Clinical characteristics and efficacious treatment of posttraumatic stress disorder in children and adolescents

Children in the United States are exposed to a variety of traumatic events. Psychosocial sequelae to these events vary in their nature and severity. PTSD is a common, debilitating response to traumatic events that may alter the normal developmental course for children. Risk and protective factors in the development of PTSD include child, caregiver, and family characteristics. To date, empirical evidence reveals the efficacy of psychosocial treatments, especially cognitive-behavior therapy. Caregiver involvement in treatment is indicated. Aside from participation in psychosocial interventions, caregivers should be encouraged to convey belief of and empathy for their children, provide a forum for children to discuss the trauma if they choose, and promote coping skills that have been helpful following other stressful events. Emerging studies suggest the potential adjunctive effects of pharmacologic treatments. Additional investigations of the efficacy of school-based group CBT, combined CBT and pharmacotherapy, and CBT for more severely impaired children are warranted. Children and families also might benefit from research on community-based interventions (eg, following disasters, terrorism, war, and community violence) and preventive interventions (designed to prevent the development of PTSD following traumatic events).