Post-Traumatic Stress Disorder
The diagnosis of post-traumatic stress disorder, or PTSD, was developed to help define the trauma experience of war veterans. What makes this disorder different from many of the other anxiety disorders discussed is that PTSD requires that a specific event occurred before the onset of symptoms. Many upsetting things can happen in your child's life, like a best friend moving or failing a test. While upsetting, these events generally do not develop into PTSD. On the contrary, PTSD is triggered by an event that was terrifying, threatening, and traumatizing for your child either physically or psychologically. Examples include physical, emotional, or sexual abuse, watching someone else being physically assaulted, or being in a disaster such as a flood, fire, or serious accident. Please note that just because your child had, or witnessed, a traumatic event, it does not mean she will develop PTSD. To the contrary, most do not.
To be diagnosed with post-traumatic stress disorder, your child must have symptoms from these three categories: re-experiencing the trauma, avoidance and emotional numbing, and increased arousal.
Exposure to a traumatic event involving threat or actual injury
Response involving intense fear, helplessness, or horror
Re-experiencing the event with distressing memories, dreams, acting, or feeling as if the event is recurring
Avoidance of reminders of the trauma
Detachment from, loss of, or limited emotions
Sleep issues, difficulty concentrating, irritability, guilt, intense panic, and/or angry outbursts
Defining the symptoms of PTSD is a little tricky for doctors and parents because PTSD has different age-specific features. Young children who are not verbal yet might develop stranger anxiety, have trouble sleeping, or regress developmentally. As they get older, some children will act out or engage in play that resembles what they went through. It is also common to see an adolescent express impulsive and aggressive behaviors as a way to deal with intense feelings.
In a large national survey, 9 percent of high-school students reported having been raped at some point in their lives. It has also been reported that 1.7 million young people between the ages of twelve and nineteen have been a victim of a violent crime.
The most important factors to consider when identifying how well a child will come through a trauma are the severity, how close physically she was to the situation, and how the parents acted in response. Research also suggests that when a child experiences a trauma where someone intentionally hurts another person, she is more likely to develop PTSD.
Depending on age, children with PTSD may have suicidal thoughts, argue with friends, develop stomach troubles, or have poor immune response. They may also engage in substance abuse or disruptive behaviors. The best place to start with your child, if she has experienced a trauma, is to communicate early and often. Allow her time to explore her feelings, allow her time to recover.
My twelve-year-old was assaulted on the bus eight months ago and everything has been fine. All of a sudden, he can't sleep and he is angry all the time. Could this still be from the assault?
Sometimes symptoms do not occur until months or even a year after an incident. This can be upsetting for parents because it seems like the symptoms have come out of nowhere. Delayed PTSD is diagnosed if the onset of symptoms occurs six months or more after the trauma. It is often triggered by an anniversary, or something that reminds the child of the original trauma, and it is very real. In this situation, it is best to see a counselor for an assessment.