Child trauma often causes PTSD; Rapid treatment can have a huge impact: Univ. Amsterdam

Scientists and psychologists in the Netherlands are calling for kids in youth care to be examined for post traumatic stress disorder (PTSD) as a new standard. It is becoming increasingly clear that trauma plays an important part in behavioral problems, and this can be prevented by PTSD screening and treatment, they said to the Volkskrant. Treatments of less than four hours were shown to have a significant impact, meaning the brief periods of consultation could also be especially cost effective.

"We see children who have been living with severe PTSD for years", researcher and clinical psychologist Carlijn de Roos of the University of Amsterdam said to the newspaper. "While these complaints can be resolved within a few weeks. We think that waiting lists can be significantly shortened by briefly screening for PTSD. If they don't suffer from traumatic experiences, you will know within five minutes. This saves healthcare millions a year."

On Thursday De Roos is publishing a study showing that the treatment method Eye Movement Desensitization and Reprocessing (EMDR) is effective in treating children with PTSD, as it is also used for treating adults. In this treatment patients are asked to recall a traumatic memory while moving their eyes backwards and forward and following a hand. It forces the brain to complete an external task while the memory is in use, allowing a patient to confront and manage a difficult memory to reduce the anxiety that memory causes.

De Roos' study, concluded as part of her PhD research, involved 103 kids between the ages of 8 and 18 who lived through a single traumatic event - rape, accident, abuse, death of a parent. All of them lived with PTSD for an average of a year and half, with outliers of 10 years. After 45 minutes of EDMR treatment, only 7 percent of them still had full-blown PTSD, 20 percent still showed some symptoms, according to the study.

The University of Amsterdam participated in the study along with the Trauma Center for Children and Youth at the GGZ Rivierduinen. Along with EMDR, they also looked into the effect of Cognitive Behavioral Writing Therapy, or WRITEjunior. "In writing therapy, the child writes a story on a computer, together with the therapist, about the event and the consequences, including all the horrid aspects of the memory. In the last session, the child shares the story of what happened to him or her with important others," the university revealed in a statement.

The EMDR treatment demonstrated positive effects after an average of 2 hours and 20 minutes, the study determined. Completing WRITEjunior therapy took an average of 3 hours and 47 minutes. "The most important thing, of course, was that the results were lasting, as shown during a follow-up measurement one year later," De Roos said in a statement sent to the NL Times.

PTSD symptoms are seen in some 16 percent of kids who experience a single traumatic incident, like the loss of a loved one, a sexual assault, physical abuse, or a traffic accident. "Children who do not get the right treatment suffer unnecessarily and are at risk of developing further problems and being re-traumatized", De Roos advocates. "The challenge for health professionals is to identify symptoms of PTSD as quickly as possible and immediately refer for trauma treatment."

Colleagues Saskia van der Oord, Bonne Zijlstra, Sascha Lucassen, Sean Perrin, Paul Emmelkamp and Ad de Jongh are all credited as authors on the study, released Thursday in the Journal of Child Psychology and Psychiatry. All authors have a position at the University of Amsterdam, except for Sean Perrin who is listed as working with the Psychology Department at Lund University in Sweden.

Clinical psychologist Iva Bicanic, head of the National Psychological Trauma Center, also advocates for PTSD screening. "Youth care knows so many children who were sexually assaulted, abused and experienced domestic violence", she said to the Volkskrant. "But often children are found so complex and instable that the choice is made not to screen or treat them. That argument has no scientific justification. In practice a family is often supported in raising the child, due to the child's behavioral problems, but the source is not acknowledged and not addressed."

According to professor Agnes van Minnen of Radboud University, a shocking number of kids have been in youth care for years without getting trauma treatment. "Aid workers often don't dare to ask about trauma because they are afraid of making it worse. Another mistake is that care workers think that children will tell them themselves if something bad happened. But if you do not ask about it, they won't come out with it."

Rafaele Huntjens, associate professor at RUG, thinks that PTSD screening is a good idea, but warns that it must be done carefully. "There is a risk that therapists will see certain signals and think there should be trauma, while those complaints may also have another cause. So you must have trained interviewers do this, and according to a reliable method."