What is PTSD?

             PTSD is a psychiatric disorder, stemming from an individual�s experience to an event that has threatened the individual�s own or another person�s life or physical integrity.  The distressed individual responds to the traumatic event with anxiety, fear, and helplessness.  Children may be diagnosed with PTSD if they have survived natural disasters, kidnapping, or rape.

 PTSD in Children

Age-specific symptoms of PTSD and Case

1) Very young children (birth-age 4):  Young children, who are unable to verbally describe their emotions, exhibit generalized fears such as separation anxiety, sleep deprivation, and preoccupation with words/events that may or may not be correlated to psychological trauma.  Young children may also lose their ability to perform developmental skills such as potty training.

Cases:

• In Phuket, Thailand, 18-month Hannes Bergstrom, who was rescued from the roof of a hotel, was found to continuously squeeze the toy in his hand and mumble.  Reunited with his father, Bergstrom stopped playing and talking, returning to normal.
  • A stable family environment and parental support are important for the well being of children, who are sensitive to trauma and unstable family life.

2) Elementary school-aged children (ages 5-12): Elementary school-aged children experience �time skew� and �omen formation� rather than amnesia following a traumatic event.  Time skew occurs when children incorrectly sequence traumatic events when recalling the past.  Omen formation refers to children who believe that they can identify warning signs to prevent future trauma.  In addition, elementary age children express posttraumatic reenactment of trauma through pictures and speech.

Cases:

• In the Aceh province of Indonesia, 35,000 children lost one of their two parents. During the tsunami, children watched as their parents, friends, and relatives swept out into sea.   A six-year old Indonesian boy pretended that he was blind after the tsunami even though doctors examined nothing was wrong.  The young boy could not stand the sight without his parents. 
  • Children who have lost psychological support from their parents need to face the horrors of the tsunami and redevelop confidence in themselves.

3) Adolescents (ages 13-18): PTSD in adolescents is similar to PTSD in adults.  Adolescents exhibit posttraumatic reenactment and aggressive behaviors. 

What are the risk factors for PTSD?

Three factors are shown to increase the probability that children will acquire PTSD.

1)  Severity of the trauma

            2)  Response of parent to the trauma

• Children with stronger family support and less parental disturbance are shown to develop less extreme symptoms of PTSD. 

• Children, who are separated from their parents by the tsunami, must face life as orphans until they are reunited with their family.

            3)   Physical distance to the trauma

• Children that have a greater proximity from the traumatic event show less distress.

• Children, who witnessed their communities destroyed, are found to feel less secure about their environment, less lively, and less able to enjoy life.

PTSD in Developing Countries

• Specific psychological problems were found in 89% of the developing country samples after natural disasters.  Eighty-one percent of the samples were identified to have PTSD.
• Samples in developing countries showed higher levels of PTSD than samples from USA.  Physical proximity to disaster accounted for 15% of the difference.
• People with lower socioeconomic status have a greater tendency to develop PTSD.
• More research on disasters in developing countries is needed.  The amount of research done in developing countries compared to the frequency of natural disaster is extremely low.  Few studies have been conducted on the impact of natural disasters on children in developing countries.