All Posts Tagged: ptsd

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Suicide Contagion And The Parkland Tragedy

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It’s just one month past the first anniversary of the massacre at Marjorie Stoneman Douglas High School and we have all been saddened to hear that two students who survived the attack recently took their lives within days of each other. Also, the father of a child who was killed in the 2012 Sandy Hook school shootings died this week in an apparent suicide. Now experts are concerned that these deaths may be the result of suicide contagion.

What Is Suicide Contagion?

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School Violence and PTSD

School Violence and PTSD

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This week marks the first anniversary of the school shootings at the Marjory Stoneman Douglas High School in Parkland, FL. On February 14, 2018, 17 students and teachers were senselessly killed and 14 more were wounded.

Reflecting on the tragedy and remembering those who lost their lives will no doubt bring up strong emotions in some children. Even those who weren’t personally connected to the event may feel sad and re-experience a sense of loss. For some kids, the anniversary may even trigger or worsen symptoms of post-traumatic stress disorder (PTSD).

Distressing events such as school shootings can affect children just like they can affect adults. In fact, it’s normal for kids to go through a range of emotions when they hear about a tragedy – they might have trouble sleeping or may express fear, sadness, anger, and grief.

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Social Skills Training can help children and young adults connect with other.

Toxic Stress and Child Development

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Stress surrounds us on a daily basis. From traffic delays to work projects, worries about finances or health, and news reports of world events, the demands of our everyday lives produce both positive and negative stress. Stressors (which are the things that cause your stress) can be physical, emotional, theoretical, or environmental. Even positive events like weddings and job promotions cause stress.

Whether negative or positive, one thing is certain – stress raises the body’s anxiety levels. When we’re under stress, the “fight or flight” response kicks in. It raises your heart rate and your blood pressure. It sometimes causes you to lose sleep or feel like you can’t breathe. While this response generally subsides after the stressor is removed, a prolonged or permanent stress response can develop in someone who is under frequent or constant stress. This is called toxic stress and it can affect children just the same as adults.

Effects of Stress on Kids

The incidence of diabetes, obesity, heart problems, cancer and other diseases increases when a child lives with toxic stress. Additionally, a child’s chances of smoking, depression, substance abuse and dependence, teen pregnancy and/or sexually transmitted disease, suicide and domestic violence escalates. So does their tendency to be more violent or to become a victim of violence.

Studies done by the Centers for Disease Control and Prevention (CDC) show that when a child is subjected to frequent or continual stress from thing like neglect, abuse, dysfunctional families or domestic abuse – and they lack adequate support from adults – their brain architecture is actually altered and their organ systems become weakened. As a result, kids who live with stress risk lifelong social and health problems.

Of the 17,000 people participating in the CDC study, two thirds reported an Adverse Childhood Experiences (ACE) score of 1 or higher. Of these, 87% had more than one ACE. By measuring and scoring ten types of trauma ranging from neglect or bullying to childhood sexual abuse and even divorce, researchers could assess the chronic disease risk for the study’s mostly white, middle class participants. Their results showed that the problem of toxic stress isn’t limited to children of certain ethnic groups or those who face poverty – children from all walks of life can have high ACE scores which will affect their entire lives.

If you would like to find out your ACE score and what it might mean for you, go here.

Signs of stress

Children who are exposed to toxic stress exhibit:

  • Poorly developed executive functioning skills
  • Lack of self-reflection and self-regulation
  • Reduced impulse control
  • Maladaptive coping skills
  • Poor stress management

Research on children who face continued toxic stress shows they are more likely to have:

  • Trouble learning in school
  • Difficulty trusting adults, forming healthy relationships and will have an increased chance of divorce as an adult
  • Higher incidence of unhealthy behaviors such as engaging in sexual experimentation and unsafe sexual practices, participating in high-risk sports, smoking, substance abuse and alcohol abuse
  • Higher incidence of depressive disorders, post-traumatic stress disorder (PTSD), behavioral disorders, and even psychosis
  • Poor health outcomes such as heart disease, obesity, diabetes, cancer, and have a higher suicide risk

Help for Toxic Stress

The key to preventing and reducing toxic stress in kids is awareness. Now that we know about the effects of ACEs, many states have conducted their own research. Some cities formed task forces, while others are working with pediatricians, schools, daycare centers and the justice system to set up screening programs that can turn lives around.

Protecting children from toxic stress involves a multi-faceted approach that targets both the caretaker and the child in order to strengthen family stability. Treatment includes intervention and implementation of methods that reduce stressors and reinforce the child or caregiver’s response to stress.

