Symptoms in children may include:
- Recurrent, distressing dreams or recollections of the traumatic event
- Generalized nightmares of monsters, of rescuing others, or of threats to self or others
- Difficulty sleeping alone
- Physicial symptoms such as stomachaches and headaches
- Extra fears or aggressive behaviors in response to stress
- Separtion anxiety
- Co-occuring depression and substance abuse is not uncommon
Primary care physicians should look to consistently identify a history of trauma and to link that trauma exposure to presenting symptoms. A brief trauma question derived from the UCLA PTSD Index (Pynoos, 1998) to be asked of children and adolescents is "Has anything ever happened to you that was really scary, dangerous or violent?" or "Have you ever seen something really scary, dangerous or violent happen to someone else?" If a trauma exposure is revealed, follow-up questions should elicit the full history, ask if the child thinks about the event, worries about the event, replays the event, has associated sleep disturbances, is withdrawn, or avoids activities and interactions with others. Child/Adolescent and parent should be involved in this dialogue. Mental health referral is indicated for symptomatic children.
While there is minimal rigorous research supporting the effectiveness of current treatments for PTSD, treatment for traumatic stress appears to be better than no treatment. A recent research study has demonstrated that children with PTSD showed significant improvement in their symptoms after receiving cognitive-behavioral therapy, a time-limited form of "talk therapy." There is additional information on treatment options here.
Other therapies such as family therapy, play therapy, and other medication treatments are available. However, there is little evidence demonstrating their effectiveness.
- Review treatment options with the child and his/her family.
- Include the child and his/her family in the treatment plan.