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Post-traumatic Reactions
Brief description:
Try as we do as parents to shield our children from trauma, many parents
find themselves facing the unthinkable. Despite the fact that millions
of children experience a traumatic event only 25% will go on to develop
PTSD. However, all children, whether they meet for a diagnosis or not,
are going to need parental love and direction to manage their recovery.
There are two primary diagnoses that are identified for trauma reactions.
While Acute Stress Disorder is immediate and is characterized by a shutting
down or numbing to emotional experience, A Post Traumatic Stress Disorder
reaction, which can begin anywhere from a month to many months after
the traumatic event is manifested by hypervigilance, emotional reactivity,
and re-experiencing of traumatic material through flashbacks. While
the diagnostic criteria for PTSD requires the witnessing of a life-threatening
event, what is critical in the development of trauma symptoms in children
is the perception of a life threat, even when no one has actually
been injured or hurt in that situation. The perceived life threat can
be traumatic and explains why despite a more positive turn of events,
some children will experience PTSD or ASD where adults may not. The
symptoms of PTSD including nightmares and flashbacks can be very frightening
to children. Explaining that flashbacks and nightmares are ways that
the brain is trying to process and make sense of a situation which was
so overwhelming, and teaching strategies to manage those symptoms is
essential starting point.
Acute Stress Disorder:
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Reaction to traumatic event includes intense fear, helplessness,
horror or disorganized or agitated behavior (also present in PTSD)
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Dissociative symptoms- numbing, detachment, disorientation, reduced
awareness of surroundings, or amnesia following a traumatic event
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onset is immediate and shorter duration than PTSD (is evident
within a month and lasts 2 days to 4 weeks after traumatic exposure).
Post-Traumatic Disorder:
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re-experiencing of the event through flashbacks, nightmares, intrusive
thoughts, repetitive play with trauma-related themes, intense distress
when exposed to reminders of the trauma, may suddenly feel that trauma
is recurring
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increased fears and anxieties especially at night or upon separation
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increased level of distress-irritable, easily set off, stressed
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avoidance of thoughts, feelings, reminders associated with trauma
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decreased interest in previously significant activities (friends,
sports, school)
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emotional regression-thumb sucking, loss of previously acquired
developmental skills (in younger children-bladder, bowel control,
language skills)
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detachment from others, restricted emotional affect, or anger,
aggressive play
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sense of foreshortened future
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increased physiological arousal-sleep disturbance, increase startle
response, irritability, difficulty concentrating, hypervigilence
Treatment focus:
Treatment for post-traumatic reactions
involves first and foremost a re-establishment of the child's safety,
and explaining to the child how, though they are now safe, that they
may have moments when they suddenly feel like the trauma is happening
again (flashbacks) while the brain is trying to process and integrate
how something so frightening could have happened, and not be happening
now. Teaching breathing techniques and present-centering exercises are
used to help slow down the accelerating fear response and help the child
restore a sense of being in control. Once a child has acquired the techniques
for managing these symptoms, treatment will involve helping the child
to process the traumatic event. The goal is to help the child construct
a cohesive picture of the events which occurred, normalizing reactions,
correcting any misperceptions of blame, healing from any loss that may
have resulted and establishing an adaptive view of the self in light
of the trauma.
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