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Apr.03.2020View related content
 Post-Traumatic Stress Disorder, Pediatric

Post-Traumatic Stress Disorder, Pediatric

Post-traumatic stress disorder (PTSD) is a mental health condition that can occur in children who experience a traumatic event, such as a threat to life, serious injury, or abuse. Some children who experience these types of events may develop PTSD. Sometimes, PTSD can occur in children who hear about trauma that happened to a close family member or friend.
It is normal for a child to show signs of stress after exposure to trauma. If these reactions do not go away, or if they get worse, your child may have PTSD. For most children, symptoms of PTSD go away with time. However, some children may continue to have symptoms for years if they do not get treatment.

What increases the risk?

This condition is more likely to occur in:
  • Children who have been victims of, or witnesses to, a traumatic event such as:
    • Physical or sexual abuse.
    • Violence or war.
    • A natural or human-caused disaster.
    • An accident or medical trauma.
    • Death of a parent.
  • Children with other mental health conditions.
  • Children who have a parent with a mental health condition.

What are the signs or symptoms?

The symptoms of PTSD are often different for children of different ages.

In children age 6 or younger

Symptoms in children age 6 or younger may include:
  • Repeated (recurring) distressing memories or dreams of the trauma.
  • Reactions as if the trauma were occurring in the present. A child may lose awareness of his or her surroundings.
  • Intense psychological distress when the child is exposed to things that remind him or her of the trauma.
  • Avoiding people, places, or things that remind the child of the trauma.
  • Marked changes in mood or reactions to situations, such as:
    • Aggressive behavior or anger.
    • Startling easily.
    • Trouble concentrating.
    • Sleep problems.

In children older than 6 years

Symptoms of PTSD in children older than 6 years can be similar to symptoms in young children, but they may also include:
  • Omen forming. This means associating certain warning signs with the traumatic event. The child believes that if he or she notices this warning sign, he or she can avoid future trauma.
  • Time skew. This means recalling an event in a different sequence than how it actually occurred.
  • Post-traumatic play. This means acting out some aspect of the trauma during play.

In teenagers

Symptoms of PTSD in teenagers are similar to symptoms in adults, and they may include:
  • Distressing dreams, or distressing memories while awake.
  • Feelings of fear, horror, intense sadness, anger, guilt, or shame in response to a reminder of the trauma.
  • Physical reactions that are triggered by reminders of the trauma. These may include increased heart rate, shortness of breath, sweating, or shaking.
  • Having flashbacks, or having the feeling of going through the event again.
  • Decreased interest or participation in daily activities.
  • Loss of connection, or avoidance of other people.
  • Being easily startled.
  • Careless or self-destructive behavior.
  • Feeling "on edge" (nervous).
  • Trouble concentrating.
  • Verbal or physical outbursts of anger toward other people or objects.
  • Trouble sleeping.
  • Not being able to remember certain parts of the traumatic event.
  • Inability to experience positive emotions, such as happiness or love.

How is this diagnosed?

PTSD is diagnosed through an assessment by a mental health professional. You or your child may be asked about any traumatic events. Your child will also be asked about how these events have changed his or her thoughts, mood, behavior, and ability to function on a daily basis. You may be asked to provide your observations about any noticeable changes in your child's behavior.

How is this treated?

Treatment for PTSD may include:
  • Medicines. Certain medicines can reduce some PTSD symptoms.
  • Counseling (cognitive behavioral therapy, CBT). Talk therapy with a mental health professional who is experienced in treating PTSD can help.
  • Eye movement desensitization and reprocessing therapy (EMDR). This type of therapy is done with a specialized therapist.
  • Play therapy. A mental health professional uses games, drawings, or other activities to help your child work through traumatic memories and emotions.
Some children with PTSD may benefit from a combination of these treatments.

Follow these instructions at home:

Lifestyle

  • Provide support to your child by:
    • Being affectionate and loving.
    • Giving your child time to accept what has happened.
    • Creating a safe family environment.
    • Reducing other things that cause stress to start (triggers), such as family fights, moving to a new home, or changing schools.
    • Limiting media exposure and news reports about distressing events, especially for young children.
    • Using simple words to answer a child's questions. Avoid providing details.
    • Talking together about feelings.
    • Staying involved in activities that are healthy for your child's mind and body.
    • Planning activities that let your child relax and have fun.
    • Creating and following schedules and routines.
  • Help your child find ways to cope with stress and anxiety. These may include:
    • Breathing exercises.
    • Meditation or yoga.
    • Listening to music.
    • Organized exercise and play.
    • Spending time with people who make your child feel safe.
    • Finding a support group or family counselor.

General instructions

  • Give your child over-the-counter and prescription medicines only as told by your health care provider.
  • Follow your child's treatment plan carefully.
  • Keep all follow-up visits as told by your child's health care provider. This is important.

Contact a health care provider if:

  • Your child has new or worsening signs or symptoms of PTSD.
  • Your child's anxiety interferes with daily tasks.
  • Your child asks questions about life and death that you cannot answer.

Get help right away if:

  • Your child expresses thoughts of suicide.
  • Your child expresses thoughts of harming others.
If you ever feel like your child may hurt himself or herself or others, or may have thoughts about taking his or her own life, get help right away. You can go to your nearest emergency department or call:
  • Your local emergency services (911 in the U.S.).
  • A suicide crisis helpline, such as the National Suicide Prevention Lifeline at 1-800-273-8255. This is open 24 hours a day.

Summary

  • It is normal for a child to show signs of stress after exposure to trauma. If these reactions do not go away, or if they get worse, your child may have post-traumatic stress disorder (PTSD).
  • PTSD is diagnosed through an assessment by a mental health professional. Your child may be asked about any traumatic events and how these events have affected him or her.
  • Treatment may include medicines, counseling, therapy, or a combination of these treatments.
  • Provide support to your child and help your child find ways to cope with stress and anxiety.

This information is not intended to replace advice given to you by your health care provider. Make sure you discuss any questions you have with your health care provider.