Stress Management

Post-Traumatic Stress Disorder (PTSD)

Children and PTSD

Symptoms of posttraumatic stress disorder in children are often quite different than from that experienced by adults. Therefore, physicians who are used to treating adult PTSD sufferers may miss diagnosing PTSD in children. This missed diagnosis may compound severity of PTSD later in their life.

As children grow into adulthood, their PTSD symptoms, if unrecognized and untreated, may evolve over time to more closely resemble the typical reactions to trauma encountered as an adult.

For example, in one study of adults who had been victims of sexual abuse as children, their Minnesota Multiphasic Personality Inventory (MMPI) scores were found to be extremely similar to those of combat veterans with PTSD. There were no differences between the two groups in depression, anxiety, difficulty in thinking and concentrating, somatization, elevated mood, or paranoid ideation. The only difference between the two populations was in the domain of anger.

Dr. John A. Talbott, professor of psychiatry at the University of Maryland, Baltimore, identified several major manifestations of PTSD in children based on how their response differed from that of adults. According to him, children often display:

1. Disorganized or agitated behavior rather than the fear, helplessness, and horror described in adults.

2. Repetitive play; in which themes of the trauma rather than the classic flashbacks and recurrent and intrusive recollections of the traumatic event are expressed.

3. Frightening dreams, which often are not of the --event and may not even have recognizable content-unlike in adults with PTSD.

4. Trauma-specific reenactment, as opposed to the "in the moment" feeling that the trauma is reoccurring. A classic example of this behavior involves the combat veteran who reflexively dives to the ground at the sound of a car backfiring or a civilian helicopter overhead.

Scientists are trying to unravel a mystery surrounding PTSD that has eluded them so far. It involves the question of whether every combat soldier has a breaking point, or only those soldiers predisposed to PTSD through adverse childhood experiences go on to develop the disorder. In other words, how much does your gene affect your susceptibility to PTSD?

Various studies have identified several predisposing factors for PTSD such as:

An influential study of Vietnam War veterans who developed severe PTSD in response to prolonged trauma concluded that even individuals with a low level of childhood trauma, good adolescent relationships, and favorable premorbid adjustment were affected. Severity of trauma outweighed the lack of predisposing factors. Another study involving 4,402 Vietnam War-era twins concluded that roughly 30% of the variance in the occurrence of PTSD in response to trauma was attributable to the genes.

Related Topic: Coping with Violence and Disasters: Strategies for Helping Children and Adolescents

See Also: How Children and Adolescents React to Trauma