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20 - Post-traumatic stress disorders

Published online by Cambridge University Press:  21 August 2009

By
William Yule ,
Patrick Smith  and
Sean Perrin
Edited by
Philip J. Graham
William Yule
Affiliation:
Institute of Psychiatry, London, UK
Patrick Smith
Affiliation:
Institute of Psychiatry, London, UK
Sean Perrin
Affiliation:
Institute of Psychiatry, London, UK
Philip J. Graham
Affiliation:
Institute of Child Health, University College London
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Summary

Research over the last three decades has shown that children and adolescents who have been exposed to extreme stressors manifest a range of short- and long-term reactions, including anxiety, fears and depression, as well as post-traumatic stress disorder (PTSD). The diagnosis was initially controversial, particularly as applied to children, but has proven to be a useful framework for describing and understanding children's reactions to a variety of life-threatening experiences. This in turn has led to the refinement of interventions for children; broadly based cognitive behavioural therapies (CBTs) within a multi-modal, family-based approach are the treatment of choice.

Post-traumatic stress reactions in children and adolescents

PTSD was first recognized by the American Psychiatric Association in the third edition of the Diagnostic and Statistical Manual (American Psychiatric Association, 1980); and in the 1987 revision it was acknowledged that it can also occur in children. The most recent edition, DSM-IV (American Psychiatric Association, 1994), describes in more detail the way in which a number of symptoms may manifest in children. PTSD is defined as: (1) exposure to an event in which the person experienced, witnessed or was confronted with the actual or threatened death or serious injury, or a threat to the physical integrity of self or others, and in which the person's response involved intense fear, helplessness or horror; (2) persistent re-experiencing of the event; (3) persistent avoidance of related stimuli or numbing of responsiveness; and (4) persistent symptoms of increased arousal.

Type
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Information
Cognitive Behaviour Therapy for Children and Families , pp. 342 - 358
Publisher: Cambridge University Press
Print publication year: 2004

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