Child Psychopathology

By Eric J. Mash; Russell A. Barkley | Go to book overview

CHAPTER
SEVEN
Childhood Posttraumatic
Stress Disorder

Kenneth E. Fletcher

The unpredictable nature of many catastrophic events makes it difficult to determine the number of children each year who are exposed to traumatic events. Between 6% and 7% of the U.S. population is exposed annually to extreme stressors, ranging from natural disasters to driving accidents to crime to acts of terrorism (Norris, 1988). Many of the victims of these disasters are children. In 2000, an estimated 99,630 children ages 14 and under were treated in hospital emergency rooms for burn-related injuries (National Safe Kids Campaign, 2002), and approximately 879,000 children were found to have suffered from maltreatment, according to statistics collected by the National Clearinghouse on child Abuse and Neglect (2002). In 2000, persons ages 12–24 were subjected to violent victimization at rates higher than individuals of all other ages (Perkins, 1997), and in 1999, 12% of homicide victims were under the age of 18 (U.S. Department of Justice Bureau of Justice Statistics, 2002). In the same year, 894,000 children and adolescents 20 years old or younger were injured in motor vehicle accidents (U.S. Department of Transportation, 1993). Clearly, a good many children can be expected to encounter hazardous circumstances at least once before their childhood ends (Saigh, Yasik, Sack, & Koplewicz, 1999). In fact, in a recent survey of over 1,400 children and adolescents, it was found that onequarter experienced one high-magnitude traumatic event by age 16 and 6% had experienced such an event within the past 3 months (Costello, Erkanli, Fairbank, & Angold, 2002).

Unfortunately, the likelihood of being exposed to calamitous events seems to be accelerating with the pace of modern life. Television and the rest of the mass media bring explosive disasters into the family living room with an immediacy that can be difficult to avoid. This was evident as far back as January 18, 1986, when children watched the Challenger space shuttle explosion live on television (Terr et al., 1999). The devastating effects of the Oklahoma City bombing of April 19, 1995, were broadcast across the country, causing distress in children and adolescents living far away from the disaster (Pfefferbaum, Seale, et al., 2000). When children in San Francisco were asked to draw their reactions to the World Trade Center and Pentagon tragedies of September 11, 2001, which occurred over 3,000 miles away, each and every one of them produced disturbingly graphic pictures of planes flying into towers while people jumped from the windows (Terr, 2001).

Exposure to traumatic events in childhood can have dire and long-lasting consequences, not only for traumatized children but for society as well. Green (1985) has suggested that “failure to master the trauma of childhood creates a continual need to repeat and reenact them during adult life” (p. 146), and others who have studied the subject agree (Pynoos & Eth, 1985b). There is evidence that childhood trauma is linked to later

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