Part II- Causes of PTSD in children
Children are for the most part remarkably flexible, adaptive, and resilient. Studies show that while nearly 50% of high school graduates have witnessed or experienced a traumatic event, only 5-6% are diagnosed with Post-Traumatic Stress Disorder (PTSD).
So what’s the difference between these two groups of children? What causes long-term PTSD in some children, while others are able to experience trauma without being traumatized?
3 key Risk Factors that lead to PTSD
Recent research suggests that most children experience traumatic events, but don’t develop long-term PTSD symptoms.
Several studies have been completed on childhood PTSD to answer the following questions:
1) Are there certain traumatic events that are more likely to cause PTSD than others?
2) Are there any physical or environmental similarities between those children who do develop PTSD symptoms?
3) Are there environmental similarities between the children, the traumatic events, and the reactions from loved ones?
The answers- yes, yes, and yes.
Research suggests that there are 3 main significant risk factors when gauging the likelihood of developing long-term PTSD symptoms.
Here they are in no particular order.
1. The severity of the traumatic event
A child’s chances of developing PTSD increase as the severity of the traumatic event increases. Severity can be described as the level of intensity and/or amount of physical and emotional damage caused by the traumatic event.
One article suggested comparing the differences between witnessing the tragic shootings at Sandy Hook Elementary vs. witnessing an automobile accident. While both incidents are defined as ‘traumatic events’, the severity of the Sandy Hook shootings defined by the physical and emotional damage done to the students, their families, and the community likely has a stronger or more severe impact on a child’s brain than witnessing a car accident.
1a. The severity of a traumatic event also includes the number of times a child is exposed to the trauma. A child’s chances of developing PTSD symptoms will increase as he or she is exposed to several traumatic events.
This category includes physically abusive parents, emotionally neglectful parents. children living in war-torn countries, and/or growing up in difficult neighborhoods where child-on-child violence is prevalent. In some cases, exposure to severe traumatic events is likely to go on for months even years.
1b. Lastly in the ‘severity’ category is the number of traumatic events witnessed in a short period of time. Children who first- witness a natural disaster, second, witness the physical damage to homes, schools,and neighborhoods, and third, the physical injuries and even deaths caused by the natural disaster. A survivor of a natural disaster may witness several if not dozens of traumatic events in a very short period of time.
2. Parent reaction to the traumatic event
There’s a fine line between over reacting and under reacting to any parenting situation, yet this risk factor still surprised me.
Parental reaction to trauma can increase or decrease a child’s chances of developing PTSD. Here’s an example-
A few months ago I rented the move ’No Escape’ from Redbox and I loved every minute of it. No Escape shared a powerful message of fighting for survival live and protecting what’s truly important. In the movie, the character played by Owen Wilson is caught in a civil war in a foreign country. As rebels take over the hotel he is staying in, he makes plans for his family to escape the city and cross the national border into a country that is more American friendly.
As the parents evade hostile enemies and gunfire, the father plays games with his children, tells them funny stories, and doesn’t allow his children to see how terrified he really is. After several near death experiences, the family makes it to safety intact and unharmed. Children are smart and we’re not fooling them by lying to them during dangerous situations. Being able to stay calm and keep your cool during high stress situations will set an example for children and they will follow your lead.
On the opposite end of this argument lies the mistake of under reacting.
As important as it is to not ‘overreact’ to traumatic events, we cannot under react either. Under reacting shows our children that we’re not interested in what’s happening to them and that we don’t care about their well-being.
Here’s a few tricks to reacting to trauma
a. Show concern for your child by listening and giving them affection.
b. Continue to be the voice of reason and point out major thinking errors when come up. For example, if a child says “I’m never riding in a car again” after witnessing a car accident it would be appropriate to show empathy and concern but point out that most people are safe when they drive, and there are additional measures that you are taking to ensure your families safety i.e. defensive driving, wearing seat belts, and not being distracted..
c. Don’t minimize the issue by sweeping it under the rug out of fear of a difficult conversations
3. Child’s proximity to the traumatic event
The final risk factor of childhood PTSD is the child’s proximity to a traumatic event. The chances of the child developing PTSD is impacted by how close or far away the child was from the event. When a child loses a loved one, it is always extremely difficult and challenging. If a child witnesses the death of a parent or loved one in an accident, it is extremely difficult and challenging and there’s a stronger chance that the child develops symptoms of PTSD.
The research also suggests that witnessing a traumatic event where people hurt other people is more likely to cause trauma than the other types of traumatic events. This is believed to be due to the fear caused by watching someone hurt someone else and the break down in the belief system that people are generally good.
A few questions to ask yourself to better understand this category:
Did the child read or hear about the traumatic event indirectly?
Did the child witness the event? And if so, how far away were they when it happened?
That’s a wrap-final thoughts
Children witness traumatic events far more often than they should, but the reality is—they do. Children who witness or experience severe traumatic events, who are over exposed to traumatic events, or who have parents who either grossly overreact or under react to traumatic events are more likely to develop PTSD symptoms.
There is hope. PTSD symptoms can be temporary, and can be completely resolved with appropriate professional trauma treatment. Combine professional treatment with a loving support network of family and friends and young children can move on from these tragic events and can return to having normal childhoods.
For more information regarding signs and symptoms of childhood PTSD, click here.
Coming Up Next: Part III “Breaking down a PTSD diagnosis”