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All children
and adolescents experience stressful events which can affect
them both emotionally and physically. Their reactions to stress
are usually brief, and they recover without further problems.
A child or adolescent who experiences a catastrophic event
may develop ongoing difficulties known as posttraumatic stress
disorder (PTSD). The stressful or traumatic event involves
a situation where someone’s life has been threatened or severe
injury has occurred (ex. they may be the victim or a witness
of physical abuse, sexual abuse, violence in the home or in
the community, automobile accidents, natural disasters (such
as flood, fire, earthquakes), and being diagnosed with a life
threatening illness). A child’s risk of developing PTSD is
related to the seriousness of the trauma, whether the trauma
is repeated, the child’s proximity to the trauma, and his/her
relationship to the victim(s).
Following
the trauma, children may initially show agitated or confused
behavior. They also may show intense fear, helplessness, anger,
sadness, horror or denial. Children who experience repeated
trauma may develop a kind of emotional numbing to deaden or
block the pain and trauma. This is called dissociation. Children
with PTSD avoid situations or places that remind them of the
trauma. They may also become less responsive emotionally,
depressed, withdrawn, and more detached from their feelings.
A child
with PTSD may also re-experience the traumatic event by:
- having
frequent memories of the event, or in young children, play
in which some or all of the trauma is repeated over and
over
- having
upsetting and frightening dreams
- acting
or feeling like the experience is happening again
- developing
repeated physical or emotional symptoms when the child is
reminded of the event
Children
with PTSD may also show the following symptoms:
- worry
about dying at an early age
- losing
interest in activities
- having
physical symptoms such as headaches and stomachaches
- Posttramatic
Stress Disorder (PTSD), "Facts for Families," No. 70 (10/99)
- showing
more sudden and extreme emotional reactions
- having
problems falling or staying asleep
- showing
irritability or angry outbursts
- having
problems concentrating
- acting
younger than their age (for example, clingy or whiny behavior,
thumbsucking)
- showing
increased alertness to the environment
- repeating
behavior that reminds them of the trauma
The symptoms
of PTSD may last from several months to many years. The best
approach is prevention of the trauma. Once the trauma has
occurred, however, early intervention is essential. Support
from parents, school, and peers is important. Emphasis needs
to be placed upon establishing a feeling of safety. Psychotherapy
(individual, group, or family) which allows the child to speak,
draw, play, or write about the event is helpful. Behavior
modification techniques and cognitive therapy may help reduce
fears and worries. Medication may also be useful to deal with
agitation, anxiety, or depression.
Child
and adolescent psychiatrists can be very helpful in diagnosing
and treating children with PTSD. With the sensitivity and
support of families and professionals, youngsters with PTSD
can learn to cope with the memories of the trauma and go on
to lead healthy and productive lives.
For additional/related
information see other Facts for Families: The Depressed Child
(#4), Child Abuse: The Hidden Bruises (#5), Responding to
Child Sexual Abuse Disorders (#28), Helping Children After
a Disaster (#36), and The Anxious Child (#47).
Article
#70 Updated 10/99
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