After the Emergency Is Over:
POST-TRAUMATIC STRESS DISORDER IN CHILDREN AND YOUTH
What Is Post-Traumatic Stress Disorder (PTSD)?
After a frightening or distressing experience (any kind of injury, a physical or sexual assault, car crash, fire, or other natural disaster), a child or teen may suffer psychological stress in addition to any physical injuries. In the first few days to weeks after a trauma happens, people of all ages find that they have unwanted or upsetting thoughts or feelings about the trauma, and that for a while they are more "jumpy" (more on the lookout for possible danger). Often, they want to avoid things that remind them of the traumatic event that just occurred. When these reactions last for more than a month and are strong enough to affect a child's or teen's everyday functioning, that child may be diagnosed as having Post-Traumatic Stress Disorder or PTSD. An estimated 70% of adults in the United States have experienced a traumatic event at least once in their lives; of these, up to 20% go on to develop PTSD. Children's experience of traumatic events is not as well documented. However, studies have found that about 30% of children who experience a traumatic event develop PTSD. Children can also develop PTSD symptoms when they witness or hear about a traumatic event that happens to someone they care about (for example, if a child witnesses a parent being attacked or hears about a friend who is shot).
What Are the Signs and Symptoms of PTSD?
Most children who experience a trauma will have at least a few of the symptoms listed here, in the first few days or weeks after the event. The majority resolve these reactions with the support of their parents and families, but some children continue to have difficulties. (A child who appears to have little reaction to the trauma in the early stages is less likely to develop symptoms of PTSD). Children or youth who have had previous traumatic experiences, who have very strong early reactions, or whose support systems (parents and others) are very distressed by the event, appear to be at higher risk for later difficulties.
There are three main categories of symptoms
of PTSD:
What Can An Adult Do to Help A Child with PTSD?
If a child continues to have symptoms that worry parents or caregivers, that bother the child or get in the way of his/her normal activities, or if a child has any behavior that endangers himself or others, do not hesitate to get help from a mental health professional. (See resources listed below.) Look for a mental health professional (counselor, psychologist, social worker, psychiatrist) with experience in helping children after trauma, and who can assess the child and make a recommendation about treatment. Treatment for PTSD in children and teens usually includes cognitive behavioral therapy to help reduce avoidance behaviors and to change ways of thinking that can perpetuate the symptoms of PTSD. Treatment for children also generally involves parents and other family members as well. Sometimes, children or teens can participate in group therapy (or a support group) with others who have also experienced a trauma.
• An extensive general bibliography on PTSD can be found at: www.sover.net/~schwcof/ptsd.html
• A comprehensive resource with useful information and links regarding trauma and PTSD can also be found at: www.trauma-pages.com
Professional Mental Health Associations and Government Agencies American Academy of Child and Adolescent Psychiatry
American Academy of Pediatrics
American Psychological Association
(www.apa.org)
American Psychiatric Association (www.psych.org)
Anxiety Disorders
Association of America (www.adaa.org)
International Society for Traumatic Stress Studies (www.istss.org)
National Assoc. of Social Workers (www.naswdc.org)
National Center for PTSD (www.ncptsd.org)
National Institute of Mental Health
(www.nimh.gov)
PTSD Alliance Resource Center (www.ptsdalliance.org)
Scientific Citations
2000. Daviss WB, et al. “Predicting
Posttraumatic Stress
After Hospitalization for Pediatric
Injury.” J. Am. Acad. Child
Adolesc. Psychiatry, 39:576-583.
1999. Horowitz, L, et al., eds. Psychological
Factors in
Emergency Medical Services for Children:
Abstracys of the
Psychological, Behavioral, and Medical
Literature.
1991-1998. Bibliographies in Psychology,
Number 18.
American Psychological Association,
Washington, DC.
1999. deVries APJ, et al. “Looking
Beyond the Physical Injury:
Posttraumatic Stress Disorder in Children
and Parents After
Pediatric Traffic Injury.” Pediatrics,
104:1293-1299.
1998. “Practice Parameters for the
Assessment and Treatment
of Children and Adolescents with Posttraumatic
Stress
Disorder.” Journal of the American
Academy of Child and
Adolescent Psychiatry, 37:10 supplement, October 1998.
1996. Fletcher K. “Childhood Post-Traumatic
Stress
Disorder.” In: Mash E, Barkley R, eds.
Child
Psychopathology. New York, NY: Guilford: pp. 242-276.
1995. Boney-McCoy S, Finkelhor D. “Psychosocial
Sequelae of Violent Victimization in
A National Youth
Sample.” J Consult Clin Psychol,
63:726-736.
1994. Diagnostic and Statistical Manual
of Mental Disorders,
4th edition (DSM-IV). Washington, DC:
American
Psychiatric Association.
1994. Pynoos RS. Traumatic Stress and
Developmental
Psychopathology in Children and Adolescents.
In Pynoos
RS, ed. Post-traumatic Stress Disorder:
A Clinical Review.
Lutherville, MD: Sidran Press; pp.65-98.
1990. DiGallo A, Barton J, Parry-Jones
WL. “Road Traffic
Accidents: Early Psychological Consequences
in Children
and Adolescents.” Br J Psychiatry,
170:358-362.
The EMSC Program is a federally funded initiative designed
to reduce child and
youth disability and death due to severe illness or injury.
the Program is jointly
administered by the Health Resources and Services Administration’s
Maternal
and Child Health Bureau and the National Highway Traffic
Safety
Administration. All 50 states, the District of Columbia,
and five U.S. territories
have received funding through the Program.