Post Traumatic Stress Disorder
Post Traumatic Stress Disorder (PTSD) is an anxiety disorder that can develop after experiencing or witnessing a traumatic event, or learning that a traumatic event has happened to a loved one. The current definition of PTSD requires that the student experience a traumatic event that involves exposure to actual or threatened death, serious injury, or sexual violence. Examples include:
- Being involved in, or witnessing, a car accident.
- Undergoing major surgery (bone marrow transplant, extensive hospitalization, severe burns).
- Experiencing or witnessing natural disasters (earthquakes, hurricanes, floods, fire).
- Violent crimes (kidnapping, physical assault, assault or murder of a parent or loved one).
- Community violence (attacks at school, suicide of a friend, family member, or a child in the same-age group).
- Chronic physical or sexual abuse.
Following the event, a student with PTSD may report intrusive symptoms such as repetitive and upsetting memories that s/he can recall, such as, “I can’t stop hearing that crunch noise when the car hit the tree,” or acted out in play such as a young student who repeatedly hits a toy car against the wall. Other intrusive symptoms include distressing and vivid night and day dreams (also called flashbackswhereby the student acts as if the event is actually happening in real time), and becoming highly distressed when exposed to reminders of the event. Students can also avoid or try to stay away from any reminders of the event, report inability to recall significant details of the event, experience a range of negative emotions such as sadness, guilt, shame, and confusion, and lack interest or desire to participate in important activities. Finally, students with PTSD also experience irritability, being jumpy or on edge, trouble concentrating, and sleep difficulties. These combined symptoms must persist for more than a month following the event to meet criteria for PTSD, although some students may experience a delayed reaction to the trauma so that clear signs are not noticeable until six months or more after the event.
How a PTSD impacts the student at school
Preschool and Kindergarten children may not have many “classic” symptoms of PTSD. Instead, they may show their anxiety by becoming afraid of strangers or even familiar people who may remind them of someone associated with the traumatic event. For example, your student may be comfortable with you as you have been his teacher all year, but may become terrified when a substitute teacher comes to teach. Young children may also try to stay home and refuse to go to preschool, wanting to stay “glued” to a parent or caregiver 24/7 for safety. They also may re-enact parts of the trauma in their play or drawings. Finally, young children who are exhibiting signs of PTSD may regress to start sucking their thumb or wetting themselves long after they had ceased these behaviours.
Older, elementary-school-aged children with PTSD may not have symptoms of amnesia as is the case in older students and adults; however, they might have some of the following symptoms:
- Omen formation. This is the belief that there were “warning signs” before the trauma occurred. Students with this belief are always on the alert for signs or warnings of “future danger”. For example, if it was raining on the day of a car accident, the student might believe that the rain was a “warning” of something bad happening, and refuse to go to school when it rains for fear s/he will have a bad day at school.
- Traumatic play. Similar to very young children, elementary students with PTSD may compulsively repeat the trauma in their play. For example, a student who has PTSD following a car accident may then play with toy cars, and have them crash in to each other, or race around the room engaging in reckless behaviour as if s/he is a car.
Adolescent students with PTSD may experience many of the same symptoms as adults; however, there are a few key differences. For example, as a teacher, you may observe that your student used to work hard and get straight “As,” yet is suddenly failing, or a student who never used drugs and never skipped class, is now dressing provocatively, smoking, and skipping school. In addition, students with PTSD often show increased aggressive and impulsive behaviours, and are at greater risk of engaging in high risk or reckless behaviors such as drug and alcohol use, speeding, unprotected sex, etc.
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