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Posttraumatic stress disorder in infants and young children exposed to war-related trauma.
J Am Acad Child Adolesc Psychiatry. 2011 Jul; 50(7):645-58.JA

Abstract

OBJECTIVE

Although millions of the world's children are growing up amidst armed conflict, little research has described the specific symptom manifestations and relational behavior in young children exposed to wartime trauma or assessed factors that chart pathways of risk and resilience.

METHOD

Participants included 232 Israeli children 1.5 to 5 years of age, 148 living near the Gaza Strip and exposed to daily war-related trauma and 84 controls. Children's symptoms were diagnosed, maternal and child attachment-related behaviors observed during the evocation of traumatic memories, and maternal psychological symptoms and social support were self-reported.

RESULTS

PTSD was diagnosed in 37.8% of war-exposed children (n = 56). Children with PTSD exhibited multiple posttraumatic symptoms and substantial developmental regression. Symptoms observed in more than 60% of diagnosed children included nonverbal representation of trauma in play; frequent crying, night waking, and mood shifts; and social withdrawal and object focus. Mothers of children with PTSD reported the highest depression, anxiety, and posttraumatic symptoms and the lowest social support, and displayed the least sensitivity during trauma evocation. Attachment behavior of children in the Exposed-No-PTSD group was characterized by use of secure-base behavior, whereas children with PTSD showed increased behavioral avoidance. Mother's, but not child's, degree of trauma exposure and maternal PTSD correlated with child avoidance.

CONCLUSIONS

Large proportions of young children exposed to repeated wartime trauma exhibit a severe posttraumatic profile that places their future adaptation at significant risk. Although more resilient children actively seek maternal support, avoidance signals high risk. Maternal well-being, sensitive behavior, and support networks serve as resilience factors and should be the focus of interventions for families of war-exposed infants and children.

Authors+Show Affiliations

Department of Psychology and Gonda Brain Sciences Center, Bar-Ilan University, Ramat-Gan, Israel. feldman@mail.biu.ac.ilNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

21703492

Citation

Feldman, Ruth, and Adva Vengrober. "Posttraumatic Stress Disorder in Infants and Young Children Exposed to War-related Trauma." Journal of the American Academy of Child and Adolescent Psychiatry, vol. 50, no. 7, 2011, pp. 645-58.
Feldman R, Vengrober A. Posttraumatic stress disorder in infants and young children exposed to war-related trauma. J Am Acad Child Adolesc Psychiatry. 2011;50(7):645-58.
Feldman, R., & Vengrober, A. (2011). Posttraumatic stress disorder in infants and young children exposed to war-related trauma. Journal of the American Academy of Child and Adolescent Psychiatry, 50(7), 645-58. https://doi.org/10.1016/j.jaac.2011.03.001
Feldman R, Vengrober A. Posttraumatic Stress Disorder in Infants and Young Children Exposed to War-related Trauma. J Am Acad Child Adolesc Psychiatry. 2011;50(7):645-58. PubMed PMID: 21703492.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Posttraumatic stress disorder in infants and young children exposed to war-related trauma. AU - Feldman,Ruth, AU - Vengrober,Adva, Y1 - 2011/04/29/ PY - 2010/11/14/received PY - 2011/02/24/revised PY - 2011/03/02/accepted PY - 2011/6/28/entrez PY - 2011/6/28/pubmed PY - 2011/12/13/medline SP - 645 EP - 58 JF - Journal of the American Academy of Child and Adolescent Psychiatry JO - J Am Acad Child Adolesc Psychiatry VL - 50 IS - 7 N2 - OBJECTIVE: Although millions of the world's children are growing up amidst armed conflict, little research has described the specific symptom manifestations and relational behavior in young children exposed to wartime trauma or assessed factors that chart pathways of risk and resilience. METHOD: Participants included 232 Israeli children 1.5 to 5 years of age, 148 living near the Gaza Strip and exposed to daily war-related trauma and 84 controls. Children's symptoms were diagnosed, maternal and child attachment-related behaviors observed during the evocation of traumatic memories, and maternal psychological symptoms and social support were self-reported. RESULTS: PTSD was diagnosed in 37.8% of war-exposed children (n = 56). Children with PTSD exhibited multiple posttraumatic symptoms and substantial developmental regression. Symptoms observed in more than 60% of diagnosed children included nonverbal representation of trauma in play; frequent crying, night waking, and mood shifts; and social withdrawal and object focus. Mothers of children with PTSD reported the highest depression, anxiety, and posttraumatic symptoms and the lowest social support, and displayed the least sensitivity during trauma evocation. Attachment behavior of children in the Exposed-No-PTSD group was characterized by use of secure-base behavior, whereas children with PTSD showed increased behavioral avoidance. Mother's, but not child's, degree of trauma exposure and maternal PTSD correlated with child avoidance. CONCLUSIONS: Large proportions of young children exposed to repeated wartime trauma exhibit a severe posttraumatic profile that places their future adaptation at significant risk. Although more resilient children actively seek maternal support, avoidance signals high risk. Maternal well-being, sensitive behavior, and support networks serve as resilience factors and should be the focus of interventions for families of war-exposed infants and children. SN - 1527-5418 UR - https://www.unboundmedicine.com/medline/citation/21703492/Posttraumatic_stress_disorder_in_infants_and_young_children_exposed_to_war_related_trauma_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0890-8567(11)00199-7 DB - PRIME DP - Unbound Medicine ER -