Post-traumatic Stress Disorder (PTSD)

Children and Post-traumatic Stress Disorder continued...

Violence on TV: Parents should guide this kind of television viewing, either making sure that they talk to their children about what they are reading and seeing—or, for very young children, limiting it or turning it off altogether. As kids get older, limiting even then is important so they are not constantly barraged by these images. Coming up with other ways to try to process what is happening, such as talking with adults, rather than just watching it over and over and over again, is helpful.

Stress at home: Kids know what's going on in their environments, even if parents don't think they do. Children can pick up on our feelings, whether it’s stress over a traumatic event or worries about a parent losing a job. Children notice the subtle, outward signs, both happy and sad. How parents react to a trauma often affects how the children are going to react.

Signs and symptoms of PTSD in children (according to the National Center for PTSD):

Young children (1-6 years)

• Helplessness and passivity, lack of usual responsiveness
  
  
• Generalized fear
  
  
• Heightened arousal and confusion
  
  
• Cognitive confusion
  
  
• Difficulty talking about the event
  
  
• Difficulty identifying feelings
  
  
• Nightmares, sleep disturbances
  
  
• Separation fears and clinging to caregivers
  
  
• Regressive symptoms (for example, returning to bed-wetting or loss of speech/motor skills)
  
  
• Inability to understand death as permanent
  
  
• Anxieties about death
  
  
• Grief related to abandonment by caregiver
  
  
• Somatic symptoms (such as stomach aches, headaches)
  
  
• Startle response to loud noises
  
  
• Freezing (sudden immobility)
  
  
• Fussiness, uncharacteristic crying, neediness
  
  
• Avoidance of or alarm response to specific trauma-related reminders involving sights/physical sensations

School-aged children (6-11 years)

• Feelings of responsibility and guilt
  
  
• Repetitious traumatic play
  
  
• Feeling disturbed by reminders of the event
  
  
• Nightmares, other sleep disturbances
  
  
• Concerns about safety, preoccupation with danger
  
  
• Aggressive behavior, angry outbursts
  
  
• Fear of feelings, trauma reactions
  
  
• Close attention to parents’ anxieties
  
  
• School avoidance
  
  
• Worry/concern for others
  
  
• Behavior, mood, personality changes
  
  
• Somatic symptoms (complaints about bodily aches/pains)
  
  
• Obvious anxiety/fearfulness
  
  
• Withdrawal
  
  
• Specific trauma-related fears, general fearfulness
  
  
• Regression (behaving like a younger child)
  
  
• Separation anxiety
  
  
• Loss of interest in activities
  
  
• Confusion, inadequate understanding of traumatic events (more evident in play than in discussion)
  
  
• Unclear understanding of death, causes of "bad" events
  
  
• Giving magical explanations to fill in gaps in understanding
  
  
• Loss of ability to concentrate at school, with lower performance
  
  
• Spacey or distractible behavior

Preadolescents and adolescents (12-18 years)

• Self-consciousness
  
  
• Life-threatening re-enactment
  
  
• Rebellion at home or school
  
  
• Abrupt shift in relationships
  
  
• Depression, social withdrawal
  
  
• Decline in school performance
  
  
• Trauma-driven acting out, such as sexual activity or other reckless risk-taking
  
  
• Effort to distance self from feelings of shame, guilt, humiliation
  
  
• Excessive activity/involvement with others, or retreat from others in order to manage inner turmoil
  
  
• Accident proneness
  
  
• Wish for revenge, action-oriented responses to trauma
  
  
• Increased self-focusing, withdrawal
  
  
• Sleep/eating disturbances, including nightmares 

Treatment: Treatment of children should include the involvement of parents and other important people such as teachers and school counselors in the child’s life. Treatment of traumatic stress in adults is generally focused on individual treatment or group therapy with other individual adults who have experienced a similar type of trauma.