Post-Traumatic Stress Disorder

As stated earlier, some children and adolescents will have prolonged problems after a traumatic event. These potentially chronic conditions include depression and prolonged grief. Another serious and potentially long-lasting problem is post-traumatic stress disorder (PTSD). This condition is diagnosed when the following symptoms have been present for longer than one month:

• Re-experiencing the event through play or in trauma-specific nightmares or flashbacks, or distress over events that resemble or symbolize the trauma.
  
• Routine avoidance of reminders of the event or a general lack of responsiveness (e.g., diminished interests or a sense of having a foreshortened future).
  
• Increased sleep disturbances, irritability, poor concentration, startle reaction and regression.

Rates of PTSD identified in child and adult survivors of violence and disasters vary widely. For example, estimates range from 2% after a natural disaster (tornado), 28% after an episode of terrorism (mass shooting), and 29% after a plane crash. The disorder may arise weeks or months after the traumatic event. PTSD may resolve without treatment, but some form of therapy by a mental health professional is often required in order for healing to occur. Fortunately, it is more common for a traumatized child or adolescent to have some of the symptoms of PTSD than to develop the full-blown disorder. People differ in their vulnerability to PTSD, and the source of this difference is not known in its entirety.

Research has shown that PTSD clearly alters a number of fundamental brain mechanisms. Because of this, abnormalities have been detected in brain chemicals that affect coping behavior, learning, and memory among people with the disorder. Recent brain imaging studies have detected altered metabolism and blood flow as well as anatomical changes in people with PTSD. Further information on PTSD and research concerning it may be found in the NIMH fact sheet, "Facts About Post-Traumatic Stress Disorder," which is posted on the NIMH Web site (http://www.nimh.nih.gov) or available by mail from the address noted on the accompanying resources list.

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