Post-Traumatic Stress Disorder is a well-known psychological disorder in adults. The media and art, especially cinema , have featured it frequently but usually only in adults.
In the diagnostic manuals, as soon as the presence of the disorder was detected, the criteria for adults were established. When it was seen that it could also affect children and adolescents , the standards already established were simply applied to this group.
However, research has shown that this is not the case, that there are some differences in how the disorder presents according to age. Therefore, the latest version of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) has established different criteria for the diagnosis of post-traumatic stress disorder in children .
WHAT IS THE ORIGIN OF THE DISORDER?
Post-traumatic stress disorder in children under 6 years of age (when they are older, the criteria for adults are used) can appear after exposure to death, serious injury or sexual violence, whether it was real or only a direct threat to themselves or about others (does not include events that have only been seen in electronic media, television, films or photographs) or indirect (knowledge that it has happened to parents or people important to the minor).
This traumatic event is the central component of the disorder, but not all children who suffer a very negative life event develop any problems. Fear in situations like this is normal, it is an adaptive fear in the face of lack of security .
WHAT ARE THE SYMPTOMS OF THE DISORDER?
Post-traumatic stress disorder in children and adults has a characteristic manifestation since its symptoms are distributed in different areas .
In adults, the symptoms are divided into four groups: intrusion, avoidance, cognitive and mood alteration, and alert and reactivity symptoms.
In the case of post-traumatic stress disorder in children, we only have three categories since the symptoms of avoidance are fused with those of cognitive alteration and mood. This decision responds to the fact that in young children cognitive symptoms are less predominant and they tend to manifest their discomfort more through irritable mood and physical symptoms. Specifically, the symptoms are the following:
- One or more intrusion symptoms associated with the trauma experienced.
- Distressing memories of the trauma.
- Dreams and nightmares related to the event.
- Dissociative reactions in which the child feels or acts as if he or she is experiencing the trauma at the time. These symptoms can occur during play.
- Very intense discomfort when exposed to related internal or environmental factors.
- Important physiological reactions to the memory of the trauma.
One or more symptoms of persistent avoidance of associated stimuli or of cognitive and mood alteration:
- Avoidance of related activities, places …
- Avoidance of people, conversations, or situations reminiscent of the traumatic event.
- Increase in the frequency of unpleasant emotional states (fear, sadness, guilt …).
- Great decrease in interest or participation in activities that were previously important.
- Inhibited and withdrawn social behavior .
- Reduction of the expression of positive emotions .
Finally, two or more symptoms of alteration of physiological reactivity and the level of attentional alertness:
- Irritable behavior and unexplained outbursts of rage.
- Excessive vigilance regarding any possible sign of threat in the environment.
- Exaggerated startle responses to stimuli.
All of these requisite symptoms must be met for a month and cause significant discomfort , problems in the child’s relationships or in daily performance.
Other characteristics that support the diagnosis of post-traumatic stress in children are regression or steps backward in development . For example, the loss of already acquired language or re-wetting the bed. Auditory pseudo-hallucinations may also appear.
Outbursts of anger are very common. Generally , prolonged, repeated and serious traumatic events lead to little ones experiencing great problems regulating their emotions and maintaining relationships with other children and adults.
SHOULD I BE ALARMED IF ANY OF THESE SYMPTOMS APPEAR IN MY CHILD AFTER TRAUMA?
As we mentioned, it is normal and adaptive to suffer a strong emotional reaction to an event that is out of the ordinary in such a negative way. All these mentioned symptoms can occur with greater or lesser severity in a person after suffering a negative event. Both children and adults, to a greater or lesser extent according to their previous experiences.
To know if it is a post-traumatic stress disorder in children we must take into account the time factor . If these symptoms occur in sufficient numbers but for less than 4 weeks, it would be what is clinically called acute stress disorder . This diagnosis is transitory and, therefore, benign (which does not mean lacking in suffering for the child and his family).
After experiencing a traumatic event, there may not be an immediate reaction and these common reaction symptoms may appear later. This is what is known as a delayed start . Everyone has their times and it is important that the family environment allows the adequate expression of discomfort.
HOW SHOULD I REACT IF MY CHILD HAS SUFFERED TRAUMA?
As we mentioned, when not enough time has passed we speak of an acute stress disorder. The passage from this to the other diagnosis is determined by many factors and a very important one is the response of the family environment .
It is best for the family environment to respond with understanding and provide a safe environment for the child. Creating a loving environment that allows you to express yourself is essential. Give time and do not burden the child with our own pain for seeing him suffer, since the rush or a very intense emotional reaction of the parents can hide their emotions. The greatest enemies of a traumatic event are silence and indifference.
In case the symptoms persist, it is very important to go to a specialist clinical psychologist since, unlike what happens in other emotional states that can remit over time, post-traumatic stress disorder in children, adolescents and adults tends to take root. and establish itself strongly with the passage of time.