Post-traumatic stress syndrome in children]

Post traumatic stress disorder occurs in children as well as in adults following a stressful traumatic event, either unique and exceptionally severe, or recurrent as in abused children. The main symptoms are repetition, avoidance and neurovegetative activation. Prevention and recognition of this disorder are important. Parents must be sensitized to the necessity of an early management.     

Posttraumatic stress disorder after dog bites in children

Of 22 children who were victims of dog bite, 12 had symptoms of posttraumatic stress disorder 2 to 9 months after the bite. Violent dog attacks inflicting multiple and/or deep wounds were associated with risk of posttraumatic stress disorder.     

Posttraumatic stress disorder in children after cardiac surgery

OBJECTIVE: Children undergoing cardiac surgery often experience traumatic situations related to their care and may be at risk for developing posttraumatic stress disorder (PTSD). The purpose of this study was to examine children's responses to cardiac surgery and the factors that mediate responses. STUDY DESIGN: Forty-three 5- to 12-year-old children undergoing cardiac surgery were evaluated pre- and postoperatively for PTSD. The effect of baseline cognitive level, temperament, family support, and length of intensive care unit (ICU) stay on PTSD symptomatology was examined. RESULTS: No child had PTSD pre-operatively. For the entire group, the number of PTSD symptoms increased significantly from pre- to postoperatively (Wilcoxon signed rank test; Z=-2.62, P<.001). PTSD symptoms increased in 10 (23%) children, decreased in 1 child, and did not change in 32 (74%) children. Five of the 43 children (12%) met criteria for PTSD postoperatively. Length of ICU stay was the only predictor of PTSD, P<.001. The number of PTSD symptoms increased if ICU stay exceeded 48 hours. CONCLUSIONS: Children undergoing cardiac surgery are at risk for developing PTSD, especially if the ICU stay is prolonged. These findings provide a basis to develop risk stratification methods and targeted interventions for this population.     

Post-traumatic stress reactions in children of war

The aims of this study were to estimate the rate of post-traumatic stress reactions in Palestinian children who experienced war traumas, and to investigate the relationship between trauma-related factors and PTSD reactions. The sample consisted of 239 children of 6 to 11 years of age. Measures included the Rutter A2 (parent) and B2 (teacher) scales, the Gaza Traumatic Event Checklist, and the Child Post-Traumatic Stress Reaction Index. Of the sample, 174 children (72.8%) reported PTSD reactions of at least mild intensity, while 98 (41%) reported moderate/severe PTSD reactions. Caseness on the Rutter A2 scale was detected in 64 children (26.8%), which correlated well with detection of PTSD reactions, but not with teacher-detected caseness. The total number of experienced traumas was the best predictor of presence and severity of PTSD. Intervention programmes for post-war children need to be evaluated, taking into account developmental and cultural aspects, as well as characteristics of the communities involved.     

Post-traumatic stress in children following motor vehicle accidents

BACKGROUND: This study examined children's experiences following a motor vehicle accident (MVA). METHODS: Approximately 9 months following the accident, children (n=50) and their parents (n=50) participated in extensive interviews about the accident and in comprehensive, structured diagnostic interviews concerning overall psychological functioning. Additional assessments included post-traumatic stress questionnaires, archival police report records, and emergency treatment medical records. RESULTS: Of the 50 children, 7 children (14%) met criteria for PTSD diagnosis, and an additional 5 children met criteria for specific phobia (10%) related to the automobile accident on the structured diagnostic interview (DICA-R-C; total of 24%). Degree of physical injury predicted more PTSD symptoms, and previous accident experiences predicted fewer symptoms, before and after controlling for other variables. Holding degree of physical injury and age constant revealed that social support predicted fewer PTSD symptoms. CONCLUSIONS: Findings suggest the possible inoculating role of previous accidents and the importance of social support following MVA injury.     

Post-traumatic stress responses following liver transplantation in older children

Eighteen children aged between 7 and 16 years who had undergone a liver transplantation were interviewed using the Child Post-Traumatic Stress Reaction Index (CPTS-RI) to discover if they had post-traumatic stress symptoms. A case control design was used to define which factors were important for the development of post-traumatic stress. Results of a one-way analysis of variance (ANOVA), with post-traumatic stress symptom intensity as measured on the CPTS-RI as the dependent variable, revealed a significant difference between the liver transplantation group compared with children who had a chronic life-threatening illness or had undergone a routine surgical operation. A post hoc (Tukey's HSD test) statistical analysis was performed and significance at the .05 level was found between the liver transplantation group and both the chronic illness group and the routine surgical operation group. Our results indicate that the acute life-threat involved in the liver transplantation contributed to the development of post-traumatic stress. It was thought that dissociation may be important in preventing the resolution of the trauma. Additional investigations are needed with larger numbers in a longitudinal study beginning before the transplant to determine the course of the PTSD symptoms and the appropriate timing of interventions to reduce the harmful effects of these symptoms.     

Bronchial tear in a child after a liquid petroleum gas tank explosion

Humans have been exposed to blast effects since the invention of gunpowder and explosives. Bronchial injury because of an explosion is a rare but lethal injury that requires prompt recognition and treatment. In this article, we present a case of a bronchial tear after an explosion.     

Psychological trauma in pre-school children

Overall clinical pictures of post-traumatic experiences in pre-school children depend on several factors: developmental, environmental and socio-cultural. Knowledge of these clinical pictures and the early management of these children are essential for their development and for building their personality.