Introduction

It has only been in the last 20 years that researchers have systematically investigated the psychological effects of trauma on children. Early studies of children's reactions to traumatic events did not use a consistent format to report symptoms and relied upon general assessments of global behaviours typically completed by parents or teachers. Adults tend to underestimate the severity of the psychological effects experienced by their children with global measure of behaviour being insensitive to the specific changes in cognitions or emotions associated with traumatic reactions. Interviews undertaken with children using assessments sensitive to the core features of post-traumatic stress disorder (PTSD), namely trauma re-experiencing, avoidance and arousal, reveal that children are significantly affected by traumatic events.

Since the mid-1980s considerable knowledge about PTSD in children exposed to single and multiple traumas has accrued. Children have been found to experience PTSD following a range of traumatic events including natural disasters such as flooding, fires, lightening strikes, hurricanes, landslides and earthquakes. PTSD following a range of human-made traumas such as wars, kidnapping, bombings, sniper attacks, abuse and hostage taking has also been documented as well as following transportation accidents such as shipping disasters and coach accidents. Finally post-traumatic stress disorder arising from more common everyday traumatic events such as road traffic accidents, acute physical injury and chronic illness has also been reported.

Definition and classification

PTSD is defined as an anxiety disorder associated with a traumatic event in which the trauma is repetitively re-experienced.