الفهرس 
BRIEF HISTORYOnly 14 pages are availabe for public view
 |  | from | 241 |  |  |
| | | from | 241 | | |
Abstract
PTSD ( Post traumatic Stress Disorder) is an anxiety disorder currently defined by the coexistence of three clusters of symptoms ( re-experiencing, avoidance and hyperarousability), persisting for at least one month in survivors of a traumatic event ( APA , 2000).
In the past ten years there has been increasing recognition that children who have been exposed to traumatic events can like trauma exposed adults develop post traumatic stress disorder (Debra Kaminar et al., 2005).
Three pretraumatic factors that were modestly but consistently related to PTSD development: (1) history of childhood abuse, (2) psychiatric history, and (3) family psychiatric history. However, results obtained by Ozer et al., (2003) suggested that Peri and posttraumatic factors, such as trauma severity, low levels of social support, and subsequent life stresses were stronger predictors of PTSD than pretrauma factors.
PTSD can present in a wide variety of clinical features in children and adolescents ; developmental factors clearly play a strong role in these variations (Amaya-Jackson et al., 1995). So, the direct application of adult diagnostic criteria for PTSD can result in the misdiagnosis of post traumatic stress reaction in children (Debra Kaminar et al., 2005 ).
Deleterious effects have been documented on children’s interpersonal relations, mood, memory, learning, impulse control and on a range of behaviors (Orlee Udwin , 1993).
Accumulated evidence indicates that severe psychologic trauma may lead to chronic alterations in the neurobiology of the stress response (Bremner et al., 1993; Charney et al., 1993; De Bellis & Putnam, 1994c; Heim et al., 2000). Models of “fear-conditioning” have been particularly useful in exploring the psychobiology of PTSD. These models implicate the amygdala and other regions of the limbic system and also suggest that several neurochemical systems are likely to be relevant, including the noradrenergic, serotonergic, glutamergic, GABAergic, dopaminergic, opioid, hypothalamic-pituitary-adrenal (Le Doux, 1996).
Advances in structural and functional imaging in PTSD patients have provided further information about the neuroanatomy of PTSD. A network of brain regions, comprising the amygdala, hippocampus and anterior cingulate has been implicated (De Bellis et al., 2000a; b; Hamner et al., 1999).
Traumatized children frequently have symptoms of disorders other than PTSD, and children with other disorders often have PTSD as a comorbid diagnosis (Famularo et al., 1992; Goldman et al., 1992; Pynoos et al., 1987a). Individuals diagnosed with PTSD also commonly suffer from other psychiatric disorders, most commonly affective disorders, other anxiety disorders, and alcohol and substance-use disorders (Brady et al., 2000).
Impressive advances in treating post-traumatic stress disorder (PTSD) in children and adolescents have been made in the past decade with respect to cognitive- behavioral therapy, group therapy, individual psychodynamically oriented psychotherapy, creative arts , eye movement desensitization and reprocessing and play therapy.
Drug therapies for PTSD are thought to address neurochemical disruptions in mechanisms controlling arousal, fear, memory, and other aspects of emotional processing that are implicated in the development and maintenance of PTSD (Van Etten and Taylor, 1998). The intent of pharmacologic therapy is to relieve disabling symptoms so that the traumatized child or adolescent is able to pursue a normal developmental pattern, and to increase tolerance to emotionally distressing material and work through such distress (Donnelly and Amaya-Jackson, 2002).
Recommendations
The importance of PTSD is clearly demonstrated especially with the increased rates of traffic accidents , terroristic attacks and natural disasters to which children and adolescents are exposed to every day .
Cases of PTSD to be noticed and treated , need more attention to this illness , more seminars , lectures and studies.
The early detection and prevention of the psychological sequelae following exposure to traumatic experiences should be a priority for the mental health profession.
Both the short-term and long-term consequences of traumatic events for children and adolescents remains an area for further investigations.
Egyptian scales must be constructed for using it in our environment , due to variations between Egyptian and other communities and altered types of traumatic experiences.
Foster care is understudied reservoir of traumatized children with PTSD and further studies should be performed in the foster homes