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NCFY Reports

August 2013

A Storm After the Calm: Post-Traumatic Stress Disorder in At-Risk Youth

Terri Weaver cuts right to the chase when describing the effects of trauma. “Your whole life has been put through the blender of traumatic experience and your ability to live life is colored by that trauma,” she says. As professor of psychology at St. Louis University in St. Louis, MO, Weaver knows that when young people experience trauma, their whole world changes. Their outlook on themselves and the world, their attention span, even their ability to connect with and trust other people. 

At their worst, these difficulties can be symptomatic of post-traumatic stress disorder, or PTSD, a mental health condition with wide-ranging symptoms that include flashbacks, numbness and self-destructive behavior. PTSD occurs after the fact in people who have experienced or witnessed a traumatic event such as rape, child abuse, domestic or community violence, natural or manmade disasters, or the sudden death of a loved one.

A Harvard Medical School study estimated that only 5 percent of young people have experienced PTSD, but other research has found that the disorder occurs in street youth at nearly six times that rate. Young people who have gone through physical or sexual abuse or intimate partner violence are also at high risk. With that in mind, here are five things family and youth workers should know about PTSD:

  1. Not all youth who’ve experienced trauma will develop PTSD. In a recent study on trauma and street youth, researchers found that 78 percent of youth had experienced a traumatic event, while only 28 percent met criteria for PTSD.
     
  2. Young people in the midst of trauma might have symptoms of PTSD—but it’s not PTSD. The disorder is diagnosed at least one month after the traumatic experience ends. That’s because when young people are in the midst of trauma, their reactions, such as becoming passive so an abuser won’t attack them, can be considered “adaptive,” Weaver says. It’s also because a young person can’t heal from trauma until its source is removed.
     
  3. PTSD may be preventable. “The more stable one’s environment following a trauma, the better one is likely to do,” says Christopher Sarampote, a program officer with the National Institute of Mental Health’s Child Trauma Program. Offering predictability and stability, keeping youth safe from an abuser, and meeting their basic needs for food, housing and safety may protect them from later developing PTSD.
     
  4. PTSD is treatable. “Getting help is important,” Sarampote says. Not treating PTSD, or traumatic responses in general, can impair young people’s recovery and even lead them to be victimized again, he says. A mental health professional can provide a diagnosis, prescribe medications if appropriate, and offer therapy. Evidence-based approaches that may help include Trauma Focused Cognitive Behavioral Therapy and Psychological First-Aid for Youth Experiencing Homelessness (PDF, 1.5MB).
     
  5. PTSD often co-occurs with other mental health problems and with substance abuse. “It’s important not to have tunnel vision and only think about PTSD” when screening a young person, Weaver says. Depending on the source of the young person’s trauma as well as personal factors, they may also have depression, suicidal thoughts, drug or alcohol addiction, or physical ailments such as injuries or gastrointestinal problems. Knowing a young person’s other struggles can help a mental health team tailor treatment and avoid therapies that might help with PTSD but hinder recovery from other conditions—or vice versa. For example, Sarampote says, anti-depressive medications may increase a teen’s risk of feeling suicidal, and teens with PTSD are already at high risk.
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