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Early Intervention with Traumatized Children

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Abstract

With the events of September 11th, childhood trauma has come to the forefront of national attention. One of the common psychiatric outcomes of trauma is Posttraumatic Stress Disorder (PTSD). Despite the fact that certain vulnerabilities may contribute to the development of PTSD in traumatized youth, the existence of an identifiable stressor provides a unique opportunity for early intervention. Cognitive Behavioral Treatment (CBT) interventions are considered by many to be the mainstay of treatment of children and adolescents with PTSD. More severe cases of PTSD are often treated with medications in the community. In this article we present a CBT program—developed by our site—STAIR—and provide useful guides and rationales for clinicians to work with when treating this population. We will also briefly review the available literature on the psychopharmacologic interventions to help guide the physician when confronted with such treatment decisions.

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References

  1. Bender L, Blau A: The reaction of children to sexual relations with adults. American Journal of Orthopsychiatry 7:500-518, 1937.

    Google Scholar 

  2. Bodman F: War conditions and the mental health of the child. British Medical Journal 11:486-488, 1941.

    Google Scholar 

  3. March J: What constitutes a stressor? The "criterion A" issue, In Posttraumatic Stress Disorder: DSM-IV and Beyond. Edited by Davidson J, Foa E. Washington, DC: American Psychiatric Press, Inc, 1992.

    Google Scholar 

  4. Kilpatrick DG, Resnick HS, Saunders BE, et al: Rape, other violence against women and posttraumatic stress disorder: Critical issues in assessing the adversity-stress-psychopathology relationship, in Adversity, Stress, and Psychopathology. Edited by Dohrenwend BP. New York, Oxford University Press, pp. 161-176, 1998.

    Google Scholar 

  5. Terr LC: Chowchilla revisited: The effects of psychic trauma four years after a school bus kidnapping. American Journal of Psychiatry 140:1543-1550, 1983.

    Google Scholar 

  6. Pynoos RS, Nader K: Children who witness the sexual assaults of their mothers. Journal of the American Academy of Child and Adolescent Psychiatry 27:567-572, 1988.

    Google Scholar 

  7. Saxe G, Stoddard F, Courtney D, et al: Relationship between acute morphine and the course of PTSD in children with burns. Journal of the American Academy of Child and Adolescent Psychiatry 40(8):915-921, 2001.

    Google Scholar 

  8. Green BL, Korol M, Grace M, et al: Children and disaster: Age, gender, and parental effects on PTSD symptoms. Journal of the American Academy of Child and Adolescent Psychiatry 30:945-951, 1991.

    Google Scholar 

  9. Pynoos RS, Goenjian A, Tashjian M, et al: Posttraumatic stress reactions in children after the 1988 Armenian earthquake. British Journal of Psychiatry 163:239-247, 1993.

    Google Scholar 

  10. Millgram NA, Toubiana Y, Klingman A, et al: Situational exposure and personal loss in children's acute and chronic reactions to a school disaster. Journal of Traumatic Stress 1:339-352, 1988.

    Google Scholar 

  11. Garrison CZ, Bryant ES, Addy CL, et al: Posttraumatic stress disorder in adolescents after Hurricane Andrew. Journal of the American Academy of Child and Adolescent Psychiatry 34:1193-1201, 1995.

    Google Scholar 

  12. Fitzpatrick KM, Boldizar JP: The prevalence and consequences of exposure to violence among African-American Youth. Journal of the American Academy of Child and Adolescent Psychiatry 32(2):424-430, 1992.

    Google Scholar 

  13. Silva RR, Alpert M, Munoz DM, et al: Posttraumatic stress disorder: Stress and vulnerability in children and adolescents. American Journal of Psychiatry 157(8):1229-1235, 2000.

    Google Scholar 

  14. Deykin EY, Buka SL: Prevalence and risk factors for posttraumatic stress disorder among chemically dependent adolescents. American Journal of Psychiatry 154(6):752-757, 1997.

    Google Scholar 

  15. Giaconia RM, Reinherz HZ, Silverman AB, et al: Traumas and posttraumatic stress disorder in a community population of older adolescents. Journal of the American Academy of Child and Adolescent Psychiatry 34(10):1369-1380, 1995.

    Google Scholar 

  16. Board of Education: The initial report to the board of education concerning the psychological effects of 9/11 on NYC school children. ARC, CU School of Public Health and the New York State Psychiatric Institute, May 6, 2002.

