What is Post-traumatic Stress Disorder?
Post-traumatic Stress Disorder (PTSD) is a stress disorder which can develop in children and adolescents as a result of directly experiencing, witnessing or being confronted with a single-incident traumatic (stressful) life event, or a period of prolonged stress due to a traumatic experience.
‘Single-incident traumatic events’ may include experiencing or witnessing serious car or pedestrian accidents, serious falls, burns or other types of accidents, violent crimes (including assault), dog attacks, natural and man-made disasters (such as bushfires, house-fires, floods, chemical explosions, cyclones), undergoing emergency medical treatments, being diagnosed with a life-threatening medical condition (e.g., cancer), or being confronted with family members or close peers who have suffered from a life-threatening situation.
‘Potentially prolonged traumatic events’ include experiencing or witnessing repeatedly over weeks or months physical and/or sexual assault or abuse, or living or working in war affected regions.
Traumatic events which can cause PTSD involve a potential threat to one’s life, or a threat of injury to self or other people. Research has shown that up to 40% of children and adolescence have experienced at least one traumatic life events, whilst about 80% of individuals in their lifetime will have experienced at least one traumatic life event. However, not all children and adolescents who experience traumatic events will develop PTSD. However a proportion of young people may be at risk of developing PTSD.
PTSD symptoms in children and adolescents:
PTSD reactions in children and adolescents may include some of the following symptoms:
- Feelings of fear and anxiety. For example, a child involved in a bus accident may be scared travelling on transport, or being afraid of returning to the place the accident happened. Following a traumatic experience, fear and anxiety reactions in children may occur suddenly, (‘out of the blue’) and the child may not necessarily make the link between their fear and situations which give rise to their fear and anxiety symptoms, as trauma-related reminders (e.g., buses) may spread to include other distantly trauma-related experiences (e.g., travelling on other types of transportation including cars and trains).
- Upsetting images or thoughts about the experience. For example, having pictures of the event suddenly ‘pop’ into one’s mind which causes distress
- Feeling like the trauma is happening again; that is re-living the experience. Some images which pop into mind may be so vivid that they seem very real, as if the stressful event was happening all over again. This experience is called a ‘flashback’.
- Trying to avoid reminders of the event or may even ‘forget’ worst parts of the experience
- Avoidance reactions include avoidance of thinking, talking or being confronted with reminders of the experience
- Bad dreams (including nightmares) or trouble sleeping
- Bad dreams about the experience or in younger children they may be prone to having bad dreams in general (more regularly than usual since the traumatic event).
- Sleeping problems may also include trouble falling or staying asleep.
- Feeling irritable or easily angered
- Children may become more moody and even experience anger outbursts.
- May become jumpy at loud, sudden noises such as a car backfiring or skidding loudly, or a door slamming.
- Trouble concentrating
- Other physical symptoms
- Children may also report experiencing more physical symptoms such as head-aches and stomach-upsets following a traumatic event.
Other emotional responses following trauma:
Children and adults may also experience other emotional reactions following a traumatic experience. The most common reactions include feeling low, sad or depressed; feelings of guilt (for e.g., surviving the experience whilst others may have been more seriously injured or even died), or self-blame (feeing somehow responsible or to blame for the trauma happening); feeling embarrassed or shame (at how they acted at the time of the trauma, and/or how they are coping with their trauma symptoms).
Persons recovering from a trauma may also experience grief reactions especially if they have experienced serious injury or witnessed other people dying. In addition, individuals recovering from trauma may also meet criteria for other anxiety and mood disorders including Major Depression.