Introduction
The object of study is a family that has experienced a traumatic event. The family includes a 10-year-old girl, Amy, and her parents. One day, when the whole family was at home, burglars broke in and beat the parents in front of the child. They also stole many valuable items and fled.
Before the incident, the family had been happy and had never had such a bad experience. Amy had always done well in school and was an active, curious child, but after the incident, she became withdrawn. Her grades deteriorated, and she isolated herself without wanting to socialize with her peers or enjoy life.
Main Body
Post-traumatic stress disorder in children is a disorder of mental activity that develops after an external psycho-traumatic event. It is manifested by repeated re-experiencing of the situation in nightmares and thoughts, a desire to get rid of memories, actual nervous tension, irritability, and anxiety, which are observed in Amy. Psychometric tests, projective techniques, observation, and conversation are used for diagnosis (Mash & Wolfe, 2015).
Post-traumatic stress disorder in children is a delayed reaction to trauma. It develops due to exhaustion of the adaptive reserves of the body and a failure of emotional-volitional mechanisms. In extreme situations, body systems function in an amplified mode, and the resistance phase becomes more active (Mash & Wolfe, 2015). Danger and unpredictability of events do not allow for weakness and emotionality. Self-esteem, fear, humiliation, and pain are forced out of consciousness, as they do not contribute to survival. As a result, after a certain lapse of time, defense mechanisms are exhausted, and experiences are actualized, transforming into intrusive memories, nightmares, tension, anxiety, and depression.
Young children, as well as older children and adolescents, typically exhibit three classic symptoms of PTSD:
- Reliving the event (through nightmares or reenactment of traumatic events).
- Avoiding reminders of the event.
- Psychological distress.
The Diagnostic and Statistical Manual of Mental Disorders also underestimates the number of children experiencing PTSD and subsequent disorders. There are several stages of PTSD – acute and chronic. The acute stage occurs when living through stress, and its duration is individual. The kid is experiencing emotional tension and dread at the start of this period (Sun et al., 2021). Nearby, there can be other people, but subjectively, the person remains one-on-one with fear, anger, despair, and helplessness. In the end, there is relief and improvement in mood, but soon, the temporary euphoria transforms into lethargy and weariness. At this point, the child needs to be helped through the negative emotions and feel supported. However, adults are often paralyzed, and the child must cope alone.
A person who does not receive support during acute stress progresses to chronic stress (Sun et al., 2021). This stage assumes long adaptation after the stress experienced. Unexpected behavioral reactions, drastic changes in habits and rhythm of life, disturbances in concentration and sleep, eating habits, an exacerbation of somatic diseases, emotional outbursts, mood swings, and other psychological symptoms characterize the stage of chronic stress.
Children’s neurophysiological systems are developing rapidly. Psychological traumas affect the process of physical and mental development. Without timely diagnosis and adequate treatment, PTSD in children becomes chronic, complicated by the development of secondary depression, the appearance of obsessive-compulsive, panic disorder, and phobias (Danese et al., 2020). Among the formalized fears, agoraphobia, claustrophobia, and fear of the dark prevail. As the child grows up, there is a risk of pathocharacterological, psychopathic development of the personality, isolation, anxiety, embitteredness, and aggression are observed (Danese et al., 2020). Behavioral disorders are associated with an increased risk of alcoholism, drug addiction, social disadaptation, and suicide.
PTSD should be diagnosed in a child within the first three months after the psychological trauma: if symptoms are ignored and PTSD is not treated, the child’s condition will worsen, and the disorder can progress to a chronic form. Diagnosing PTSD in children is difficult enough; therefore, specialists should only perform it in childhood mental illness (Haag et al., 2020). In diagnosing PTSD, diagnostic clinical interviews are used – with both the child and their parents. Particular questionnaires are also administered for more accurate characterization of post-traumatic stress disorder.
