Early Intervention with Traumatized Children

With the events of September 11th, childhood trauma has come to the forefront of national attention. One of the common psychiatric outcomes of trauma is Posttraumatic Stress Disorder (PTSD). Despite the fact that certain vulnerabilities may contribute to the development of PTSD in traumatized youth, the existence of an identifiable stressor provides a unique opportunity for early intervention. Cognitive Behavioral Treatment (CBT) interventions are considered by many to be the mainstay of treatment of children and adolescents with PTSD. More severe cases of PTSD are often treated with medications in the community. In this article we present a CBT program—developed by our site—STAIR—and provide useful guides and rationales for clinicians to work with when treating this population. We will also briefly review the available literature on the psychopharmacologic interventions to help guide the physician when confronted with such treatment decisions.

[1]  K. Koenen,et al.  The Impact of Borderline Personality Disorder on Process Group Outcome among Women with Posttraumatic Stress Disorder Related to Childhood Abuse , 2001, International journal of group psychotherapy.

[2]  D. Pond.  Textbook of Clinical Psychiatry. , 1968 .

[3]  Dan J Stein,et al.  An open trial of citalopram in adolescents with post-traumatic stress disorder , 2001, International clinical psychopharmacology.

[4]  K. Fitzpatrick,et al.  The prevalence and consequences of exposure to violence among African-American youth. , 1993, Journal of the American Academy of Child and Adolescent Psychiatry.

[5]  E. Foa,et al.  Imagery Rescripting: A New Treatment for Survivors of Childhood Sexual Abuse Suffering From Posttraumatic Stress , 1995, Journal of Cognitive Psychotherapy.

[6]  Lynda A. King,et al.  Relationship between acute morphine and the course of PTSD in children with burns. , 2001, Journal of the American Academy of Child and Adolescent Psychiatry.

[7]  F. Bodman.  War Conditions and the Mental Health of the Child , 1941, British medical journal.

[8]  Dan J Stein,et al.  Comparison of response to a selective serotonin reuptake inhibitor in children, adolescents, and adults with posttraumatic stress disorder. , 2002, Journal of child and adolescent psychopharmacology.

[9]  S. Buka,et al.  Prevalence and risk factors for posttraumatic stress disorder among chemically dependent adolescents. , 1997, The American journal of psychiatry.

[10]  J. Dunne,et al.  Practice parameters for the assessment and treatment of children and adolescents with obsessive-compulsive disorder. AACAP. , 1998, Journal of the American Academy of Child and Adolescent Psychiatry.

[11]  N. Milgram,et al.  Situational exposure and personal loss in children's acute and chronic stress reactions to a school bus disaster , 1988 .

[12]  J. McClellan,et al.  Summary of the practice parameters for the assessment and treatment of children and adolescents with posttraumatic stress disorder. American Academy of Child and Adolescent Psychiatry. , 1998, Journal of the American Academy of Child and Adolescent Psychiatry.

[13]  L. Terr.  Chowchilla revisited: the effects of psychic trauma four years after a school-bus kidnapping. , 1983, The American journal of psychiatry.

[14]  J. Horrigan.  Guanfacine for PTSD nightmares. , 1996, Journal of the American Academy of Child and Adolescent Psychiatry.

[15]  L. Fairbanks,et al.  Post-traumatic Stress Reactions in Children After the 1988 Armenian Earthquake , 1993, British Journal of Psychiatry.

[16]  D. Looff,et al.  Carbamazepine for PTSD. , 1995, Journal of the American Academy of Child and Adolescent Psychiatry.

[17]  E. F. Dehane.  Dislocation of the Hip-Joint, Reduced under the Influence of Æther , 1847, Provincial medical & surgical journal.

[18]  D. Kilpatrick,et al.  Posttraumatic stress disorder in adolescents after Hurricane Andrew. , 1995, Journal of the American Academy of Child and Adolescent Psychiatry.

[19]  D. Pine,et al.  Trauma in children and adolescents: risk and treatment of psychiatric sequelae , 2002, Biological Psychiatry.

[20]  L. Bender,et al.  THE REACTION OF CHILDREN TO SEXUAL RELATIONS WITH ADULTS , 1937 .

[21]  R. Pynoos,et al.  Children who witness the sexual assaults of their mothers. , 1988, Journal of the American Academy of Child and Adolescent Psychiatry.

[22]  P. Blakeney,et al.  Imipramine treatment in pediatric burn patients with symptoms of acute stress disorder: a pilot study. , 1999, Journal of the American Academy of Child and Adolescent Psychiatry.

[23]  J. Davidson,et al.  Posttraumatic stress disorder : DSM-IV and beyond , 1993 .

[24]  R. Harmon,et al.  Clonidine for posttraumatic stress disorder in preschool children. , 1996, Journal of the American Academy of Child and Adolescent Psychiatry.

[25]  A. Leonard,et al.  Children and disaster: age, gender, and parental effects on PTSD symptoms. , 1991, Journal of the American Academy of Child and Adolescent Psychiatry.

[26]  H. Reinherz,et al.  Traumas and posttraumatic stress disorder in a community population of older adolescents. , 1995, Journal of the American Academy of Child and Adolescent Psychiatry.

[27]  R. Silva,et al.  Stress and vulnerability to posttraumatic stress disorder in children and adolescents. , 2000, The American journal of psychiatry.