Stress and Vulnerability to Posttraumatic Stress Disorder in Children and Adolescents

• Published in: The American journal of psychiatry Vol. 157; no. 8; pp. 1229 - 1235
• Main Authors: Silva, Raul R., Alpert, Murray, Munoz, Dinohra M., Singh, Sanjay, Matzner, Fred, Dummit, Steven
• Format: Journal Article
• Language: English
• Published: Washington, DC American Psychiatric Publishing 01.08.2000; American Psychiatric Association
• Subjects: Adolescent; Age Factors; Anxiety disorders; Biological and medical sciences; Child; Child Abuse - statistics & numerical data; Child clinical studies; Child, Preschool; Children & youth; Disease Susceptibility; Domestic Violence - statistics & numerical data; Families & family life; Family Relations; Female; Humans; Life Change Events; Male; Medical sciences; Post traumatic stress disorder; Psychiatry; Psychology. Psychoanalysis. Psychiatry; Psychopathology. Psychiatry; Regression Analysis; Severity of Illness Index; Stress Disorders, Post-Traumatic - diagnosis; Stress Disorders, Post-Traumatic - epidemiology; Stress Disorders, Post-Traumatic - etiology; Urban Population - statistics & numerical data; Human; Preschool age; Posttraumatic syndrome; Violence; Anxiety disorder; Vulnerability; Victimology; Stress; Symptomatology; Child abuse; School age; Life events; Criterion; Adolescent; Risk factor; Family environment; Clinical investigation; Diagnosis; Child; Comparative study; Aggressiveness
• ISSN: 0002-953X; 1535-7228
• DOI: 10.1176/appi.ajp.157.8.1229

OBJECTIVE: This study examined the experiential factors and interacting vulnerabilities that contribute to the development of posttraumatic stress disorder (PTSD) in children and adolescents. METHOD: Of 100 consecutive referrals to an inner-city child and adolescent psychiatry clinic, 59 had experienced a trauma that qualified as a precipitant of PTSD. For those with trauma, ages ranged from 3 to 18 years (mean=9.9, SD=4.10); 39 (66%) were males. The authors used a series of multiple regression analyses to examine the contribution of demographic characteristics, the nature of the stressor(s), and the role of preexisting clinical signs in the development of PTSD. RESULTS: Twenty-two percent of the 59 children who had been traumatized met full criteria for PTSD, 32% had some symptoms of PTSD but did not meet full criteria, and 46% had no symptoms of PTSD. Witnessing domestic violence or being physically abused predicted severity of PTSD. Children with preexisting aggressive behavior were more likely to be victims of physical abuse. CONCLUSIONS: Traumatic experience interacts with factors in the child and family to contribute to the development of PTSD. Trauma that threatens family integrity appears to make a strong contribution to the development of PTSD. Increased understanding of the factors contributing to PTSD may provide additional opportunities for developing effective interventions.