PTSD in kids: Video case studies applied to DSM5 criteria

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Sep 082018
 

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HELLO FELLOW B-LISTERS!!  Again this week, we continue with our write-ups and (free) videos regarding DSM-5 diagnoses that are found in the records of our students identified as having mental health and/or behavio(u)ral disabilities.

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This week, we look at the hyper-alert, guarded, and varied fear-based reactions that have their source in traumatic events that happened in one’s past (or may be continuing into the present).  Nowadays, that trauma is referred to as ACEs (Adverse Childhood Experiences) or ELA (Early Life Adversity).  

           

This week’s videos (made by a couple of my super grad students in our teacher training program in the area of mental health & behavior disabilities) serve well for short staff professional development sessions.  Professors can make use of them in education or psychology classes.  Parents of children/youth with PTSD become more informed regarding their loved ones condition and how it can be addressed.  Please spread the informational  wealth! 

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Each video will provide you with a case study of a hypothetical youngster.  Then the characteristics of that child will be compared to the diagnostic criteria of the DSM-5 diagnostic manual structure for that disorder.  That part is then followed by suggestions for intervention.

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REVIEW: All anxiety disorders have the same derivation: An irrational (to others) fear of something; a perception of a threat to their physical or psychological comfort/safety.

 

 

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PTSD (Post Tramatic Stress Disorder in children) can be defined as “an anxiety disorder that develops after exposure to a terrifying event or ordeal in which grave physical harm occurred, was observed, or was threatened.” Traumatic events that may trigger PTSD include violent personal assaults, natural or human-caused disasters, exposure to warfare, forced and/or difficult migration, accidents, or lack of sustinence or positive support in the home, among other harrowing events (singular or recurring).

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In the words found in the DSM-5 Psychiatric Manual: “PTSD is an anxiety disorder that develops in relation to an event which creates psychological trauma in response to actual or threatened death, serious injury, or sexual violation. The exposure must involve directly experiencing the event, witnessing the event in person, learning of an actual or threatened death of a close family member or friend, or repeated first-hand, extreme exposure to the details of the event.”

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Here are the videos on PTSD as it relates to children and youth:

1. https://www.youtube.com/watch?v=X2_ksaDtYQw (DSM-4 criteria… since revised a bit in DSM-5)

2. https://www.youtube.com/watch?v=P-wtNEp8E6Y (DSM-5)

 

 

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Interventions

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As with the other anxiety disorders, early and intensive provision of emotional support services is mandatory.  Support from parents, school, and peers is essential.  These supporters will most likely need to be trained so that they can be truly therapeutic in their assistance, and avoid inadvertantly heightening the after-effects of the trauma.Most importantly, the supporters of this youngster must work as a team to establish feelings of being safe and protected in the aftermath of happenings that have created doubt of that safety and security. Therapy sessions by well-trained individuals should allow the youngster to play, draw, write or talk freely about the event.  Reflective listening strategies help the youngster to continue addressing the emotional challenge in a supportive environment.&nbs p;
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How we phrase things when talking with anxiety-impacted kids can heighten or lower the perception of a threat.
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Other sometimes-indicated interventions include behavior modification techniques that promote “desensitization” (engaging in progressive goals that reduce the frequency and intensity of the negative recollections), and cognitive behavioral therapy that teaches the child to reframe the events in a manner that helps to reduce fears and worries.
 
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Medication can also contribute to a lessening of anxiety, and ability to benefit from counseling as the youngster deals with the emotional after-effects of the trauma.  Some of the common prescription meds are: SSRIs (selective serotonin reuptake inhibitors that stop recycling thoughts), antidepressants, and Bensodiazepines (anti-anxiety/sedatives).Bibliotherapy and play therapy are often utilized.

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How to talk with kids in a manner that reduces anxiety & builds positive relationships

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Freebie for you and your kids with anxiety: Knowing that her teachers needed to decompress after their work day, Dr. Donia Fahim (“Dr. Donia”), a former colleague of mine in our Department of Special Education at Hunter College would start and end her evening graduate classes with a short relaxation session.  I asked her to make an audio recording for me.  She was kind to do so.  To listen to this free 11 minute audio,  here’s the link https://youtu.be/2Mbg9BXNweQ.  Call it up, close your eyes, and fl oat away.

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Remember that you can find all of the previous weeks’ blasts (Murphy’s Law as applied to behaviour, ODD, ADHD, Generalized Anxiety Disorder, various other Anxiety Disorders) at: http://www.behavioradvisor.com/blog-3/   Scroll down through them to find the one you’d like to read. 

 

** Be aware that I conduct workshops for schools and the general public regarding Childhood Trauma, it’s effects on youngsters (physically, cognitively, emotionally) and how the schools and community can respond.  If your district is interested, contact me at DoctorMac@BehaviorAdvisor.com

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Dr. Mac

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Tom McIntyre, Ph.D. (Dr. Mac)

Professor of Special Education and Coordinator of the Graduate Program in Behavior Disorders

Hunter College of the City University of New York

DoctorMac@BehaviorAdvisor.com

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