CHILD MALTREATMENT AND THE DEVELOPMENT OF POSTTRAUMATIC-STRESS-DISORDER

Objective.-The purpose of this study was to compare the relative effec ts of various forms of maltreatment on the development of posttraumati c stress disorder (PTSD) in children. Design.-Children were randomly s elected from a population of court-involved maltreated children. The c hilden were then assigned to a PTSD group and a non-PTSD group on the basis of their responses to a structured interview. Setting.-A juvenil e/family court in a large urban area. Participants.-This study examine d 101 children who were before a juvenile/family court because of seve re child maltreatment. All children had been removed from parental cus tody as a result of the maltreatment. Interventions.-None. Measurement s and Results.-Structured clinical psychiatric interviews were adminis tered to each child and each parent, and all court records were review ed. The major analyses assessed the extent to which the presence and d uration of the most common types of severe maltreatment were associate d with a diagnosis of PTSD. Thirty-nine children met criteria for PTSD . Those who were sexually maltreated and those who witnessed family vi olence had a much greater likelihood of developing PTSD than did those whose histories of maltreatment did not include these types of events . The duration of emotional abuse (psychological terror) also proved t o be a significant factor in discriminating children diagnosed as havi ng PTSD from other severely maltreated children. Conclusions.-These fi ndings delineate factors implicated in the cause of PTSD. Moreover, th ey provide information that will enable the protective service communi ty to screen more effectively for PTSD among maltreated children.