PTSD in Children and Adolescents

200 Pages·2001·1.39 MB·English

by  Jerald Kay

PTSD in Children and
Adolescents
Review of Psychiatry Series
John M. Oldham, M.D.
Michelle B. Riba, M.D., M.S.
Series Editors
PTSD in Children and
Adolescents
EDITED BY
Spencer Eth, M.D.
No. 1
Washington, DC
London, England
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Copyright © 2001 American Psychiatric Publishing, Inc.
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ALL RIGHTS RESERVED
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The correct citation for this book is
Eth S (editor): PTSD in Children and Adolescents (Review of Psychiatry Series,
Volume 20, Number 1; Oldham JM and Riba MB, series editors). Washington,
DC, American Psychiatric Publishing, 2001
Library of Congress Cataloging-in-Publication Data
PTSD in children and adolescents / edited by Spencer Eth.
p. ; cm — (Review of Psychiatry ; v. 20, no. 1)
Includes bibliographical references and index.
ISBN 1-58562-026-2 (alk. paper)
1. Post-traumatic stress disorder in children. 2. Teenagers—Mental health.
[DNLM: 1. Stress Disorders, Post-Traumatic—diagnosis—Adolescence.
2. Stress Disorders, Post-Traumatic—diagnosis—Child. 3. Stress
Disorders, Post-Traumatic—therapy—Adolescence. 4. Stress Disorders,
Post-Traumatic—therapy—Child. 5. Forensic Psychiatry—methods. 6.
Psychotherapy—methods—Adolescence. 7. Psychotherapy—methods—
Child. WM 170 P975 2001] I. Title: Post-traumatic stress disorder in
children and adolescents. II. Eth, Spencer, 1950- III. Review of psychiatry
series ; v.20,1
RJ506.P55 .P875 2001
616.85′21—dc21
00-067404
British Library Cataloguing in Publication Data
A CIP record is available from the British Library.
Cover photograph: Copyright © 2001 David Oliver/Stone.
To my wife, Cheryl, a woman
of kindness and valor.

Contents
Contributors xi
Introduction to the Review of Psychiatry Series xiii
John M. Oldham, M.D., and
Michelle B. Riba, M.D., M.S., Series Editors
Introduction: Childhood Trauma in Perspective xvii
Spencer Eth, M.D.
Chapter 1
Evaluation and Assessmentof PTSD in
Children and Adolescents 1
Evan B. Drake, Ph.D.
Sherry F. Bush, Ph.D.
Wilfred G. van Gorp, Ph.D.
Introduction 1
Issues in the Assessment of
ChildrenandAdolescents 1
Clinical Guidelines for Assessment 4
Recent Developments in Clinical Assessment 5
Multidimensional Approach to Assessment 15
Conclusions 26
References 27
Chapter 2
Forensic Aspects of PTSD in
Children and Adolescents 33
James E. Rosenberg, M.D.
Introduction 33
Diagnosis 34
Epidemiology 38
Genetics 39
Risk Factors in Various Settings 39
Psychophysiology 44
Assessment 45
PTSD and Memory 47
Treatment 50
Conclusions and Recommendations 51
References 54
Chapter 3
PTSD in Children and Adolescents in the
Juvenile Justice System 59
William Arroyo, M.D.
Introduction 59
Demographics 60
Mental Disorders 61
Posttraumatic Stress Disorder 62
Incarcerated Youth 63
Female Population 65
Predisposing Factors 65
Interventions 70
Special National Challenge 77
Summary 78
References 79
Chapter 4
Biological Treatment of PTSD in
Children and Adolescents 87
Soraya Seedat, M.B.
Dan J. Stein, M.B.
Diagnosis and Phenomenology 88
Neurobiologic Systems in PTSD 90
Biologic Treatments in ChildrenandAdolescents 94
Assessing Outcome in ChildrenandAdolescents 104
Quality of Life 105
Conclusions 105
References 107
Chapter 5
Relationship Between Childhood Traumatic
Experiences and PTSD in Adults 117
Rachel Yehuda, Ph.D.
Ilyse L. Spertus, Ph.D.
Julia A. Golier, M.D.
Introduction 117
Long-Term Consequences of Childhood
Maltreatment—Sexual Abuse, Physical
Abuse, Emotional Abuse, and/or Neglect 118
Challenges in Formulating a
Model of the Effects of Early
Child Maltreatment on the Adult 124
Long-Term Consequences of Single-Episode
Traumatic Events: Preliminary Evidence 125
Prevalence of PTSD in Children and
Adults Following Childhood Trauma 127
Impact of Early Maltreatment on
Reaction to Subsequent Trauma and
Risk of Revictimization 129
Biological Models of the Effects of Stress:
The Centrality of Sensitization as a
Mechanism of Permanent Stress Responses 132
Developmental Influences of
Early Stress in Animals 133
Biological Consequences in Adults
Who Experienced Trauma in Childhood 135
PTSD and Other Psychological
Symptoms in Adults Who
Survived the Holocaust as Children 141
Methodologic Considerations in the Study of
the Long-TermImpactofChildhoodTrauma 143
Summary and Conclusions 146
References 146
Index 159