  17. Pine DS, Cohen JA: Trauma in children and adolescents: Risk and treatment of psychiatric sequelae. Biological Psychiatry 51(7):519-531, 2002.

    Google Scholar 

  18. Cloitre M, Davis L, Mirvis S, et al: Working With Multiply Traumatized Youth: STAIR/NST, Treatment Manual unpublished manuscript.

  19. Cloitre M, Koenan K: Interpersonal group process treatment for CSA-related PTSD: A comparison study of the impact of borderline personality disorder on outcome. International Journal of Group Psychotherapy 51:379-398, 2001.

    Google Scholar 

  20. Cohen J: Practice parameters for the assessment and treatment of children and adolescents with post traumatic stress disorder. Journal of the American Academy of Child and Adolescent Psychiatry, 37(9):997-1001, 1998.

    Google Scholar 

  21. Horrigan J: Guanfacine for PTSD nightmares (letter). Journal of the American Academy of Child and Adolescent Psychiatry 35:975-976, 1996.

    Google Scholar 

  22. Harmon R, Riggs P: Clonidine for post traumatic stress disorder in preschool children. Journal of the American Academy of Child and Adolescent Psychiatry 35:1247-1249, 1996.

    Google Scholar 

  23. Loof D, Grimley P, Kuller F, et al: Carbamazepine for PTSD (letter). Journal of the American Academy of Child and Adolescent Psychiatry 34:703, 1995.

    Google Scholar 

  24. Famularo R, Kinscherff R, Fenton T: Propanolol treatment for childhood post traumatic stress disorder, acute type. American Journal of Disorders in Children, 142:1244-1247, 1988.

    Google Scholar 

  25. Robert R, Blakeney P, Villareal C, et al: Imipramine treatment in pediatric burn patients with symptoms of acute stress disorder; A pilot study. Journal of the American Academy of Child and Adolescent Psychiatry 38:873-882, 1999.

    Google Scholar 

  26. Kaplan HI, Sadock BJ: Textbook of Clinical Psychiatry, 2nd ed. New York, Lippincott Williams & Wilkins, 1996.

    Google Scholar 

  27. Seedat S, Lockhat R, Kaminer D, et al: An open trial of citalopram in adolescents with post traumatic stress disorder. International Clinical Psychopharmacology 16:21-25, 2001.

    Google Scholar 

  28. Seedat S, Stein D, Ziervogel C, et al: Comparison of response to a selective serotonin reuptake inhibitor in children, adolescents and adults with post traumatic stress disorder. Journal of Child and Adolescent Psychopharmacology 12:37-46, 2002.

    Google Scholar 

  29. Cohen JA, Mannarino AP, Deblinger E: Child and Parent Trauma-Focused Cognitive Behavioral Therapy Treatment Manual. 2002.

  30. Layne CM, Saltzman WR, Pynoos RS: Trauma/Grief-Focused Group Psychotherapy Program. Manual used by the Child and Adolescent Trauma Treatment Consortium for the New York State Office of Mental Health and the Research Foundation for Mental Hygiene, 2002.

  31. Smucker MR, Dancu C, Foa EB, et al: Imagery rescripting: A new treatment for survivors of childhood sexual abuse suffering from posttraumatic stress, in Clinical Advances in Cognitive Psychotherapy: Theory and Application. New York, Springer, pp. 294-310, 2002.

    Google Scholar 

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Authors and Affiliations

  1. Child Study Center, Division of Child and Adolescent Psychiatry, Department of Psychiatry, New York University School of Medicine, New York

    Raul R. Silva, Marylene Cloitre, Lori Davis, Jill Levitt, Sandy Gomez, Irene Ngai & Elissa Brown

Authors
  1. Raul R. Silva
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  2. Marylene Cloitre
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  3. Lori Davis
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  4. Jill Levitt
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  5. Sandy Gomez
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  6. Irene Ngai
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  7. Elissa Brown
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Correspondence to Raul R. Silva.

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Silva, R.R., Cloitre, M., Davis, L. et al. Early Intervention with Traumatized Children. Psychiatr Q 74, 333–347 (2003). https://doi.org/10.1023/A:1026035426446

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  • DOI: https://doi.org/10.1023/A:1026035426446

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