Acute and posttraumatic stress disorders in children and adolescents

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Acute and posttraumatic stress disorders are reactions to overwhelming traumatic events that involve recurring, intrusive memories of the event as well as emotional numbness and increased tension or alertness (arousal). Children tend to avoid reminders of the event.

The disorder may develop after children witness or experience an act of violence, such as a dog attack, a school shooting, an accident, or a natural disaster.
Children not only reexperience the event, but they may also feel emotionally numb, extremely tense, and jittery.
The diagnosis is based on symptoms that occur after a traumatic event.
Treatment involves psychotherapy, behavioral therapy, and drugs.

(See also Acute Stress Disorder and Posttraumatic Stress Disorder in adults.)
Acute stress disorder (ASD) typically begins immediately after the traumatic event and lasts from 3 days to 1 month.
Posttraumatic stress disorder (PTSD) can be a continuation of ASD or may not develop until 6 months after the event.
Stress disorders may develop after children witness or experience an event that threatens their own or another’s life or health. During the event, they typically feel intense fear, helplessness, or horror. These events include acts of violence, such as child abuse, school shootings, car accidents, attacks by a dog, injuries (particularly burns), fires, wars, natural disasters (such as hurricanes, tornados, or earthquakes), and deaths. In young children, domestic violence is the most common cause. Not all children who experience a severe traumatic event develop a stress disorder.
Children do not have to directly experience the traumatic event. They may develop a stress disorder if they witness a traumatic event happening to others or learn that one occurred to a close family member.
Certain factors may affect whether children develop posttraumatic stress disorder and, if it develops, how well they do. These factors include the following:

How severe the traumatic event was
Whether physical injuries occurred during the event
What the temperament of the child is
What the social and economic status of the family is
Whether the child has experienced adversity (such as sexual abuse) before
How well the family functions
Whether the child has family members with mental health disorders
Whether the child has family and social support