Trauma Institute

A number of psychiatric manifestations of stress exist. Posttraumatic stress disorder (PTSD) may occur due to a traumatic or critical incident. Set criteria in psychiatry determine if an individual qualifies for a diagnosis of PTSD. Individuals must be exposed to a high-risk, potentially traumatizing experience or situation. A combination of major and minor symptoms established a PTSD diagnosis, as follows;

• Flashbacks
• Dreams
• Déjà vu
• Avoidance
• Sleep disturbance
• Loss of interest
• Detachment
• Emotional numbing
• Increased startle
• Intensification

Within the first 24 hours, more than 85% of people experience stress reactions in response to critical incidents. After 6 months, approximately 20% of the original group continue to have stress symptoms. After 1 year, about 5-10% of the original group still have symptoms; approximately 3% of the original group is diagnosed with PTSD.

PTSD is a stress response to trauma that can occur in some people after experiencing a trauma. What distinguishes people, including children, who develop PTSD from those who are temporarily stressed after a trauma, is that they become ‘stuck’ on the trauma. They keep reliving it in thoughts, feelings or actions. This intrusive reliving of the trauma, rather than the traumatic event itself, that causes behavioural and physiological reactions in the person is what is known as PTSD. The DSM-IV diagnosis on PTSD is made on the existence of three core symptom clusters;

1. Re-experiencing symptoms (intrusive thoughts or images; flashbacks; physiological arousal to event related stimuli)
2. Avoidance (effort to avoid thoughts and feelings associated with the trauma; effort to avoid activities or situations that arouse recollection of trauma; markedly diminished interest in significant activities)
3. Hyper-arousal (hyper-vigilance; heightened startle response; irritability or anger)
   In younger children, distressing dreams of the event may change into generalised nightmares of monsters, rescuing others, or of threats to self or others. In addition, young children usually do not have sense that they are reliving the past, rather reliving of the trauma may occur through repetitive play and physical symptoms may be present (i.e. headaches or stomach aches).

References

Fitzgerald Rice, K. & McAlister Groves B. (2005) “Hope and Healing: A Caregivers Guide to Helping Young Children Affected by Trauma. USA: ZERO to THREE

Perry, B. (2006) Effects of Traumatic Events on Children. Retrieved May 15, 2007, from http://www.childrauma.org/ctamaterials/inerdis.asp