Factors Related to Posttraumatic Stress Disorder in Adolescence

Abstract

Studies of posttraumatic stress disorder (PTSD) in adolescence published from 2000 to 2011 indicate that adolescents are at greater risk of experiencing trauma than either adults or children, and that the prevalence of PTSD among adolescents is 3-57%. Age, gender, type of trauma, and repeated trauma are discussed as factors related to the increased rates of adolescent PTSD. PTSD in adolescence is also associated with suicide, substance abuse, poor social support, academic problems, and poor physical health. PTSD may disrupt biological maturational processes and contribute to the long-term emotion and behavior regulation problems that are often evident in adolescents with the disorder. Recommendations are presented for practice and research regarding the promotion of targeted prevention and intervention services to maximize adolescents' strengths and minimize vulnerabilities. Public policy implications are discussed.Keywords adolescent, trauma, posttraumatic stress, abuse, development, risk factors, suicidality, substance use Key Points of the Research Review Trauma in AdolescenceFour of five adolescents meet DSM criteria for exposure to a serious traumatic event. Of these, 3-57% meet diagnostic criteria for Posttraumatic Stress Disorder (PTSD). Child maltreatment is a common type of trauma for those under 18. There were over 2 million reported cases in the United States in 2008, which likely represents a fraction of the actual incidents of abuse and neglect. PTSD in AdolescenceThe average rate of adolescent PTSD was nearly 14% among studies conducted in the last decade. Rates of PTSD in adolescence are related to type of trauma. Trauma that is associated with more shame and deviance is associated with higher rates of PTSD (e.g., for sexual abuse 57% have PTSD vs. 10% for natural disasters). Risk Factors for PSTDRates of traumatic exposure peak in adolescence compared to adulthood, which is associated with correspondingly higher rates of PTSD (adult PTSD 7% vs. adolescent PTSD 13%). Adolescent females are twice as likely to develop PTSD following a significant trauma than males. Repeated trauma, regardless of type, heightens the probability of PTSD symptoms and diagnosis. Adolescents with less social support are more likely to experience trauma and develop PTSD.Serious physical health problems increase risk of PTSD in adolescence. Correlates of PTSDAdolescents with PTSD are significantly more likely to have failed a grade or to have been suspended than those without PTSD. Over 80% of individuals with PTSD have a comorbid substance-use disorder, typically beginning in adolescence. Approximately 6% of adolescents with PTSD have made a suicide attempt versus less than 2% for adolescents with no history of trauma or PTSD. Brain imaging studies relate PTSD and trauma to differences in emotion regulation, dopamine, and norepinephrine activation.

Children and adolescents treated for post-traumatic stress disorder at the Free State Psychiatric Complex

“…More than half (59.2%) of the participants received psychotherapy (mainly cognitive and be havioural therapy and play therapy), while 36.7% received a combination of psychotherapy and medication. This approach is in line with current policy to treat PTSD in children and adolescents with a combination of psychotherapy [19,24,29,30] and medication. [29,30] …”

“…[18] Adolescents face a number of new phase-specific developmental demands including the acquisition of coherent identities, establishing relations with peers and developing independence from parents. [19] International studies have also highlighted high rates of traumatisation and PTSD in children and adolescents. For example, Holford et al [20] reported that 25 -100% of children and adolescents exposed to sudden unanticipated violence develop PTSD.…”

“…For instance, adolescents are more likely to engage in a variety of risky behaviours, such as gang-related activities, teenage pregnancies, substance abuse and peer group pressure. [24] Nooner et al [24] reported that the prevalence of PTSD among adolescents was 3 -57%, and that age, gender, type of trauma and repeated trauma were important factors related to the increase in the number of adolescents with the disorder. Suicide, substance abuse, poor social support, academic problems and poor physical health were risk factors associated with PTSD in adolescence.…”

Agression sexuelle et violence dans les relations amoureuses

“…Les manifestions cliniques de ce trouble comprennent des symptômes d'intrusion, d'évitement des stimuli associés à l'événement traumatisant et d'hyperéveil. Ainsi, parmi l'éventail des répercussions associées à l'agression sexuelle vécue pendant l'enfance, les SSPT sont parmi les plus fréquemment retrouvés chez les victimes d'agression sexuelle (Oddone Paolucci, Genuis et Violato, 2001), avec 57 % des adolescents présentant un historique d'agression sexuelle qui souffrent de SSPT atteignant le seuil clinique (Nooner et al, 2012). L'adolescence constituerait une période critique pour le développement des SSPT.…”

“…L'adolescence constituerait une période critique pour le développement des SSPT. En effet, les jeunes sont exposés à plus d'événements traumatiques que les adultes et présentent des taux de SSPT plus élevés que ces derniers (Nooner et al, 2012). Sur le plan des différences liées au genre, si certaines observations indiquent que les filles présentent des taux d'état de stress post-traumatique deux fois plus élevés que les garçons (Kilpatrick et al, 2003 ;Nooner et al, 2012), d'autres semblent indiquer que les garçons et les filles présentent des taux équivalents (Maikovich, Koenen et Jaffee, 2009).…”