Post-traumatic Reactions

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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:

  • Reaction to traumatic event includes intense fear, helplessness, horror or disorganized or agitated behavior (also present in PTSD)
  • Dissociative symptoms- numbing, detachment, disorientation, reduced awareness of surroundings, or amnesia following a traumatic event
  • 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:
  • 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
  • increased fears and anxieties especially at night or upon separation
  • increased level of distress-irritable, easily set off, stressed
  • avoidance of thoughts, feelings, reminders associated with trauma
  • decreased interest in previously significant activities (friends, sports, school)
  • emotional regression-thumb sucking, loss of previously acquired developmental skills (in younger children-bladder, bowel control, language skills)
  • detachment from others, restricted emotional affect, or anger, aggressive play
  • sense of foreshortened future
  • 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.

Brought to you by The Children's and Adult Center for OCD and Anxiety.

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