PTSD: A Child Perspective

For our book project, my group focused exclusively on adults- statistics, diagnoses, symptoms, and treatments.  All of these areas can differ a lot between adults and children, so for the sake of clarity we chose just adults, but I am still interested in how children experience PTSD.  The statistics that I found for rates of PTSD were HUGE ranges, but surprisingly, consistent in several different sources.  According to the National Center for PTSD, (http://www.ptsd.va.gov/professional/page/ptsd_in_children_and_adolescents_overview_for_professionals.asp) 15-43% of girls and 14-43% of boys experience at least one traumatic event in adolescence.  I’m a bit confused about how this range is so big, so consistently, but such a statistic would certainly be hard to monitor precisely.  Out of those children who experience a traumatic event, an estimated 3-15% of girls and 1-6% of boys will show symptoms worthy of a PTSD diagnosis.  The rates of PTSD development vary with different types of trauma- some studies suggest that up to 100% of children who witness the death of a parent or sexual assault will develop PTSD.  Rates for sexually abused children are also very high, at about 90%.  Studies have also found that children are more likely to develop PTSD if the trama was an interpersonal one, such as rape or assault- I have read that this is also true for adults, and it makes sense to me, because if someone forms a dysfunctional belief and generalizes it (NO ONE is trustworthy, everyone wants to hurt me), he/she will be reminded of this upon every human encounter.

Risk factors include the severity of the event, the child’s physical proximity to the event, and parental response to the event.  I found the third factor particularly interesting, because though still difficult to control, it is the only factor that is really capable of being manipulated.  I think that children are a lot more intuitive than we often give them credit for, and they pick up on seemingly subtle things.  For a child, when the person who takes care of  him/her gets upset, there is no one to soothe the child.  If parents can remind themselves to stay as calm as possible, this may mediate the effects the trauma will have on the child.

Another website (http://anxiety.emedtv.com/ptsd/ptsd-in-children-p2.html) reported an increased risks for children of minority ethnicities to develop PTSD.  Thinking back to the finding that Natasha discussed about pre-trauma stressors increasing the risk for PTSD, maybe these children have experienced more chronic lifetime stressors than others, and are therefore predisposed to and less able to effectively manage the effects of trauma.

Krill (Krill, W. E. PTSD in children: child specific symptoms) explains that the symptoms of child PTSD differ those seen in adults.  A list of these child-specific symptoms is:

“enuresis (both night time and day time), encopresis (both day time and night time), feces manipulation or play, excessive and/or public sexual self stimulation, lack of recall following a stress episode, sleepiness following a stress episode, pupil dilation (and other physical signs) while in a stress episode, food hoarding or overeating, sugar craving, self harm behaviors, rage accompanied by very colorful vulgar language, and excessive clinginess with caregiver”

Although each of these symptoms is not indicative of PTSD by itself, in combination they hint at the disorder.

In terms of treatment, CBT is usually recommended, often TF-CBT (trauma-focused), during which the child discusses his or her memories, feelings, and thoughts about the trauma.  Guilt can be a big obstacle in the recovery of children if they irrationally blame themselves for the trauma.  An example of an activity used to create an accurate perception of responsibility, a therapist may ask a child to divide up the sections of a ruler and draw out his/her responsibility, the responsibility of the person who hit the car, the responsibility of the person driving the child’s car, etc.   Art therapy is also very beneficial for some children, especially young children whose lack of language skills impedes effective CBT.  It is also becoming popular in mental hospitals and regular hospitals for people in all sorts of recovery.  There are tons of cool sites about art therapy, and because I can’t figure out how to put pictures on here, I’ll just give you the links:

War vet art therapy:

http://www.washingtonpost.com/wp-dyn/content/article/2007/04/14/AR2007041401246.html

General art therapy blog:

http://www.arttherapyblog.com/

(interestingly, the first blog post isn’t about art, but is about MDMA treatment for PTSD!)

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