While post traumatic stress disorder (PTSD) is most often associated with battle-scarred soldiers, children who have been exposed to trauma may also develop this condition.
According to a study published in the Annals of General Psychiatry, exposure to a traumatic event and PTSD are prevalent in South African youth, owing to high rates of violent crimes, including physical and sexual assault, hijacking and domestic violence.
And it’s not just those who have been directly involved in the trauma who experience PTSD. The condition can affect those who witness it and who are there in the aftermath, such as emergency workers, law enforcement officers, even family and friends.
Risk factors and the impact of trauma
But everyone experiences trauma in different ways. “Research has shown that some factors increase the possibility that a person will experience an event as traumatic,” says Dr Karl Swain, a clinical psychologist in the Department of Behavioural Medicine at the University of KwaZulu-Natal, who has done extensive research in the areas of neuropsychology and traumatic stress. “These include pre-trauma risk factors, such as young age, low socioeconomic status, previous exposure to trauma, existing mental health conditions, current life stressors and poor social support.”
Dr Swain adds that one of the most devastating effects of traumatic events on children is the impact on their development, particularly tasks related to psychological health in adulthood. Trauma in childhood may disrupt the normal process of becoming independent and autonomous. Often these children also have problems regulating their emotions, especially anger and fear, and because of the potential long-term, damaging effects of trauma, a professional psychologist should see these individuals.
In the South African context, trauma in children could be isolated incidents or recurring events, and these can range from physical disasters, such as motor-vehicle accidents, assault, hijackings and sexual assault, to natural disasters like floods. We have also seen political violence, in the form of xenophobic attacks, and one could add to that violence related to political intolerance and witnessing of domestic violence, which is especially rife in South Africa.
Also read: how to help your child deal with stress and anxiety.
How it manifests
According to psychiatrist Prof Soraya Seedat, a distinguished professor of psychiatry and executive head of the Department of Psychiatry at Stellenbosch University, writing for World Psychiatry, PTSD in children exhibits as a persistent re-experiencing of the traumatic event, such as memories and flashbacks, triggered by exposure to reminders, avoidance of these reminders (including places, people and conversations) and chronic physiological factors, such as sleep disturbances, poor concentration and hypervigilance to a perceived threat.
“Symptoms usually develop within the first month after the traumatic event, but may not show up until months or even years have passed,” says Dr Swain. “These symptoms often continue for years after the event, or, in some cases, may ease and return later in life if another event triggers memories of the trauma. In fact, anniversaries of the event can cause a flood of emotions and bad memories.”
“Children can and do recover from traumatic events,” says Dr Swain, “and parents are instrumental in obtaining helpful interventions from the appropriate professionals. To be able to assist the child’s recovery, the parent must also keep in shape physically, emotionally and spiritually. It is also important that the physical safety of the child be established, particularly if the child has been a victim of abuse.”
Supporting a child with PTSD (information supplied by Dr Karl Swain)
- Find a good therapist
- Request a school consultation
- Determine your child’s immediate and long-term needs
- Be available to assist school interventions
- Be cognisant of the needs of the rest of the family
- Engage in good self-care
- Be vigilant of the symptoms and learn about common reactions
- Be patient; there’s no correct time for healing
- Explain and reinforce to your child that they are not responsible for what happened
- Assure your child that they are safe
- Maintain regular school and home routines.
Common signs and symptoms
- Re-experiencing the traumatic event (nightmares, intrusive recollections, flashbacks, traumatic play)
- Avoidance of memories or situations that remind the child of the event
- Sleep problems
- Emotional numbing
- Symptoms of increased arousal and hypervigilance
- Altered cognitive function
- Behavioural inhibition
- Regression
- Difficulties with physical contact (for abuse victims).
