Even Young Children can Experience PTSD

When you think of PTSD (posttraumatic stress disorder), soldiers returning from combat may come to mind.  But years of research suggest many others experience PTSD, too, even young children, though their symptoms may differ from those of older children, adolescents and adults.

PTSD in adults and children can occur after exposure to a traumatic event — living through one, witnessing one in person, or learning about a traumatic event that involved a family member. A traumatic event can include a violent experience in the home or community, a fire, a natural disaster, a car accident, or the sudden death of a family member. The younger a child is, the greater the impact. The loss of a parent or being removed from a parent, for example, feels like a threat to a child, according to child psychiatrist Judith Cohen, M.D., medical director of the Center for Traumatic Stress in Children & Adolescents at Allegheny General Hospital in Pittsburgh.

Many children experience trauma — an estimated 14 to 43 percent, according to the National Center for PTSD. Of those, as many as 15 percent of girls and 6 percent of boys develop PTSD. Children with PTSD may experience distressful thoughts, ­and memories of the trauma may occur without warning. They may also have trouble sleeping and nightmares (though they may not seem clearly tied to the event). Traumatized children may try to avoid people or objects that are reminders of the event and they may act more irritable, have angry outbursts, or be easily startled. They may regress, wet the bed or talk baby-talk, and they may experience physical symptoms, such as headaches and stomachaches. The symptoms can cause major distress and can impact how a child behaves or relates to family members.

To help a child heal from PTSD, treatment involves working with the child and parents and caregivers, creating a feeling of safety, helping the child to understand the condition, and encouraging the youngster to talk about his or her feelings (through art and play), to help develop relaxation and coping skills. Rehabilitation begins with building trust and it needs to be fun and engaging for young children, according to Dr. Cohen. Several different types of treatment are available for children with symptoms of PTSD and early intervention can be important in helping little ones cope with and heal from the effects of trauma.

For more information on understanding and helping children of all ages heal from traumatic events visit the National Child Traumatic Stress Network.

By Debbie Cohen, health writer, APA

Don’t Over-Tax Yourself Over Tax Season!

With the April 15 tax deadline looming, it’s an anxious time for many people. Try these tips to keep your financial stress under control at tax time ­— and all year round.

Break It Up. A mountain of paperwork for your tax return or for any other financial responsibility, like applying for a college loan or mortgage, can seem overwhelming. Break up the process into smaller chunks, such as gathering pay stubs, finding your home mortgage interest statements, or organizing your receipts. Then tackle each task one by one. But before you do so…

Make a Plan. This is even more important when you’re on a tight deadline (like being just a few days away from April 15). Once you’ve broken down what you need to accomplish into pieces, put those steps in order and write down how and when you’re going to make each one happen. This will help you feel like you have control over the process. Being out of control is very stressful!

Keep Mentally Fit. Eat well, get a full night’s sleep, find a way to exercise every day, and connect with friends and loved ones. Financial deadlines may have you feeling like you need to lock yourself away and pull an all-nighter with a bag of potato chips and your 1040, but you’ll just raise your stress level, and you probably won’t accomplish your goal anyway.

Resist Unhealthy Temptations. When stress arises, it’s tempting to cope in unhealthy ways such as binge eating, smoking, or drinking alcohol. Avoid these negative coping strategies. Instead of a cigarette or a glass of wine, take a walk or call a friend to vent.

Don’t Go It Alone. It’s not too late to get help. Ask for help from a spouse, a trusted friend, or ideally, a financial professional like a certified public accountant. Some tax professionals will even save you the step of visiting their office and will review your documents and calculations online. Having too much on your shoulders and no help is a recipe for anxiety.

Request an Extension. If you’re utterly overwhelmed and you feel like there’s no way you’ll have it all together by April 15, talk to a tax professional about how to request an extension on filing. You’ll still have to pay your estimated taxes on time (or pay interest), but you’ll have an extra six months to get your paperwork in order.

Plan Ahead for Next Year. If you’ve procrastinated about your taxes this year, use the stress you’re experiencing now as you try to get everything together at the last minute for a good cause: Keeping you on track to plan ahead for tax time 2016. Set a realistic budget and stick to it, and keep track of your finances as you go along. Having a plan and living within your means makes your life much less stressful.

by David Ginsberg, M.D., clinical associate professor and vice chair for clinical affairs, Department of Psychiatry, and chief of the Psychiatry Service, NYU Langone Medical Center in New York City.

Giving Kids a "Sip" of Alcohol Can Send the Wrong Message About Drinking

That little sip of wine or beer that some parents offer their kids at a wedding or on New Year’s Eve may muddle messages about alcohol, according to a new study by researchers at the Center for Alcohol and Addiction Studies at Brown University. The scientists surveyed middle school students for three years to learn whether even a taste in early childhood was a predictor of risky behavior in high school.

