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| |    Understanding Post-traumatic Stress in Children by Robert Needlman, M.D., F.A.A.P. reviewed by Laura Jana, M.D., F.A.A.P. When a disaster strikes, everyone affected by it is exposed, in varying degrees, to emotional stress. A high proportion--50 to 75 percent--of the people directly involved in the disaster are likely to develop a severe reaction to the crisis known as post-traumatic stress disorder, or PTSD. Many of those who experience the disaster indirectly, such as through television viewing, may show milder symptoms that resemble PTSD. What is PTSD? PTSD is an emotional and behavioral response to severe stress. Key features of the disorder include generally heightened fear or anxiety and specific unwanted memories of the stressful event. These memories may seem so immediate and vivid that the person feels as if she's reliving the event over and over. They can be triggered by sounds, sights, or smells, or they can come in the form of nightmares. Adults may develop a sense that the world is not real and begin to dread the future. PTSD in children Children with PTSD may not show all the symptoms that adults do. Their anxiety often surfaces in sleep problems and nightmares, and increased fears of monsters or animals. In this sense, they may seem to regress to habits or behaviors they had years ago. Some startle easily in response to loud or sudden noises and develop vague aches and pains that are signs of stress. Children may try to avoid things that reawaken distressing memories, particularly talking about the traumatic event. Sometimes they connect certain objects or situations with the trauma that, to an adult's eye, are not obviously related. Other symptoms include a numbing of regular emotions, such as happiness, or a child's loss of interest in her usual play or friends. Children express themselves through play, and one of the primary symptoms of PTSD is repetitive, compulsive play that reenacts the traumatic event. For example, a child who has been disturbed by witnessing violence between her parents may act out violent scenes with her dolls for hours at a time. The difference between this play and normal play is that the latter typically has more variety. A child's attitude while she's playing is another tip-off: Children with PTSD are usually very somber while they're playing; they don't seem to really be having fun. What is the treatment? Treatment for PTSD generally requires collaboration between parents, psychiatrists, and therapists. Both play and talk therapies are useful. A key part of therapy is explaining to children and parents about the normal response to traumatic events and correcting misconceptions they may have. For instance, many children believe that the traumatic events were somehow their fault. Medication is not a standard part of therapy, but it can be useful for some children. Treatments for children often differ from those for adults, so it is especially important that both the therapist and the doctor have experience working with children. Can PTSD be prevented? There is no surefire way to prevent PTSD. Given a severe enough trauma, it can develop in anyone. Some children may be less prone to developing PTSD simply as a matter of their inborn temperaments. "Toughening a child up" psychologically does not work. On the contrary, children who have been exposed to prior traumas (for example, unexpected or lengthy separations from their parents) may be even more likely to develop PTSD. On the other hand, children who are secure and well loved may have a stronger emotional base from which to withstand the stress of a traumatic event. More information: Talk about: If you wish to print this article, click here for a printer-friendly version. If you do not have a PDF reader, you can download and install a free copy from Adobe. All content within this Site (as well as the organization and layout of the Site) are owned and copyrighted by The Dr. Spock Company or its affiliates and may be accessed, downloaded or printed for your personal, non-commercial use only. Please email info@drSpock.com if you have any questions.
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