Epidemiological, phenomenological, and treatment aspects of trauma and posttraumatic stress disorder in children and adolescents
Date
2005-12
Authors
Seedat, Soraya
Journal Title
Journal ISSN
Volume Title
Publisher
Stellenbosch : University of Stellenbosch
Abstract
Many gaps remain in our current state of knowledge about
the epidemiology, phenomenology, neurobiology, and
psychopharmacology of posttraumatic stress disorder (PTSD)
in children and adolescents. Empirical evidence,
particularly in non-Western settings, is sparse and there
is little convergent understanding of the interrelationship
of epidemiological factors, PTSD symptom
expression, full and partial syndromes, disorders comorbid
with PTSD, and pharmacotherapeutic interventions.
Clinicians are faced with the difficult task of treating
this often complicated and debilitating disorder in youth
in the absence of data from well-controlled clinical
trials. The studies detailed here are a point of departure
for understanding the confluence that exists between
epidemiological, phenomenological, and pharmacotherapeutic
aspects of adolescent PTSD. Two studies were conducted to
investigate the prevalence and effects of violence exposure
and PTSD, clinical and functional correlates of full and
partial syndromes, and associated gender differences in
school and clinic samples, respectively. Two preliminary
open-label trials assessed the efficacy and safety of a
selective serotonin reuptake inhibitor (SSRI) in
adolescents with at least moderate severity PTSD. The results indicate that (i) partial PTSD is a common
nosological entity in adolescents, (ii) gender-related
differences in PTSD, even if not manifest in differences in
prevalence (i.e., in the rates of trauma exposure and full
and partial PTSD), may well manifest in symptom expression
(i.e., higher symptom burden in girls), associated
morbidity, and functional impairment, and (iii) SSRIs may
be effective in treating core PTSD symptoms in this age
group.
While not yet demonstrated, the partial subtype may have
similar biological underpinnings to full PTSD in
adolescents and may benefit from similar
pharmacotherapeutic interventions. This is an area
deserving of further investigation. Controlled SSRI data
are needed to establish if these should be agents of choice
for paediatric PTSD.
Description
Thesis (PhD (Psychiatry))--University of Stellenbosch, 2005.
Keywords
Post-traumatic stress disorder in children -- Treatment, Post-traumatic stress disorder in adolescence -- Treatment, Psychic trauma in children -- Treatment, Psychic trauma in adolescence -- Treatment, Dissertations -- Psychiatry, Theses -- Psychiatry