The Internet-based study, published in the April 1^st issue of the Journal of Studies on Alcohol and Drugs, included more than 500 Rhode Island school students. More than one-third of the kids surveyed reported trying their first sip of alcohol by the sixth grade, and most said that their first taste took place at home. Wine and beer were the most commonly tried beverages, usually at a special occasion, such as a wedding or a holiday, and adults were the primary source of the alcohol. Nearly three-quarters of the children were offered sips by their own mom or dad.

The study also showed that kids who sipped alcohol by the sixth grade were five times more likely to down a full alcoholic beverage by the time they reached 9^th grade—26% of sippers consumed a full drink versus 5.5% of non-sippers. The earlier sippers were also four times more likely to get drunk or binge drink by early high school, and trying alcoholic beverages earlier in life also raised a child’s risk for trying other substances.

Even when the researchers controlled for other factors, such as risk-taking behavior, the drinking habits of parents, and a history of alcoholism in a parent, kids who’d sipped before sixth grade had higher odds of alcohol use by their freshman year of high school.

The take-home message: Offering a child a sip of your beverage may send the wrong message, says study author Kristina Jackson, Ph.D., associate professor in the Department of Behavioral and Social Sciences at Brown School of Public Health.

"Parents should provide clear, consistent messages about the unacceptability of alcohol consumption for youth,” Jackson advises. “Younger teens and tweens may be unable to understand the difference between drinking a sip and drinking one or more drinks. Certainly there are exceptions, such as religious occasions, so the most important thing is to make sure that children know when drinking alcohol is acceptable and when it is not.”

The context of alcohol use is important, says Oscar G. Bukstein, M.D., M.P.H., medical director at DePelchin Children’s Center and a clinical professor of psychiatry at Baylor College of Medicine and the University of Texas Health Science Center-Houston, who was not involved in the research. “Often, by allowing children to sip or try alcohol on ‘special occasions’, the message delivered may be one of ‘this is how we celebrate’, we drink,” Buckstein says.

He says that sipping may be associated with increased access to alcohol, too, or more lax parent attitudes and that undermines any anti-drinking messages kids hear.

April 21^st is the national day to talk with your kids about alcohol. Visit Mothers Against Drunk Driving’s (MADD) Power of Parents page to learn more.

by Mary Brophy Marcus, health writer, APA

Autism Awareness Month: Learning more about a complex condition

You probably know someone with autism—in your neighborhood, in your workplace, in your school, in your family.   In fact, an estimated one in 68 children in the U.S. has been identified with autism spectrum disorder, according to the Centers for Disease Control and Prevention.   The data on adults is less clear, but the numbers are growing. 

April is Autism Awareness Month – a chance to raise awareness and learn a little more about this complex condition affecting so many.  Here are just a few sources that might help answer some questions.

Want a good quick overview of what autism is?  Check out the CDC’s main autism page.

Looking for a good app to help someone with autism function better?  There are many apps available to help people with autism with communication, behavior, organization, creative arts, and more. In fact, there are so many apps that it can be hard to know where to start or what might be useful for a particular person. Check out Autism Speaks’ searchable resource on autism apps – with information on function, device, target age, and the research data that’s been gathered to evaluate or inform the app.

 One resource you may be familiar with already is Siri, the personal assistant on the iPhone. See a New York Times column by a mom of a child with autism who has made good use of Siri, “To Siri, With Love: How One Boy With Autism Became BFF With Apple’s Siri.”  Siri is not only tirelessly patient in responding to repetitive questions (common among some with autism) but lets you know she doesn't understand (leading to practice with phrasing and enunciation) and will gently encourage polite language.

Want to know how to talk with parents of children with autism?  See a recent Today.com article on “11 things never to say to parents of a child with autism (and 11 you should).”

Want to know a little about what it’s like for some people with autism and sensory sensitivity issues to experience their environment? (Note of caution:  Every person with autism is different. No two experience sensory sensitivity in the same way.) View the short video from the UK-based National Autistic Society, Experience For 60 Seconds How The World Looks, Sounds, And Feels To Someone Who Has Autism.” Some people with autism have difficulty processing multiple sensory experiences at once. An animated video by the Interacting with Autism project gives a glimpse into sensory overload and how sensory experiences intertwine in everyday life.

Want to know more about the latest research on autism spectrum disorders or the latest clinical trials? Find out how your family can participate in research  or find out about clinical trials.

Have more questions? Visit national organizations, such as Autism Speaks and the Autism Society of America, or federal agencies, including the CDC and the National Institute of Mental Health.  Join the conversation #autismawareness, #autism, #mentalhealth.

by Deborah Cohen, senior writer, American Psychiatric Association

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