PTSD in Child Vicitms of Interpersonal Abuse

Complex PTSD in Children

The diagnosis of PTSD is very specific, and has very specific rules for diagnosis. The child must have experienced one particular event that produced symptoms from a list of three particular categories. The diagnosis and rules for diagnosing it is largely based on work done in the 1960’s and 1970’s on soldiers coming back from Viet Nam.

Since that time, there has been much more learned about stress disorders, and mental health professionals now speak in terms of “complex PTSD.” This means that the person suffering from PTSD may have more than one event that caused their stress disorder, and multiple and complex behaviors associated with it. Some mental health professionals speak about “rolling stress.” What is meant by this is that some children who have lived in very chaotic and inconsistent environments develop many of the same symptoms that are seen in classic PTSD.

The idea of many traumatic events happening to a child is not news to those who work with children in foster care. In most cases, these children have some kind of mental health disorder, and have many signs of high stress and reactivity resulting in acting out behaviors. In cases where the child has been physically or sexually abused, there have been multiple events of this type that have contributed to the behavioral symptom the child demonstrates.

Since the diagnosis for PTSD was based largely on adults, and adults coming home from battle conditions in war, the symptoms and behavioral signs were shaped around the adult’s experience. Once veterans began to be diagnosed, mental health professionals began to notice that other people who had experienced traumatic events (such as rapes, natural disasters, etc.) also had similar symptoms as did the veterans. It was only natural and logical that victims of other traumas received a closer looking over for PTSD signs.

Though children who have PTSD do demonstrate classic signs of the disorder, they also can express these signs in ways that are specific to children and are not seen in adults. As such, children who are diagnosed with PTSD may have had many other diagnoses and treatments for those diagnoses before they were discovered to really have PTSD.

The three classic symptom clusters in the diagnosis of PTSD are:

1. Re-experiencing symptoms.
2. Avoidance, numbing, and detachment symptoms.
3. Affect dysregulation and arousal dysregulation.

Three other symptoms clusters that many mental health professionals recognize as important to PTSD are:

1. Psychological alteration symptoms.
2. Relational damage symptoms.
3. Ego structure damage symptoms.

Each of these six symptom clusters have many other, specific and discrete behavioral signs and symptoms.