PTSD: Not For Adults Only
By Susan Bunnell

    Children and adolescents are exposed to a wide range of traumatic events in today’s society, ranging from school shootings to the terrorist acts of September 11. These acts of violence, or any other sudden, unexpected and serious event such as terminal illness in the family, a car accident, a natural catastrophe, peer suicide, or sexual abuse may overwhelm a child emotionally, physiologically and cognitively. Events that fall outside the realm of normal experiences would cause stress to anyone. But when stress-related symptoms persist for at least a month, the child may be suffering from posttraumatic stress disorder (PTSD). Left untreated, these symptoms can last for months or years.

Symptoms differ from adults

     Although the diagnosis for PTSD in children and adults is similar, there is a significant difference in the way symptoms are presented.
• Re-experiencing phenomenon: Intrusive recollections and images may be disguised as play by young children. They may compulsively repeat some aspect of the trauma (such as blowing things up). They may draw in red paint. They may suffer from nightmares.
• Numbing or avoidance: Children show a reduced interest in their usual activities. Younger children especially become more isolated and detached, unhappy or emotionless. Often they may have a foreshortened sense of the future. They may lose an acquired developmental skill.
• Increased states of arousal: Children may exhibit a fight or flight response. They may have difficulty concentrating, be easily startled or be hyper vigilant.
• Younger children tend to become confused and clingy.
• Elementary school-aged children may become aggressive or overly shy. They may repeatedly tell stories of the traumatic event, often inappropriately.
• Adolescents tend to reenact the trauma by incorporating aspects of the event into their daily lives. They may exhibit impulsive and aggressive behaviors. They may have problems in school, and turn to substance abuse.

Treatment

      The history of PTSD in children has erred on the side of doing too little to help traumatized children. Children are more easily traumatized than adults. Once a trauma has occurred, early intervention is essential. The sooner emotional support is provided, the less likely children (or adults) will suffer from long-term effects. Parents should watch for the warning signs. Parents, teachers and peers should establish a feeling of safety. Psychotherapy, behavior modification techniques, cognitive therapy and medication are various means of therapy to help children cope with memories of trauma.
Dr. Bunnell treats children and adolescents at Centra Health’s Piedmont Psychiatric Center in Bedford and Lynchburg, tel. 434-947-5999.