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Dec.03.2020
 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. 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 symptoms last for more than a month, your child may have PTSD. For most children, symptoms improve over time. However, some children may continue to have symptoms for years if they do not get treatment.

What are the causes?

This condition may develop when a child experiences a traumatic event.

What increases the risk?

This condition is more likely to occur in:
  • Children who have experienced 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?

In children age 6 or younger

Symptoms may include:
  • Repeated (recurring) distressing memories or dreams of the trauma.
  • Reactions as if the trauma were occurring in the present.
  • 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 temper tantrums.
    • Startling easily.
    • Trouble concentrating.
    • Sleep problems.

In children older than age 6

In addition to the symptoms seen in younger children, these children may experience:
  • Omen forming. This is a type of magical thinking where a child believes that if he or she notices some warning sign, he or she can avoid future trauma.
  • Time skew. The child recalls an event in a different sequence than how it actually occurred.
  • Post-traumatic play. The child acts 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:
  • Intrusive symptoms. The teen re-experiences the physical and emotional sensations of the traumatic event, such as:
    • Having distressing memories while awake or distressing dreams.
    • Experiencing intense feelings in response to a trigger that reminds him or her of the trauma.
    • Having 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 believing he or she is going through the event again.
  • Avoidance symptoms. The teen avoids anything that reminds him or her of the trauma. This may also include:
    • Losing interest or not participating in daily activities.
    • Feeling disconnected and avoiding other people.
  • Increased arousal symptoms. This is when the teen has physical or emotional symptoms, such as:
    • Being easily startled or nervous.
    • Behaving in a careless or self-destructive way.
    • Having trouble concentrating.
    • Having verbal or physical outbursts of anger toward other people or objects.
    • Having trouble sleeping.
  • Negative mood and thoughts. These include:
    • Not being able to remember certain parts of the traumatic event.
    • Being unable 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 to describe the experience of the traumatic event. 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,or CBT) or exposure therapy with a therapist who specializes in treatment of PTSD.
  • Eye movement desensitization and reprocessing (EMDR) therapy. This type of therapy is done with a specialized therapist.
  • Play therapy with a mental health professional who specializes in this approach with children.
Some children with PTSD may benefit from a combination of these treatments.

Follow these instructions at home:

Support your child

Provide support to your child by:
  • Being affectionate and loving.
  • Giving your child time to accept what has happened.
  • Using simple words to answer your child's questions.
  • Talking and listening to your child about his or her experience and feelings.

Manage stress and anxiety

  • Help your child find ways to manage 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.
  • Reduce things that cause stress to start (triggers), such as family fights, moving to a new home, or changing schools.
  • Limit media exposure and news reports about distressing events, especially for young children.

Activity

  • Offer your child opportunities to do activities that are healthy for your child's mind and body.
  • Plan activities that let your child relax and have fun.
  • Create and follow schedules and routines.

General instructions

  • Give your child over-the-counter and prescription medicines only as told by your child's 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.

Where to find more information

Contact a health care provider if:

  • Your child's PTSD symptoms do not improve.
  • Your child has new or worsening symptoms of PTSD.
  • Your child seems to be thinking and talking a lot about death.

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 shares 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.).
  • Call a suicide crisis helpline, such as the National Suicide Prevention Lifeline at 1-800-273-8255. This is open 24 hours a day in the U.S.
  • Text the Crisis Text Line at 741741 (in the U.S.).

Summary

  • It is normal for a child to show signs of stress after exposure to trauma. If these symptoms last for more than a month, your child may have post-traumatic stress disorder (PTSD).
  • PTSD is diagnosed through an assessment by a mental health professional. Treatment is also performed by a specialist in PTSD.
  • Treatment may include medicines, various types of therapy, or a combination of these treatments.
  • Provide support to your child and help your child find ways to manage stress and anxiety. Contact your health care provider if your child's PTSD does not improve.

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.

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