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.