[Post-traumatic stress syndrome in children]

Posttraumatic stress disorder is a form of anxiety disorder which is poorly known in children and manifests as a series of symptoms occurring after an extraordinary event outside the range of usual human experiences and responsible for a feeling of terror. Virtually pathogmonic symptoms include re-experiencing the event through play and ceaselessly repeated behaviors (re-enactments), cognitive distortions when relating the facts (chronological errors, belief in omens), changes in attitudes towards others and life in general, and neurovegetative hyperactivity (hypervigilance, startle responses, difficulties controlling impulses). Although adequate follow-up data are lacking, the disorder can probably become chronic in children, as in adults. This nosographic entity raises the theoretical issue of the roles of life events and individual vulnerability. A number of factors may either "predispose" or "protect" the child: degree and duration of exposure to the trauma, nature of the event, preexistence of psychiatric disorders, level of cognitive development, sex, degree of social support, and containing or noncontaining attitude of the family. Treatments advocated in adults (pharmacotherapy, cognitive and behavioral therapies, group therapy) remain to be used and evaluated in children.