eMedicine Specialties > Pediatrics: Developmental and Behavioral > Medical Topics

Posttraumatic Stress Disorder in Children: Follow-up

Author: Roy H Lubit, MD, PhD, Assistant Clinical Professor, Mount Sinai School of Medicine; Clinical Faculty, Department of Child Psychiatry, New York University School of Medicine; Private Practice
Contributor Information and Disclosures

Updated: Mar 4, 2008

Follow-up

Further Outpatient Care

  • Besides treatment of the presenting categorical diagnostic symptoms (eg, reexperiencing, numbing, hyperarousal), children with posttraumatic stress disorder (PTSD) require treatment of all associated problems (eg, depression, anxiety, destructive acting out) and ongoing support of participation in the normal developmental experiences of childhood.
  • Long-term support and social skills training may be needed to help a child remedially gain the skills that were not developed during a period of months or years of withdrawal, especially if PTSD is not treated shortly after the incident.
  • Monitoring and educating the child and parents is important because symptoms may reoccur, even after resolution.

Prognosis

  • The prognosis of PTSD widely varies. Although one half of individuals with PTSD recover within 3 months, some proceed to develop a long-term problem with a posttraumatic personality, including impulsive behavior, substance abuse, aggression, eating disorders, sexual acting out, labile mood, rage, panic attacks, and dissociation.
  • Terr (1991) describes type 1 and type 2 traumas.10 Type 1 trauma involves individual incidents, whereas type II trauma involves long-term exposure. Long-term exposure has a far more serious prognosis.
  • Symptoms may reoccur months or years later in response to subsequent stressful or life-changing events.

Patient Education

Miscellaneous

Special Concerns

  • Posttraumatic stress disorder (PTSD) has become a dominating issue in forensic psychiatry. Large numbers of lawsuits involve accusations of PTSD. The forensic evaluation of PTSD is a complex matter that requires expertise well beyond that of the clinician who treats PTSD.
  • For information about the forensic evaluation, see "Forensic Evaluation of PTSD."8
 


More on Posttraumatic Stress Disorder in Children

Overview: Posttraumatic Stress Disorder in Children
Differential Diagnoses & Workup: Posttraumatic Stress Disorder in Children
Treatment & Medication: Posttraumatic Stress Disorder in Children
Follow-up: Posttraumatic Stress Disorder in Children
References
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Further Reading

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Keywords

PTSD, post traumatic stress disorder, posttraumatic stress syndrome, trauma, traumatic event, emotional trauma, disorders of extreme stress, conduct disorder, substance abuse, depression, eating disorders, behavioral disorders, sexual acting out, depression, anxiety disorders, posttraumatic play, nightmares, night terrors, dissociative phenomena, personality change, social withdrawal, impaired relationships, rape, sexual abuse, childhood disruptive disorders

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Contributor Information and Disclosures

Author

Roy H Lubit, MD, PhD, Assistant Clinical Professor, Mount Sinai School of Medicine; Clinical Faculty, Department of Child Psychiatry, New York University School of Medicine; Private Practice
Disclosure: Nothing to disclose.

Medical Editor

Angelo P Giardino, MD, PhD, Clinical Associate Professor, Department of Pediatrics, Baylor College of Medicine; Medical Director, Texas Children's Health Plan, Inc
Angelo P Giardino, MD, PhD is a member of the following medical societies: Academic Pediatric Association, American Academy of Pediatrics, American Professional Society on the Abuse of Children, Harris County Medical Society, Helfer Society, and International Society for Prevention of Child Abuse and Neglect
Disclosure: Nothing to disclose.

Pharmacy Editor

Mary L Windle, PharmD, Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy, Pharmacy Editor, eMedicine
Disclosure: Pfizer Inc Stock Investment from financial planner; Avanir Pharma Stock Investment from financial planner ; WebMD Salary and stock Employment and investment from financial planner

CME Editor

Carrie Sylvester, MD, MPH, Director of Education in Child and Adolescent Psychiatry, Professor, Departments of Psychiatry and Pediatrics, Northwestern University Medical School
Carrie Sylvester, MD, MPH is a member of the following medical societies: American Academy of Child and Adolescent Psychiatry, American Academy of Pediatrics, American Medical Women's Association, American Psychiatric Association, and American Society for Adolescent Psychiatry
Disclosure: Nothing to disclose.

Chief Editor

Caroly Pataki, MD, Professor of Clinical Psychiatry and Behavioral Sciences, Department of Psychiatry, Division Chair, Child and Adolescent Psychiatry, Director of Training, Child and Adolescent Psychiatry Residency Program, University of Southern California Keck School of Medicine
Caroly Pataki, MD is a member of the following medical societies: American Academy of Child and Adolescent Psychiatry, New York Academy of Sciences, and Physicians for Social Responsibility
Disclosure: Nothing to disclose.

 
 
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