June is post-traumatic stress disorder (PTSD) awareness month. To help raise awareness for PTSD, this article will discuss what PTSD is, associated symptoms, and common evidence-based treatments, with a particular focus on PTSD in children and adolescents.

The following symptoms are characteristic of PTSD. Except where otherwise noted, these criteria are applicable to both children and adults.

• Exposure to trauma
  • Diagnostic criteria specify that for a diagnosis of PTSD, one must have been exposed to actual or threatened death, serious injury, or sexual violence. However, the means of exposure can vary. PTSD can develop after experiencing a trauma, witnessing a trauma, or learning that a traumatic event happened to a close friend or family member.
• Intrusion symptoms
  • This category refers to ways the trauma is reexperienced. This may include distressing memories, dreams, and flashbacks, as well as experiencing distress or physiological reactions to reminders of the trauma. In young children, these symptoms may manifest more as recurrent themes in play.
• Avoidance symptoms
  • This category refers to avoidance of internal or external reminders of the trauma. Avoidance of internal reminders may include effort to avoid memories, thoughts, or feelings related to the trauma. Avoidance of external reminders may include effort to avoid people, places, activities, situations, conversations, objects, etc. that may be associated with the trauma.
• Negative alterations in cognition or mood
  • This category refers to negative changes in thoughts and/or feelings associated with the trauma. Some examples include not being able to remember certain aspects of the trauma, new negative beliefs about the world or people in it, blaming self for the trauma, increased negative emotions, diminished interest in usual activities, and diminished positive emotions.
  • In addition to the differences in the criteria discussed above, another difference in PTSD diagnostic criteria for children younger than six is the number of symptoms required for a diagnosis. While older children and adults must display symptoms from each category, for children under six, avoidance symptoms and negative alternations in cognition or mood are combined. Therefore, young children may display only avoidance symptoms or only negative alternations in cognition or mood, not necessarily both, and still meet diagnostic criteria if all other criteria are met.
• Alterations in arousal and reactivity
  • This category refers to changes in arousal and reactivity associated with the trauma. Some examples include irritability, anger, aggression, reckless behavior, hypervigilance, easily startled, trouble concentrating, and difficulty with sleep.

Treatment

Therapy can be helpful in reducing distress experienced after a trauma. There are several types of therapy specifically designed to help those who are experiencing distressing symptoms after a trauma. Some of the most common therapies to treat PTSD in adults include prolonged exposure (PE), cognitive processing therapy (CPT), and eye movement desensitization and reprocessing (EMDR). There is some debate regarding which type of therapy might work best or which aspects are the most helpful, but findings suggest that a therapy treatment that includes an exposure element, which refers to recounting and processing the trauma in some fashion, is the most effective therapeutic element to reduce distress from PTSD symptoms. For children, a good specific therapy for PTSD or other trauma symptoms is called Trauma-Focused Cognitive Behavioral Therapy (TF-CBT). This treatment also includes an exposure element in which children are guided through a recounting of their trauma, as well as associated parent sessions to process the trauma with parents as well. Medication may also be prescribed by a psychiatrist if symptoms significantly interfere with daily functioning.

Thank you for reading! If you have further questions regarding trauma or PTSD, please talk with your clinician or contact Arkansas Families First in Conway or North Little Rock to learn more about counseling services for kids and families.