in things they used to enjoy; detachment; general lack of responsiveness; feeling numb
- difficulty feeling affectionate toward others
- irritability, more aggressive than before, or even violent
- avoiding certain places or situations that bring back memories
- flashbacks or intrusive images (flashbacks can come in the form of images, sounds, smells, or feelings; a person usually believes that the traumatic event is happening all over again)
- losing touch with reality
- reenactment of an event for a period of seconds or hours or, very rarely, days
- problems in school; difficulty concentrating
- worry about dying at an early age
- regressive behaviors; acting younger than their age (i.e., thumb sucking, bedwetting)
- physical symptoms (i.e., headaches, stomach aches)
How is post-traumatic stress disorder diagnosed?
Not every child or adolescent who experiences a trauma develops PTSD. PTSD is diagnosed only if symptoms persist for more than one month and are adversely affecting the child's life and level of functioning. In those who are diagnosed with PTSD, symptoms usually begin within three months following the trauma, but can also start months or years later.
PTSD can occur at any age, including childhood, and may be accompanied by:
- depression
- anxiety
- substance abuse
- symptoms of inattention and hyperactivity
- obsessions
The length of the condition varies. Some people recover within six months, others have symptoms that last much longer.
A qualified mental health professional usually diagnoses PTSD in children or adolescents following a comprehensive psychological evaluation. Parents who note symptoms of PTSD in their child or adolescent can help by seeking an evaluation early. Early treatment can decrease future problems.
Treatment for Post-traumatic Stress Disorder
Specific treatment for post-traumatic stress disorder will be determined by your child's physician or mental health provider based on:
- your child's age, overall health, and medical history
- extent of your child's symptoms
- your child's tolerance for specific medications, procedures, or therapies
- expectations for the course of the disorder
- your opinion or preference
PTSD can be treated. Early detection and intervention is very important and can reduce the severity of symptoms, enhance the child's normal growth and development and improve the quality of life experienced by children or adolescents with PTSD.
Treatment should always be based on a comprehensive evaluation of the child and family. Treatment recommendations may include psycho-social therapies or group therapy for the child or adolescent. Some children may also benefit from treatment with medications.
The child or adolescent's recovery from PTSD is highly variable and dependent on the child or adolescent's internal strengths, coping skills and resiliency (ability to "bounce back") as well as severity of the trauma, frequency of reexposure of traumatic eventss and comorbidity of other mental health disorders. Recovery is also influenced by the support available within the family environment. Parents play a vital supportive role in the treatment process.
Prevention of Post-traumatic Stress Disorder
Preventive measures to reduce the incidence or lessen the chance of traumatic experiences in children include, but are not limited to, the following:
- Teach children that it is okay to say NO to someone who tries to touch his/her body or approach him/her in any way that makes him/her feel uncomfortable
- Teach children that it is okay to tell an adult he/she trusts right away if someone makes him/her feel uncomfortable
- Encourage violence prevention programs within your community or local school system
- Foster school programs to deal with severe emotional distress
Contact us
For additional information on this or any Health Topic, please call the Family Resource Center, 513-636-7606, or your pediatrician.
Written 11/00; rev. 5/03, 6/05, 7/07