Treatment
Since Amy is afraid to go to bed, her treatment will involve working with a child psychologist, psychotherapist, and specialists to help her recognize, process, and release the traumatic events. In this case, treatment may focus on cognitive-behavioral methods. These involve meetings with a specialist to increase awareness and re-experience the psychological trauma (Boterhoven de Haan et al., 2021). Then, essential desensitization techniques are used. Several stimuli of the same type but different intensities are chosen.
An emotional response (fear, crying) is provoked with gradual intensification and coping skills are developed (Boterhoven de Haan et al., 2021). As a result, the connection between the trigger and the emotion is eventually severed, and the girl can observe a regular sleep routine. This can also include the psycho-correction of Amy’s destructive feelings. This can occur with the help of projective techniques and play situations, as a result of which feelings of guilt will be eliminated, and attacks of aggression and self-aggression will be corrected.
Highly suggest and recommend that Amy and her parents undergo psychotherapy since all family members were involved in the traumatic event. This involves working with parents and close family members to relieve anxiety and emotional tension. During this therapy, situations are created so the child can express herself, be active, and not be afraid.
If the therapy sessions do not correct the problem, Amy will be prescribed medication therapy. This may be unavoidable, as the girl’s school performance and future life depend on her getting rid of the disorder. This therapy is prescribed for severe PTSD to treat phobias, panic attacks, and hallucinations. Sedatives and selective serotonin reuptake inhibitors (SSRIs) may be used. These medications relieve tension and intrusive thoughts, improve mood, eliminate anxiety, stabilize the CNS, and reduce aggression (Park & Kim, 2022). Amy’s severe and nighttime anxiety can be treated with tranquilizers, asthenic symptoms can be treated with nootropics, and psychotic symptoms can be treated with neuroleptics.
It is worth mentioning Professor Foa’s method of prolonged exposure therapy, which allows for a short time to sharply reduce the intensity of painful memories of the traumatic event and subsequently eliminate them. Since the girl is now severely behind in her school curriculum, this method can work well for her, as it is pretty fast. During treatment with this method, Amy will learn to regulate her thoughts about the traumatic event, self-manage her symptoms, and eliminate anxiety, fears, phobias, and worry through meditative techniques (Bragesjö et al., 2021). The child becomes adequate, and her behavior becomes calmer. Psychotherapy returns the child to a normal childhood and an interest in previously special activities and things.
Prognosis
In Amy’s case, the prognosis is favorable; it is assumed that the disorder can be resolved by comprehensive psychotherapeutic care supplemented by medication. If treatment is not begun, a chronic form of the syndrome will occur, which is more challenging to treat – complications will develop, and the psychiatrization of the personality will occur. Pathological changes are more stable, requiring long-term medical supervision. It is possible to reduce the probability of developing an exacerbation of post-traumatic syndrome by correctly organizing life.
Rehabilitation
Amy’s parents must ensure that the child is as involved as possible in social relationships: going to school, having friends over, participating in sports, and having active family vacations. Passion for the present – meetings, studies, creativity, achievements – is essential. If Amy wants to discuss a problematic event that happened, parents should not refuse, but it is worth talking about it as an experience. It is also worth mentioning that scientists have created a self-help site based on a psychotherapeutic introduction to a stressful situation.
First, PTSD patients meet with a therapist in person. After this meeting, participants can go to the site for more information about PTSD and ways to cope; their doctors can also go to the site to give advice or instruction as needed. Overall, scientists believe that therapy in this form is a promising treatment for many people with PTSD (De Witte et al., 2021). In this way, Amy will be able to cope with the symptoms and the illness in general on her own.
Conclusion
Thus, treating PTSD in children is a critical and complex process. If left untreated, a child will grow up incomplete and closed off from society, harming them in the future. The disorder must be diagnosed in time for the most successful and effective treatment. Researchers are working to improve screening, early treatment, and follow-up for mass trauma survivors, developing ways to teach them self-control and self-reflection skills and a referral mechanism for psychiatrists. Adequate steps to alleviate child and parent distress and strengthen their relationship will help prevent parents and children from developing post-traumatic reactions (Cramm et al., 2022). However, there is only early evidence to support these treatments in the acute period, and further research is needed.
References
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