Posttraumatic stress without trauma in children Full Text
American Journal of Psychiatry, 06/22/2010
Clinical Article
William E. Copeland et al. – Relative to low-magnitude stressors, extreme stressors place children at greater risk for posttraumatic stress symptoms. Nevertheless, a sizable proportion of children manifesting posttraumatic stress symptoms experienced only a low-magnitude stressor.
Methods- Representative community sample of 1,420 children, ages 9, 11, and 13 at intake, was followed annually through age 16
- Low-magnitude and extreme stressors as well as subsequent posttraumatic stress symptoms were assessed with the Child and Adolescent Psychiatric Assessment
- 2 measures of posttraumatic stress symptoms were used: having painful recall, hyperarousal, and avoidance symptoms (subclinical PTSD) and having painful recall only
- During any 3-month period, low-magnitude stressors occurred 4 times as often as extreme stressors (24.0% compared with 5.9%)
- Extreme stressors elicited painful recall in 8.7% of participants and subclinical PTSD in 3.1%, compared with 4.2% and 0.7%, respectively, for low-magnitude stressors
- Because of their higher prevalence, however, low-magnitude stressors accounted for two-thirds of cases of painful recall and half of cases of subclinical PTSD
- Exposure to low-magnitude stressors predicted symptoms even among youths with no prior lifetime exposure to an extreme stressor
