From Your School Psychologist…..
Post-Traumatic Stress Disorder
Definition
Post-Traumatic Stress Disorder (PTSD) is an anxiety disorder that develops after a traumatic event
or ordeal. The condition often appears within 3 months of the event but may occur much later.
Historically, the label appears to have originated in the mid-70’s as ‘post-Vietnam Syndrome’ due to
combat stress. [1] Currently, the accepted definition is an “extreme psychological trauma” that is
emotionally painful, distressful and shocking --usually life-threatening in nature. In children and
adolescents, such events would include: victim/witness to physical, emotional, or sexual abuse;
involvement in accidents/natural disasters; attacks by animals; victim/witness of violent crime; or
diagnosis of life-threatening illness. Students may also develop PTSD symptoms by experiencing
bullying or mobbing. [2]
Symptoms of the condition include but are not limited to: flashbacks, nightmares, sleeplessness,
disorganization, hypersensitivity, hypervigilence, survival guilt, difficulty recalling facts or lists,
sudden anger, irritability, exaggerated responses/reactions to situations, difficulty concentrating,
withdrawal/flat affect; school phobia; disruptive behavior. [2] Based upon the onset of symptoms,
PTSD can be specified as: acute, chronic, or delayed. [3] It is also reported that symptoms of PTSD in
children/adolescents are often misdiagnosed. PTSD is often a concomitant diagnosis with other
conditions including: depression, substance abuse, other anxiety disorders, ADHD, oppositional
defiant disorder, conduct disorder, and phobias.
Who is at Risk?
More females than males are affected but factors would include the age and developmental level and
type of trauma. While the duration varies, complete recovery can occur within 3 months in 50% of
most cases; however, available information suggests that 40% of children still suffer symptoms one
year after their diagnosis. [2, 3]
Medication and Treatment:
“There is no clear drug treatment for PTSD” [4] Medications are usually prescribed based upon one
of three behavioral symptoms of: re-experiencing, avoidance, or hyperarousal. Tranquilizers or
Selective Serotonin Reuptake Inhibitors such as Prozac, Zoloft and Paxil are frequently implemented
in conjunction with Cognitive Behavioral Therapy that seeks to change patterns of thinking and help
the individual to address the negative emotions of fear and distress. [2, 4 ,5]
PTSD and the School Setting:
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Try to retain routine for normalcy, but be flexible in observed sleep deprivation
Be aware of coping and relaxation skills and stress management techniques; use
encouragement/reinforcement of appropriate behavior
Listen to concerns; reassurance of ‘safety’ and ‘it wasn’t your fault’ are critical for the
student; provide a supportive environment
Allow the student to be sad and understand that reaction to trauma is normal; avoid the ‘get
tough’ comments
Allow student choices and work on decision-making to enhance the student’s feeling of a
sense of control in his/her life
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Listen to the student and then consider situations that might trigger symptoms
Be aware of cultural differences in addressing trauma and its aftermath
Be cautious about physical ‘closeness’ or touching the child [2]
References:
1. Download: Post-Traumatic Stress Disorder—Wikipedia—source: When trauma tips you
over: PTSD Part 1 All in the Mind, Australian Broadcasting Commission, October 9, 2004.
2. Pamphlet: Child and Adolescent Mental Health Problems-Fact Sheets for School
Personnel—2004-2005—multiple sources listed in this pamphlet
3. Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, American
Psychiatric Association, Washington, D.C.
4. Download: Post-Traumatic Stress Disorder—Wikipedia—source: Maxmen, J.S.; Ward,
N.G. (2002) Psychotropic Drugs: fast facts (third edition). New York; W.W. Norton. P. 346
ISBN-0-393-70301-0
5. Download 1: Post-Traumatic Stress Disorder—Wikipedia—source: Hassija, C.M. and
Gray, M.J. (2007) Behavioral Interventions for Trauma and Posttraumatic Stress Disorder.
International Journal of Behavioral Consultation and Therapy, 3(2), 166-175. BAO
Download 2: Mental Health America: Post-Traumatic Stress Disorder
Informational Websites:
National Center for PTSD, US Dept. of Veterans Affairs—
www.ncptsd.va.gov/ncmain/ncdocs/fact shts/fs what is ptsd.html
National Institute of Mental Health—www.nimh.nih.gov/publicat/anxiety/cfm#1