Post-traumatic stress disorder is a psychological condition that arises after experiencing, witnessing or hearing about a traumatic incident. Otherwise known as PTSD, the condition can affect sufferers for many years after the event. While there are symptoms particularly common among children, psychologists use the same criteria to diagnose PTSD in children and in adults. As they may experience any combination of the symptoms and stressors to receive a diagnosis, the types of PTSD in children are practically innumerable.
Initial Trauma
A diagnosis of PTSD first requires an initial stressor, according to the "Diagnostic and Statistical Manual of Mental Disorders." Known as Criterion A, this stressor must involve actual or perceived death, serious injury or a threat to the physical integrity of your child or others in her life. An example of a threat to physical integrity is hearing of or witnessing inappropriate conduct between an adult and another child. While this stressor is vital, a diagnosis of PTSD requires that your child experienced intense fear, helplessness or horror after the event. While these reactions are common among both adults and children, children often react instead with disorganized or agitated behavior.
Intrusive Recollection
After experiencing the initial stressor, a child must experience symptoms from each of three categories to receive a diagnosis of PTSD. Criterion B is intrusive recollection, which involves persistently reliving the event. Among children, these recollections include repetitive play involving themes or aspects of the stressor, nightmares without familiar content and direct re-enactment of the trauma. To meet the criteria for PTSD, a child must either experience one of the above symptoms, or physically or emotionally respond to these recollections or other events that resemble the initial stressor.
Avoidant/Numbing
Criterion C involves avoiding events, objects or ideas associated with the trauma and a general lack of responsiveness. Children must experience three symptoms from this Criterion to meet a diagnosis of PTSD. These include a lack of interest in favorite activities, feelings of detachment that weren't present before, an inability to experience certain emotions and thoughts of a limited future. While children may not have flashbacks or memory lapses, they are likely to be unable to remember the events of the initial trauma in the right order. In addition, they often believe that there were signs preceding the stressor. This leads children to actively seek and avoid these signs in the belief that this prevents future traumas.
Hyper-Arousal
The final aspect of PTSD is persistent hyper-arousal that was not present before the initial stressor. Symptoms include sleep problems, irritability or angry outbursts, difficulties concentrating, being overly alert and perceptive and an over-reactive startle response. Together known as Criterion D, at least two of these symptoms must be present for your child to receive a diagnosis of PTSD. Additional symptoms unique to children include an intense fear of being separated from a parent, aches and pains with no physical cause, new phobias unrelated to the trauma and the loss of abilities present before the initial stressor.
