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, or events that cause intense fear, helplessness, or horror, may develop ongoing difficulties known as post traumatic stress disorder (PTSD). The stressful or traumatic event involves a situation in which someone’s life has been threatened or severe injury has occurred. The child may be the victim of or a witness to physical abuse, sexual abuse, violence in the home or in the community, automobile accidents, or natural disasters (such as flood, fire, earthquakes), or 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 They may also become less responsive emotionally, depressed, withdrawn, and more detached from their feelings. People with PTSD continually re-experience the traumatic event; they avoid individuals, thoughts, or situations associated with the event, and they have symptoms of excessive emotions. People with PTSD have symptoms for longer than one month and cannot function as well as they did before the traumatic event. Symptoms usually appear within three months of the traumatic experience; however, they sometimes occur months or even years later.
The symptoms of PTSD may last from several months to many years. 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.
Possible Signs of Trauma in Children
- Worry about dying at an early age
- Losing interest in activities
- Headaches and stomachaches
- Sudden and extreme emotional reactions
- Problems falling or staying asleep
- Problems concentrating
- Acting younger than same age peers
- Increased alertness to the environment
- Repeating behavior that reminds them of the trauma
- Physical abuse and sexual abuse
- Multiple moves and caregivers
- Separation from siblings
- Maternal stress in utero
- Separation from birth parent at birth or afterwards
- Moving to another country
- Witnessing violence
- Death of or separation from parents
Source: The American Academy of Child and Adolescent Psychiatry (www.aacap.org).