Stress and vulnerability to posttraumatic stress disorder in children and adolescents

Objective: This study examined the experiential factors and interacting vul nerabilities that contribute to the development of posttraumatic stress dis order (PTSD) in children and adolescents. Method: Of 100 consecutive referrals to an inner-city child and adolescent psychiatry clinic, 59 had experienced a trauma that qualified as a precipit ant of PTSD. For those with trauma, ages ranged from 3 to 18 years (mean = 9.9, SD = 4.10); 39 (66%) were males. The authors used a series of multiple regression analyses to examine the contribution of demographic characteris tics, the nature of the stressor(s), and the role of preexisting clinical s igns in the development of PTSD. Results: Twenty-two percent of the 59 children who had been traumatized met full criteria for PTSD, 32% had some symptoms of PTSD but did not meet ful l criteria, and 46% had no symptoms of PTSD. Witnessing domestic violence o r being physically abused predicted severity of PTSD. Children With preexis ting aggressive behavior were more likely to be victims of physical abuse. Conclusions: Traumatic experience interacts with factors in the child and f amily to contribute to the development of PTSD, Trauma that threatens famil y integrity appears to make a strong contribution to the development of PTS D. Increased understanding of the factors contributing to PTSD may provide additional opportunities for developing effective interventions.