Post-Traumatic Syndromes in Childhood and Adolescence: A Handbook of Research and Practice

By Vittoria Ardino | Go to book overview

Chapter Two
Vulnerability and Resilience in
Childhood Trauma and PTSD

Scott D. Cicero, Kate Nooner, and Raul Silva


Introduction

Trauma and its sequelae have been reported since the early twentieth century (for review, see Saigh & Bremner, 1999). The nomenclature of traumatic disturbance has evolved as knowledge has increased regarding the patterns of illness presentation. By 1980, Post-Traumatic Stress Disorder (PTSD) was officially recognized in the Diagnostic and Statistical Manual of Mental Disorders – Third Edition (DSM-III) (American Psychiatric Association (APA), 1980). Although it was not until the DSM-III-R (APA, 1987) that features specific to the developmental differences in children were included in the description of PTSD, early reports described psychological sequelae in children exposed to severe stressors, such as war and maltreatment (Bender & Blau, 1937; Bodman, 1941). Features such as avoidance, hyperarousal, and reexperiencing are chronicled in the reported cases and are very similar to current diagnostic criteria for PTSD.

Children and adolescents in today’s society are increasingly exposed to a variety of environmental stressors. Whether domestic or community violence, terrorism, natural disasters or different forms of abuse and neglect, the myriad of stressors provides the substrate for the development of PTSD. DSM-IV criteria stipulate a cause-and-effect model or pathway between traumatic event exposure and the development of PTSD. However, only a fraction of children exposed to traumatic events go on to develop the disorder (Spitalny, 2004). This suggests that resilience and vulnerability factors may mediate the development of PTSD. Identifying these risk and protective factors can serve as a crucial step in establishing early and possibly preventive treatments.

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