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Child maltreatment and the development of posttraumatic stress disorder
R Famularo1, T Fenton, R Kinscherff
1Boston Juvenile Court Clinic, Massachusetts Department of Mental Health, Boston, MA 02108.
Insights
Sexual abuse and witnessing family violence significantly increase children's risk for developing posttraumatic stress disorder (PTSD). The duration of emotional abuse also impacts PTSD development in maltreated youth.
Area of Science:
- Child Psychology
- Trauma Studies
- Forensic Psychiatry
Background:
- Child maltreatment is a significant public health issue.
- Posttraumatic stress disorder (PTSD) is a common consequence of trauma in children.
- Understanding specific maltreatment types linked to PTSD is crucial for intervention.
Purpose of the Study:
- To compare the effects of different forms of child maltreatment on PTSD development.
- To identify specific risk factors for PTSD in court-involved children.
- To inform screening and intervention strategies for maltreated youth.
Main Methods:
- A cohort of 101 court-involved, maltreated children was studied.
- Children were assessed using structured clinical psychiatric interviews.
- Court records were reviewed to determine maltreatment history and duration.
Main Results:
- 39 children (38.6%) met criteria for PTSD.
- Sexual maltreatment and witnessing family violence were strongly associated with higher PTSD likelihood.
- The duration of emotional abuse was a significant predictor of PTSD diagnosis.
Conclusions:
- Sexual abuse, witnessing domestic violence, and prolonged emotional abuse are key factors in childhood PTSD.
- Findings aid protective services in identifying at-risk children.
- This research informs targeted interventions for maltreated children.
Abstract:
OBJECTIVE--The purpose of this study was to compare the relative effects of various forms of maltreatment on the development of posttraumatic stress disorder (PTSD) in children. DESIGN--Children were randomly selected from a population of court-involved maltreated children. The children were then assigned to a PTSD group and a non-PTSD group on the basis of their responses to a structured interview. SETTING--A juvenile/family court in a large urban area. PARTICIPANTS--This study examined 101 children who were before a juvenile/family court because of severe child maltreatment. All children had been removed from parental custody as a result of the maltreatment. INTERVENTIONS--None. MEASUREMENTS AND RESULTS--Structured clinical psychiatric interviews were administered to each child and each parent, and all court records were reviewed. The major analyses assessed the extent to which the presence and duration of the most common types of severe maltreatment were associated with a diagnosis of PTSD. Thirty-nine children met criteria for PTSD. Those who were sexually maltreated and those who witnessed family violence had a much greater likelihood of developing PTSD than did those whose histories of maltreatment did not include these types of events. The duration of emotional abuse (psychological terror) also proved to be a significant factor in discriminating children diagnosed as having PTSD from other severely maltreated children. CONCLUSIONS--These findings delineate factors implicated in the cause of PTSD. Moreover, they provide information that will enable the protective service community to screen more effectively for PTSD among maltreated children.