Post-Traumatic Stress in Children

Post-Traumatic Stress Disorder in Children

Post-traumatic stress disorder (PTSD) is most commonly associated with war veterans. Researchers have, however, increasingly recognized this condition in women, children, and men from all backgrounds and for a variety of reasons. According to Roberts et al. (2011), the condition results from the experience of an event that is traumatic, and that makes the individual feel helpless, horrified, or afraid. A common factor among sufferers of PTSD is persistence. The individual persistently avoids stimuli he or she associates with the event, for example. There is also a tendency to re-experience the event persistently. There are also several health consequences associated with the condition. These include a tendency towards suicide, substance abuse, impaired functioning and general health problems (Roberts et al., 2011). When it occurs in children, post-traumatic stress disorder can have significant long-term consequences on their development. Several studies have investigated the demographic nature of those who are most vulnerable to the condition. Since children are a generally vulnerable part of the population, diagnosis and treatment of the condition is especially important to help them develop and grow into healthy and productive adults.

Demographics

Roberts et al. (2011) note that PTSD is differentiated according to race or ethnic differences. This is both the result of differential exposure to traumatic events that are severe enough to cause PTSD and the differential risk of developing the condition as a result of the exposure. The study by Roberts et al. (2011) found that the condition is most prevalent among Blacks, followed by Hispanics and Whites, while Asians experience the lowest risk of developing the condition. Interestingly, while Whites were found to be more likely to experience trauma to themselves, or to learn of it happening to someone close. On the other hand, Black and Hispanics have a higher tendency to experience or witness maltreatment a children.

The challenge comes when seeking treatment. This is a crucial step towards obtaining assistance and overcoming to condition. This is also differentiated among demographic groups, with minority groups being less likely that Whites to seek treatment. The authors found that fewer than half of those from minority groups diagnosed with PTSD sought treatment.

Roberts et al. (2011) conclude that culturally sensitive ways need to be developed to assist those from minority groups with PTSD to seek assistance for their condition. Increasing accessibility to such treatments is also important.

Causes and Consequences of PTSD in Children

There are various reasons why children might develop PTSD. One of these is physical injury. According to Odenbach et al. (2014), physical injuries to children occur very often. This is so not only because children are particularly vulnerable to injury, but also simply because of the nature of their stage of life. The authors emphasize the need to recognize the potential physical and emotional impacts of injury on children.

Emergency departments usually focus primarily on the physical aspects of injury. This creates a risk for young children to develop conditions such as acute stress disorder and post-traumatic stress disorder as a result of the psychological trauma related to the injury. The problem is that, if left unrecognized and/or untreated, these conditions can worsen and extend into adulthood.

The authors therefore suggest that screening guidelines should be implemented at facilities that treat child injuries in order to identify the potential for stress disorders in injured children. When these are in place, the disorders can be treated before they affect the individuals involved in the long-term.

Another basis for developing PTSD among children is being orphaned or abandoned (Whetton et al.). These children are particularly vulnerable to suffer from potentially traumatic events. The study found that, PTSD is often associated with emotional and behavioral difficulties in these children. In addition, when event exposure increases, the emotional and behavioral issues increase as well. Hence, these children are in need of mental health services, with equal protection being needed by both girls and boys.

According to Whetten et al. (2011), the problem is significant, since there are more than 143 million children worldwide who have been subjected to the death of a parent. Even more have been abandoned by both their parents. It is therefore difficult for organizations to meet the needs of these children, particularly on the emotional scale, where a significant amount of help and support is needed. Indeed 47.5 million children were orphaned in Sub-Saharan Africa during 2007, with even more orphans being abandoned either willfully or by the death of their parents in South and Southeastern Asia. This is a crisis because the future of nations depend upon the stability and future productivity of their children (Whetten et al., 2011).

For this reason, one of the main areas of investigation when considering the safety and well-being of these children is their risk of experiencing traumatic events and to develop PTSD as a result. As mentioned above, the condition causes significant instability even in adults. Hence early detection and treatment in children are particularly important.

When considering orphaned and abandoned children, one should therefore recognize that losing one or both parents is in itself a traumatic event. The likelihood of experiencing negative events as traumatic is therefore heightened and the risk of PTSD increases. As such, Whetten et al. (2011) demonstrate that orphaned and abandoned children, already having been traumatized by the loss of one or both parents, are at increased risk of experiencing negative events as traumatic. High-risk events may differ, however, from individual to individual.

The authors conclude by demonstrating that further trauma can be averted by means of protective intervention and the appropriate mental health care for the children involved.

Another current problem is that female children tend to be treated with greater care and concern than male children. The authors found, however, that both genders are equally vulnerable to potentially traumatizing events when they are abandoned or orphaned. This emphasizes the need to implement policies and strategies that target not only the physical needs, but also the emotional and mental needs of these children.

