Early Intervention Helps Reduce Risk of Posttraumatic Stress in Kids

A new approach that helps improve communication between children and caregivers was found to prevent chronic and sub-clinical posttraumatic stress disorder in 73% of children, according to a study published in the Journal of Child Psychology and Psychiatry.

After experiencing a potentially traumatic event such as a car accident, a physical or sexual assault, a sports injury, or witnessing violence, as many as one in five children will develop PTSD. Researchers from University of Pennsylvania and Yale University Child Study Center developed an intervention to help improve communication between children and caregivers through recognition and managing of traumatic stress symptoms and teaching coping skills. The intervention, called the Child and Family Traumatic Stress Intervention (CFTSI) also reduced PTSD symptoms in children—which can include reliving a traumatic experience, sleep disturbances, emotional numbness, angry outbursts or difficulties concentrating—and promoted recovery more quickly than a comparison intervention, said researchers.

“This is the first preventative intervention to improve outcomes in children who have experienced a potentially traumatic event, and the first to reduce the onset of PTSD in kids," said lead study author Steven Berkowitz, MD, associate professor of Clinical Psychiatry at the University of Pennsylvania School of Medicine, in an online report. "If this study is replicated and validated in future studies, this intervention could be used nationally to help children successfully recover from a traumatic event without progressing to PTSD."

In the study, 106 children ranging from ages seven to 17 years and a caregiver were randomly assigned to receive the four-session CFTSI intervention or a four-session supportive comparison intervention, both of which were provided within 30 days following exposure to a traumatic event. Participants were recruited through telephone screening based on reports from police referrals, a forensic sexual abuse program, or the local pediatric emergency department in an urban city in Connecticut.

The CFTSI intervention began with an initial baseline assessment to measure the child's trauma history and a preliminary visit with the caregiver, focusing on their role in the process. The sessions focused on improving communication between the child and caregiver, as well as other supportive measures. At the end of the next two sessions, the clinician, caregiver and child, decided on a homework assignment to practice certain coping skills. The behavioral skill components are designed to provide techniques to recognize and manage traumatic stress symptoms, according to the authors.

In their assessment of the two groups, Berkowitz and colleagues found that at follow-up, the intervention group “demonstrated significantly fewer full and partial PTSD diagnoses than the comparison group on a standardized diagnostic measure of PTSD,” and had significantly lower posttraumatic and anxiety scores.

Although future studies are needed to validate the effectiveness of the intervention, these results do indicate that brief and effective interventions like the CFTSI can provide “a promising approach to preventing chronic PTSD.”

For more information:

Journal of Child Psychology and Psychiatry—The Child and Family Traumatic Stress Intervention: Secondary prevention for youth at risk of developing PTSD

Pharmacy Times—The Impact of Stress on Health: Learning to Cope

eMedicine: Posttraumatic Stress Disorder in Children