NEW YORK (Reuters Health) - While exposure to traumatic events among children and teens is "almost commonplace," only a small fraction of young people will go on to develop post-traumatic stress disorder (PTSD) after such exposure, a new study shows.
But the findings shouldn't be interpreted to mean that kids don't suffer after a trauma, Dr. William E. Copeland of Duke University Medical Center in Durham, North Carolina, the study's lead author, told Reuters Health. While children exposed to a single traumatic event did seem to fare well, those exposed to two or more such events were at higher risk of developing post-traumatic stress symptoms, as well as psychiatric disorders such as depression and anxiety.
"Resiliency may be a question of degree," the researcher said. "Once you take a certain number of punches, all of us are going to go down."Little is known about children's risk for developing PTSD, Copeland and his colleagues point out in the May issue of Archives of General Psychiatry. Studies of kids and PTSD have usually looked at the aftermath of a specific type of event, for example a car crash. To better understand risk after exposure to a range of possible events, the researchers followed 1,420 children for several years. Study participants were 9, 11 or 13 years old when the study began, and were interviewed annually up until age 16.
Nearly 7 out of 10 reported exposure to some type of traumatic event, such as having a loved one die violently, being sexually abused or being diagnosed with a serious illness. Nearly 31% experienced one such event, while 37% were exposed to two or more.
Overall, the researchers found, less than 0.5% of children in the study met full diagnostic criteria for PTSD. But 13.4% of the children exposed to one or more traumas did develop at least one symptom of traumatic stress, such as intrusive thoughts of the traumatic event or nightmares. Those who were exposed to sexual or violent events tended to have more of these symptoms. And children who had experienced trauma in the past, those with anxiety disorders, and those from poor or less educated families were more likely to develop symptoms.
Based on the results, Copeland noted, it's possible to predict which children will go on to develop posttraumatic stress symptoms and psychiatric problems after trauma. This suggests that "rather than trying to get every kid that has something bad happen to them into therapy," he said, parents and mental health professionals should focus their attentions on higher-risk children.
The findings also suggest, he added, that the criteria used to diagnose PTSD-based on the experiences of Vietnam veterans and adult rape victims-may need to be adjusted for children. "We need to really rethink the way that kids respond to these events, and possibly change some of the thresholds that we have."