Children trauma

Acting or feeling as if the traumatic event were recurring (includes a sense of reliving the experience, illusions, hallucinations, and dissociative flashback episodes, including those that occur on awakening or when intoxicated). Note In children trauma-specific reenactment may occur. 

Glover D, Poland R (2002) Urinary cortisol and catecholamines in mothers of child cancer survivors with and without PTSD. Psychoneiu oendocrinology 27 805-819 Goeinjian AK, Pynoos RS, Steinberg Am, Endres D, Abraham K, Geffner ME, Fairbanks LA (2003) Hypothalamic-pituitary-adrenal activity amongArmenian adolescents with PTSD symptoms. J Trauma Stress 16 319-323... 

Bernstein, D.P., Stein, J.A., Newcomb, M.D., Walker, E., Pogge, D., Ahuluvalia, T., Stokes, J., Handelsman, L., Medrano, M., Desmond, D. and Zule, W. (2003) Development and validation of a brief screening version of the childhood trauma questionnaire. Child Abuse and Neglect 27, 169-190. 

The assessment of pediatric PTSD must be bound in a developmental framework that is sensitive to the child s social context and the type of trauma. At present there is no generally agreed upon gold standard instrument for the assessment of childhood PTSD. Several of the most commonly used instruments will be discussed as they relate to screening, formal diagnosis, and symptom monitoring in response to medication treatment. The interested reader is referred to a more comprehensive exposition on PTSD assessment in youth (i.e., March, 1999). 

March and Amaya-Jackson (personal communication) have developed a self-report PTSD screening measure, the Child and Adolescent Trauma Screen (CATS) that has demonstrated excellent factor analytic and psychometric properties across the domains of reexperiencing, avoidance, and hyperarousal. Amaya-Jackson et al. (2000) developed the Child PTSD Checklist, which is a child-friendly instrument with sound psychometric properties that can provide a formal diagnosis of PTSD. 

Giaconia, R.M., Reinherz, H.Z., Silverman, A.B., Pakiz, B., Frost, A.K., and Cohen, E. (1995) Traumas and posttraumatic stress disorder in a community population of older adolescents. J Am Acad Child Adolesc Psychiatry 34 1369-1380. 

Putnam, F.W, and Trickett, P.K. (1993) Child sexual abuse a model of chronic trauma. Psychiatry 56 82-95. 

Pediatric patients who develop psychiatric syndromes following acute medical illness or injury or invasive procedures (e.g., a child who develops post-traumatic stress disorder [PTSD] following a motor vehicle accident and trauma a child who develops PTSD following stem cell transplantation)... 

Wozniak, J., Crawford, M.H., Biederman, J., Faraone, S.V., Spencer, T.J., Taylor, A., and Blier, H. (1999) Antecedents and complications of trauma in boys with ADHD findings ftom a longitudinal study. / Am Acad Child Adolesc Psychiatry 38 48-55. 

A seven-month-old child "fell over" while crawling, and now presents with a swollen leg. At age one month, the infant has multiple fractures in various states of healing (right clavicle, right humerus, right radius). At age seven months, the infant has a fracture of a bowed femur, secondary to minor trauma (see x-ray below). The bones are thin, have few trabecula, and thin cortices. A careful family history ruled out nonaccidental trauma (child abuse) as a cause of the bone fractures. The child is most likely to have a defect in ... 

On the Recollective-Analytic level, a large part of the phenomena are familiar ones in the literatures of psychoanalysis and hypnosis. The unconscious materials are unusually accessible, and the patient may recall or live through traumatic experiences from his early life. The events may be seen (eidetic images), or felt to be occurring, or vividly remembered. The patient, perhaps assisted by the therapist, can immediately review the recollection or age regression with an adult consciousness that interprets the events more appropriately than the child did. Even as the trauma is recalled or relived, a coexisting adult consciousness can draw mature conclusions. Even if abreaction does not occur, interpretation by the mature consciousness may still prove therapeutic. 

After a disaster, families and children will require mental health services and counseling. Qualified child psychologists, psychiatrists, social workers, and counselors should provide this treatment. To meet children s psychosocial needs following a disaster, health care professionals must consider the children s developmental levels, their caregivers, and their families when conducting assessments and providing treatment (Mohr, 2002). Also critical to treatment is an assessment of the nature of the child s exposure to the disaster, the severity of the disaster, and the duration of the trauma or crisis (Mohr, 2002). 

Fatty infiltration of the liver and/or other organs Dilated or hypertrophic cardiomyopathy Allegation of child abuse (not trauma, physical harm)... 

Exposure to a traumatic event is required for a diagnosis of PTSD. The person must have witnessed, experienced, or have been confronted with a situation that involved definite or threatened death or serious injury, or possible harm to themselves or others. The patient s response to the trauma must include intense fear, helplessness, or horror. Some examples of traumatic events include motor vehicle accidents, natural disasters, rape, being held hostage, child sexual abuse, and witnessing a murder or injury of another. 

The symptoms of infection by varicella zoster are usually unmistakable the slight fever accompanied by a rash, which tends to be concentrated on the central part of the body (the trunk) rather than on the face, arms and legs. The spots (vesicles) resemble drops of water on the skin, and these soon dry to form scabs. The infected child is inconvenienced rather than incapacitated by the infection. In adults, chicken pox can have very serious consequences, and may lead to potentially life-threatening encephalitis or pneumonia. However, the more common form of varicella zoster infection in adults leads to a condition known as shingles. This is manifested as severe inflammation of the sensory nerves, which is usually accompanied by intense pain, and later by a rash. In most instances, it seems that the varicella zoster virus of infancy has lain dormant for many decades in the nerve cells, and has been reactivated in response to some kind of trauma (perhaps depresssion or an infection), to produce an attack of shingles. 

Havenaar JM, van den Brink W, van den Bout J, et al Mental health problems in the Gomel region (Belarus) an analysis of risk factors in an area affected by the Chernobyl disaster. Psychol Med 26 845-855,1996 Kolominsky Y, Igumnov S, Drozdovitch V The psychological development of children from Belarus exposed in the prenatal period to radiation from the Chernobyl atomic power plant. J Child Psychol Psychiatry 40 299-305, 1999 Koscheyev VS, Martens VK, Kosenkov AA, et al Psychological status of Chernobyl nuclear power plant operators after the nuclear disaster. J Trauma Stress 6 561-568, 1993... 

THROMBATE III (Bayer) is a plasma-derived product that is used to treat AT-III deficiency, the first inherited trait discovered which was identified in 1965. The condition is associated with thrombophilia caused by low levels of AT-III or the presence of altered AT-III activity. Both conditions can result in excessive blood clotting. Acquired AT-III deficiency is another condition that occurs in situations with high risk of thrombosis such as trauma, burns, and sepsis. GTG Biotherapeutics conducted chnical trials with ATryn in high-risk situations such as surgery or child de-Hvery to prevent deep-vein thrombosis in hereditary AT-III-deficient patients and heparin-resistant patients with acquired AT-III deficiency undergoing coronary bypass. A pharmacokinetic study in patients with hereditary AT-III deficiency indicated that the administration of the recombinant product resulted in an increase in blood... 

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