In addition to generally traumatic events, some children face extremely high levels of victimization in the form of maltreatment, abuse, and injury (Berkowitz, Stover, and Marans, 2011). Children are by nature vulnerable as a result of their limited size, strength and means. They are therefore at high risk of exposure to these dangers and of developing PTSD as a result. Indeed, Berkowitz, Stover, and Marans (2011) note that more than 60% of children and adolescents have been thus exposed to at least one event over the course of a year. Children are also exposed to high levels of domestic violence, with the figure coming to 15.5 million children in the United States per year witnessing or experiencing this type of violence. Many of these children are injured as a result. Hence, the numbers of children suffering from PTSD in either full or partial form are potentially very high, even up to the millions.

The authors note that children who are exposed by several factors in terms of social difficulty are at higher risk of developing PTSD than their counterparts who live in more stable circumstances. Poverty is one of these factors, with the authors asserting that, from a sample of elementary and middle school children in a poor urban community, 50% were found to display positive for full PTSD, with a further 21% screening positive for partial PTSD. These rates are extremely high and signifies the need for urgent attention to the matter.

As a solution, the authors suggest that a strong caregiver-youth relationship should be established and maintained. This can then be used as a platform preventative early interventions, particularly in poor communities where the risk of exposure is high.

Another cause for developing PTSD could be extreme circumstances, such as having to flee persecution in one's own country and resettling in a new country. When this happens to children and adolescents, several factors affect the developing or prevention of PTSD. When the new country is found to be nurturing and supportive, for example, PTSD is less likely to develop than when this is not the case (Fazel et al., 2011, p. 266). More often than not, such children emigrate from poor communities into high-income countries.

Risk factors for these children include the stress and trauma of the initial push factors, such as persecution or extreme poverty, and subsequently the stress of displacement and separation from family, friends, and an environment that is known or "home" to them. Upon arrival, the refugees face complex legal issues such as immigration laws, refugee status, and repatriation. Once these have been navigated, the young refugee must contend with social, cultural, and linguistic differences between their home country and the new world they have entered. From the time they took flight, therefore, these children are exposed to high levels of stress from all the external factors they face. All this could cause PTSD, which will serve only to compound the problems, difficulties, and stress factors they already face.

Despite this, there are cases in which asylum decisions are rapidly resolved, and the children's assimilation into and access to community goods and services are facilitated. In such cases, the healing process occurs more rapidly and children can pursue their lives without having to travel the dark path towards mental instability. This is why Fazel et al. (2011) have distinguished both risk and protective factors in their review, in which they indicate what can be done for children by high-income countries where these children come to seek asylum.

Basically, the authors have found that one of the most important protective factors is the ability to integrate into the host society while not losing one's sense of cultural identity. As such, supportive measures should be put into place for immigrant children to prevent them becoming a burden by succumbing to mental conditions. Instead, they should be encouraged to PTSD is not an isolated condition, as seen. It affects an individual's life and abilities in the long-term, especially with regard to its effects on the emotional and mental life of the person. There can, however, also be physical effects. Raphael and Widom (2010), for example, found that there is a significant correlation between PTSD diagnosed in childhood and pain symptoms in middle adulthood. This is particularly the case when the child has experienced PTSD as a result of childhood victimization. Indeed, the combination of PTSD and childhood victimization by means of abuse or neglect is statistically linked to most types of pain complaints in adulthood. As such, PTSD has also been found to be a marker for stress vulnerability (Raphael and Widom, 2010).

Another physical consequence of childhood victimization that caused PTSD is elevated rates of the chronic diseases of aging and higher rates of morbidity and mortality of these (Miller, Chen, and Parker, 2011). In addition to children who were maltreated, the poor is also a high-risk population for this eventuality, showing a high vulnerability for vascular disease, autoimmune disorders, and premature mortality.

To explain this, Millder, Chen, and Parker (2011) have created a Biological Embedding Model by combining evidence from both behavioral and biomedical literature. According to the model, childhood stress is, as it were, programmed into the molecular structure of the physical body in the form of macrophages through what the authors refer to as "epigenetic markings, post-translational modifications, and tissue remodeling" (Miller, Chen, and Parker, 2011). Cells are then provided with pro-inflammatory tendencies, which in turn reacts somewhat violently as the person ages and experiences additional stressful events over the life course.

The authors also recognize that there are long-term emotional and mental consequences when a child develops PTSD. These include excessive vigilance for threats, a sense of mistrust when it comes to other people and a consequent poor relationship to others, impaired regulation of self, and life choices that are generally considered unhealthy. These exacerbate physical consequences like altered endocrine and autonomic discharge patterns. All of these effects result in an aggravation of inflammation and the tendency towards chronic disease in later adulthood.