Academic journal article European Journal of Psychotraumatology

Trauma and Post-Traumatic Stress Disorder in Children and Adolescents

Academic journal article European Journal of Psychotraumatology

Trauma and Post-Traumatic Stress Disorder in Children and Adolescents

Article excerpt

ABSTRACT

Many children and adolescents are exposed to different types of trauma, e.g. abuse or various disasters. Trauma can cause severe and long-term impairment and consequences, the most studied of which are post-traumatic stress disorder (PTSD) and PTSD symptoms (PTSS). PTSD is highly prevalent in clinical practice (about 7%) and is a debilitating consequence of trauma. Of those children and adolescents exposed to trauma, about 16% will develop PTSD: almost 10% as a consequence of non-interpersonal traumatic events and 25% following interpersonal traumas. In this paper, we review predictors, assessment and treatment options for youth with PTSD (symptoms) and give directions for future research.

In the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5), PTSD has been included in the new chapter on Trauma- and Stressor-Related Disorders and now also includes a subtype of PTSD for preschool children; this represents a significant step in DSM taxonomy as it is the first developmental subtype of a psychiatric disorder. More emphasis has been placed on behavioural changes, with new wording, and consequently the chances of diagnosing PTSD in this population have been enhanced three- to eight-fold.

Predictors of PTSD include acute stress reaction, depression, anxiety, parental effects, and smaller effects of female gender, injury severity, duration of hospitalization, heart rate after admission, pre-existing psychiatric problems, history of significant losses or threat to life, insufficient psychological and social support systems, and presence of functional impairment. Other consequences of trauma include depression, anxiety, addiction and somatic health problems.

The thorough and accurate assessment of trauma and its impact using the appropriate instruments is important to implement appropriate early prevention and treatment interventions (Olff, 2015). The study of phenotypes or domains, e.g. cognitive, memory and executive functioning, may be a new approach in studying PTSD and its impact.

There are few studies on the long-term effects of mass trauma on victimized communities (Thordardottir et al., 2016). In the aftermath of major natural disasters, acute stress reactions are expected, and overall resilience is the rule rather than the exception. Many studies have shown that 1-6 months post-trauma, PTSD is reduced by approximately 50%; nevertheless, there are doubts as to whether there is further reduction of PTSD after 6 months post-trauma. …

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