School-Based Intervention May Prevent PTSD in Children

Anyone who experiences or witnesses a traumatic event is at risk of developing Post-Traumatic Stress Disorder (PTSD). While children are generally more resilient to stress and trauma than adults, they can and do develop PTSD in response to traumatic events. The development of a new program appears to help prevent PTSD in children who experience traumatic events, according to a recent study.

Professor Michelle Slone, a psychologist at Tel Aviv University conducted a study to test the effectiveness of a program she developed to help children avoid developing PTSD in response to events they have experienced. Slone used children who had experienced daily rocket attacks from Gaza or other acts of political violence in her study.

First, Professor Slone and her fellow researchers assessed the differences between children who appeared to exhibit psychological distress in response to trauma to those who appeared to exhibit psychological well-being to determine the factors that separated the two groups. She discovered four important resilience factors in the children who appeared to possess psychological health: attributing meaning to the traumatic experience, improving self-esteem, mobilizing appropriate support, and developing problem-solving and self-efficacy skills.

Once she discovered these important resilience factors, Professor Slone and her fellow researchers created workbooks that focused on each specific resilience quality. The intervention took place in schools and the researchers trained the teachers on how to utilize the workbooks. Children were then led through four-to-six week workshops focused on developing resilience qualities. Finally, students also took questionnaires and participated in interviews and evaluations both before and after workshops focused on resilience qualities.

The researchers analyzed the interviews, evaluations, and questionnaires the students took before and after the workshops and discovered that not only did the students develop the resilience factor, but they also possessed a better sense of well-being, improved academic performance and social interactions, and less aggressive behavior and anxiety. The researchers also discovered teachers benefited from the school intervention. Teachers had no techniques for talking to the students about the traumatic symptoms they observed in the children before the intervention. Teachers asserted the workshops improved school and class morale as well as gave them the confidence they needed to help their students cope with difficult problems.

Professor Slone suggests that while the intervention would need to be modified for differing cultural factors, this school-based intervention may be useful internationally. She asserts that the first step would be to determine resilience factors in a given society and then to modify the workshops to focus on developing those particular factors.

Any time an individual experiences or witnesses a traumatic event, he or she is at risk for developing Post-Traumatic Stress Disorder (PTSD). A traumatic event is defined as an event where an individual faced actual or threatened serious injury or death or is faced with the threat of physical integrity of others or oneself, according to the Diagnostic and Statistical Manual of Mental Disorder IV-TR criteria for PTSD. A traumatic event also involves feelings of horror, intense fear, and/or helplessness.

Individuals who develop PTSD experience intrusive recollection symptoms, which include psychological distress to internal or external cues that symbolize an aspect of the trauma, nightmares of the event, intrusive recollections of the trauma, including perceptions, thoughts, and images, physiologic reactivity to internal or external cues that symbolize the trauma, and/or flashbacks or feeling that the event is happening again. In addition, individuals suffering with PTSD experience three or more avoidance symptoms, which include a sense of a foreshortened future, attempts to avoid thoughts, conversations, and feelings associated with the trauma, an inability to remember an important aspect or detail of the event, feeling detached from others, attempts to avoid, people, activities, and places that remind the individual of the event, a restricted range of affect (an inability to feel a range of emotions), and a decreased interest or participation in important activities. Finally, individuals with PTSD also exhibit at least two hyperarousal symptoms, which are an exaggerated startle response, sleeping difficulties, hypervigilance, outbursts of anger or irritability, and concentration difficulties.

If you would like more information about this study, you may visit the journals Psychiatry and International Journal of Behavioral Development and the Journal of Child Psychology.

Sources:

Psych Central: Program Helps Children Manage PTSD:
http://psychcentral.com/news/2010/10/22/program-helps-children-manage-ptsd/19985.html

United States Department of Veterans Affairs: DSM IV-TR Criteria for PTSD:
http://www.ptsd.va.gov/professional/pages/dsm-iv-tr-ptsd.asp