Example of Posttraumatic Stress John is a 12 year-old seventh grader who refuses to ride boats or go down to the pier for fishing trips with his friends and family. One year ago, John went on what was supposed to be a one-day fishing trip with his father and his diabetic uncle. While far out to see, their boat's engine and radio transmitter died. They subsequently floated, lost at sea for 5 days with little food and water. John's uncle ran out of his insulin and died in front of John on the boat. Although John and his father were eventually rescued, John felt extreme helplessness and horror during the 5-day ordeal. He remembered watching his uncle die and felt as if he too would die at sea. Since returning to the safety of home, John experiences terrible nightmares about the event. He also becomes very fearful and starts perspiring when anyone mentions the trip, his dead uncle, fishing, or boats. John now also hates his once favorite hobby of fishing and always avoids it when friends and family organize fishing trips. He has difficulties sleeping, is often irritable, has difficulty concentrating, and is very "jumpy" in response to loud noises.

What is Posttraumatic Stress Disorder?

Those suffering from Posttraumatic Stress Disorder (PTSD) develop symptoms following exposure to a traumatic event involving actual or threatened death or serious injury or harmful threats to oneself or others. The child or adolescent's response to the traumatic event involves intense fear, helplessness, horror, and/or disorganized or agitated behavior.

A primary feature of posttraumatic stress is that the traumatic event is persistently "re-experienced" by the victim in the form of recurrent, intrusive, and frightening recollections or dreams. The child or adolescent often acts as if the event were about to reoccur through feelings of intense distress or arousal in response to symbolic cues that resemble some aspect of the event.

In addition, affected youths generally avoid objects, people, or places associated with the trauma, fail to remember important details about the event, as well as tend to experience a severe loss of interest in activities, feelings of detachment, restriction of feelings, and/or a sense of shortened future. Further, the child or adolescent will often experience associated symptoms such as difficulty sleeping, irritability or anger outbursts, difficulty concentrating, being overly vigilant, and/or exaggerated startle responses. The disturbance occurs for more than one month and causes marked distress for the child.

Source: Silverman, W. K., Ortiz, C. D., Viswesvaran, C., Burns, B. J., Kolko, D. J., Putnam, F. W., & Amaya-Jackson, L. (2008). Evidence-based psychosocial treatments for child and adolescent exposed to traumatic events: A review and meta-analysis. Journal of Clinical Child & Adolescent Psychology, 37, 156-183.