What is Post Traumatic Stress Disorder (PTSD)?
Children and adolescents are susceptible to developing Post Traumatic Stress Disorder (PTSD) when they experience an event that involves a threat to their life or physical integrity in which they respond with intense fear, helplessness, or horror.
There are a number of traumatic events that have been shown to cause PTSD in children and adolescents. Studies document PTSD in child and adolescent survivors of: natural and man made disasters such as floods; violent crimes such as kidnapping, rape or murder of a parent, sniper fire, and school shootings; motor vehicle accidents such as automobile and plane crashes; severe burns; exposure to community violence; war; peer suicide; and sexual or physical abuse.
How many children develop PTSD?
Few studies have been conducted that examine rates of exposure and PTSD in children and adolescents from the general population. Results from these studies indicate that 15 to 43% of girls and 14 to 43% of boys have experienced at least one traumatic event in their lifetime. Of those children and adolescents who have experienced a trauma, 3 to 15% of girls and 1 to 6% of boys meet criteria for PTSD.
Rates of Post Traumatic Stress Disorder are much higher in children and adolescents recruited from at risk samples, varying from 3-100%. For example, studies have shown that as many as 100% of children who witness a parental homicide or sexual assault, 90% of sexually abused children, 77% exposed to a school shooting, and 35% of urban youth exposed to community violence develop PTSD.
What are the risk factors for PTSD?
There are three factors that have been shown to increase the likelihood that children will develop PTSD: the severity of the traumatic event, the parental reaction to the traumatic event, and the temporal proximity to the traumatic event. In general, most studies find a strong relationship between children’s reports of trauma severity and PTSD. As would be expected, children and adolescents who report having experienced the most severe traumas also report the highest levels of PTSD symptoms. Family support and parental coping has also been shown to effect PTSD symptoms in children. Studies show that children and adolescents with greater family support and less parental distress have lower levels of PTSD symptoms. Finally, children and adolescents who are farther away from the traumatic event report less distress.
There are several other factors that have been shown to be related to Post Traumatic Stress Disorder. Research suggests that interpersonal traumas such as rape and assault are more likely to result in PTSD than other types of traumas. Additionally, there is a relationship between the total number of previous traumas an individual has experienced and PTSD, with greater numbers of traumatic events increasing the risk of developing PTSD. In terms of gender, several studies suggest that girls are more likely than boys to develop PTSD. A few studies have examined the connection between ethnicity and PTSD. While some find that minorities report higher levels of PTSD symptoms, this has been shown to be due to other factors such as differences in levels of exposure. The impact of age at time of exposure and PTSD is less clear. While some studies find a relationship others do not. Differences may be due to differences in the way PTSD is expressed in children and adolescents of different ages or developmental levels (see next section).
Besides PTSD, what are the other effects of trauma on children?
Besides PTSD, children and adolescents who have experienced traumatic events often exhibit other types of problems. Perhaps the best information available on the effects of traumas on children comes from a review of the literature on the effects of child sexual abuse. It has been shown that sexually abused children often have problems with: fear, anxiety, depression, anger and hostility, aggression, sexually inappropriate behavior, self-destructive behavior, feelings of isolation and stigma, poor self esteem, difficulty in trusting others, and substance abuse. These problems are often seen in children and adolescents who have experienced other types of traumas as well. In addition, children who have experienced traumas often have relationship problems with peers and family members, behavioral acting out, and problems with school performance.
Along with associated symptoms, there are a number of psychiatric disorders that are also commonly found in children and adolescents who have been traumatized. One commonly co-occurring disorder is major depression. Other disorders include: substance abuse; other anxiety disorders such as separation anxiety, panic disorder; and generalized anxiety disorder; and externalizing disorders such as attention-deficit/hyperactivity disorder, oppositional defiant disorder, and conduct disorder.
How is Post Traumatic Stress Disorder treated in Children and Adolescents?
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. Few treatment studies have been done examining which treatments are most effective for children and adolescents. A review of the adult treatment studies of PTSD shows that cognitive behavioral treatment (CBT) is the most effective approach. CBT for children generally includes: exposure (child directly discusses the traumatic event), anxiety management techniques such as relaxation and assertiveness training and correction of inaccurate or distorted trauma related thoughts. Exposure can be done gradually and can be paired with relaxation such that children can learn to relax while recalling their experiences. Through this procedure, they learn that they do not have to be scared of their memories. CBT also involves challenging children’s false beliefs such as the belief that “the world is totally unsafe.” The majority of studies that have been conducted using CBT for children with PTSD have found that it is safe and effective.
Psycho-education is the process of learning about the symptoms of PTSD. It is equally important for parents and caregivers to understand the effects of PTSD. In addition, research shows that the better parents cope with the trauma and the more they support their children, the better their children will function. Therefore, at times it is important for parents to seek treatment to develop the necessary coping skills to support their children. A specialized intervention might be required for inappropriate sexual behavior or extreme behavior problems.
What can I do to help my child with Post Traumatic Stress Disorder?
The most important thing that you can do now is to support your child. If your child is suffering with PTSD, call Providence Pass today to discuss your child’s history and symptoms, and let our team of qualified professionals help you determine if it is time for intervention
Resource: National Center for PTSD Fact Sheet