How Post-Traumatic Stress Affects Children and Adolescents

More than 65% of children and adolescents are estimated to experience one or more traumatic life events by age 16, and of those, about 16% will develop post-traumatic stress disorder. To understand how post-traumatic stress disorder in children and adolescents is treated, it is important to first understand this disorder.

What is post-traumatic stress disorder?

Post-traumatic stress disorder, or PTSD, is a stress and trauma-related disorder that may develop after exposure to an event or ordeal in which death, severe physical harm or violence occurred or was threatened.

In community samples, more than two-thirds of children report experiencing a traumatic event by age 16. And, it is not uncommon for children and adolescents to be exposed to more than a single traumatic event.

While not all children who experience a traumatic event develop PTSD, an increased frequency or prolonged exposure may increase a child’s vulnerability of developing this disorder.

Common examples of traumatic experiences that children and adolescents may experience include:

  • Sexual abuse / rape

  • Physical abuse

  • Domestic violence

  • Community and school violence

  • Medical trauma

  • Natural disasters

  • Military-family related stressors

  • Sudden or violent loss of a loved one

  • Neglect

  • Life-threatening illnesses

  • Serious accidents, include motor-vehicle accidents

What are the symptoms?

Following exposure to a traumatic life event, most children and adolescents experience some form of short-term distress, however, most return to their prior levels of functioning after a few weeks or months.

In some cases, they may exhibit ongoing symptoms that interfere with their daily life, such as:

  • Nightmares

  • Sleep problems, such as difficulty falling or staying asleep

  • Reliving the event over and over in thought or in play

  • Becoming very upset when something causes memories of the event

  • Lack of positive emotions

  • Loss of interest in activities that previously enjoyed

  • Intense fear or sadness

  • Irritability

  • Outbursts of anger

  • Acting helpless, hopeless or withdrawn

  • Denial that the event happened

  • Avoiding places or people associated with the event

  • Easily startled or increased alertness

  • Difficulty concentrating

Additionally, children and adolescents may experience symptoms that are not commonly seen in adults, including:

  • Behavioral problems

  • Developmental regression

  • Physical symptoms, such as headaches or stomachaches

  • Generalized fears

According to the CDC, children who have experienced traumatic stress may seem restless, fidgety, or have trouble paying attention and staying organized, the symptoms of traumatic stress can be confused with symptoms of attention-deficit/hyperactivity disorder.

Diagnosis and treatment of childhood and adolescent and childhood PTSD

According to the American Psychological Association, the identified trauma may not be the one that is most distressing to the child. For this reason, gathering a thorough, detailed history of trauma exposure is essential.

There are several treatment options available that will discuss more in-depth in the second part of this series. Your child’s doctor will recommend a customized treatment plan based on:

  • Your child’s age, overall health and medical history

  • The extent of your child’s symptoms

  • Your child’s tolerance for specific medications or therapies

  • Expectations for the course of the disorder

  • The parent or guardian’s opinion or preference

Your child’s treatment plan may include one or more of the following types of therapy:

  • Cognitive behavioral therapy

  • Exposure-based therapy

  • Psychodynamic therapy

  • Narrative therapy

  • Supportive counseling

  • Family-based therapy

  • Eye movement desensitization and reprocessing (EMDR) therapy

If you notice symptoms of PTSD in your child or teen, it is important to consult a child psychiatrist or other qualified mental health professional who will conduct a comprehensive psychiatric evaluation. Post-traumatic stress disorder may also be accompanied by depression, substance abuse and anxiety.

The care team at Mind Body Seven in Brooklyn, New York, specializes in working with child, teens and young adults with PTSD as well as a variety of mood, anxiety, attention and adjustment difficulties. For more information, call (212) 621-7770.