As more programs are formed, researchers have found that children can benefit even when the solutions are solely focused on their caregiver and aren’t aimed at the child. This is most likely because the caregiver’s altered interaction with the child makes the child feel safer. Parenting classes, family-based programs, access to social resources for parents, peer support and telephone support are beneficial. Cognitive behavioral therapy and relaxation methods like yoga and mindfulness are also helpful. Additionally, community-based programs like Head Start have been shown to be effective.

Do you have Questions?

For more information about toxic stress and its effects on child development, contact the Children’s Center for Psychiatry Psychology and Related Services in Delray Beach, Florida or call us today at (561) 223-6568.

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Sexual Abuse by Teachers is on the Rise

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Lately, it seems like it has become common to see news stories involving the arrest of teachers who are being charged with sexual abuse and misconduct involving their students, some of whom are as young as 11 years old. Schools are expected to be a safe environment for children, but these arrests make people realize kids aren’t as safe as we’d like them to be when we send them off to school.

Stop Educator Sexual Abuse Misconduct & Exploitation (SESAME) is an organization that describes itself as a national voice for prevention of abuse by educators and other school employees. It has compiled alarming statistics on the incidences of sexual abuse in schools nationwide, reporting that just under 500 educators were arrested in 2015 (2016 statistics were unavailable as of this writing):

  • Of children in 8th through 11th grade, about 3.5 million students (nearly 7%) surveyed reported having had physical sexual contact from an adult (most often a teacher or coach). The type of physical contact ranged from unwanted touching of their body, all the way up to sexual intercourse.
  • This statistic increases to about 4.5 million children (10%) when it takes other types of sexual misconduct into consideration, such as being shown pornography or being subjected to sexually explicit language or exhibitionism.
  • Very often, other teachers “thought there might be something going on”, but were afraid to report a fellow educator if they were wrong. They didn’t want to be responsible for “ruining a person’s life,” although that is exactly what they are doing to the child if they don’t speak up, thus allowing the abuse to continue.

Reasons for the Increase in Sexual Misconduct

So, why are we suddenly seeing a rise in the number of cases of sexual misconduct and teacher/student relationships? It may be partially due to more transparency as schools seek to report what they formerly kept hidden and tried to deal with on their own. More than likely, however, the upward trend is due to the use of social media and cell phones.

The Washington Post ran a story in 2015 that related how about 80% of children age 12 – 17 had a cell phone and 94% had a Facebook account that year. In 2014, The Post says about 35% of the educators convicted or accused of sexual misconduct had used social media to gain access to their victims or to continue the teacher – student relationship.

Today’s technology makes it easy for predators to discreetly prey on children. Students usually have their phones with them at all times, which allows the perpetrator free and unmonitored access to the child. Even children without cell phones can be targeted through their laptop, tablet, or personal computer.

  • The Department of Justice notes that about 15% of children in the 12 – 17 age group who own a cell phone have received nude, semi-nude, or sexually suggestive images of someone they know via text.
  • 11% of teenagers and young adults say they have shared naked pictures of themselves online or via text message. Of those, 26% are trusting enough to think the person to whom they sent the nude pictures wouldn’t share them with anyone else.
  • About 26% of teenagers and young adults say they have participated in sexting.

Signs of Sexual Abuse by Teachers

If you are concerned your child might be being sexually abused, there are warning signs you can look for. Keep in mind that the presence of one sign doesn’t necessarily mean your child is in danger, but seeing several signs should alert you to the need to ask questions.

In general:

  • Unexplained nightmares or sleep problems
  • Refusal to eat, loss of appetite, or trouble swallowing
  • Sudden mood swings, insecurity, or withdrawal
  • A new or unusual fear of a certain person or place
  • Exhibits knowledge of adult sexual behaviors and language
  • Draws, writes, dreams, or talks about frightening images or sexual acts
  • Thinks of themselves or their body as “bad” or “dirty”
  • Not wanting to be hugged or touched

In teens or adolescents:

  • Running away from home
  • Drug or alcohol abuse or may be sexually promiscuous
  • Either stops caring about bodily appearance or compulsively eats or diets obsessively
  • Anxiety or depression
  • Attempting suicide

What to do if You Suspect Sexual Misconduct by an Educator

If your child tells you about being abused or if you suspect it, your reaction is very important.

  • Don’t overreact and don’t criticize or blame the child
  • Don’t demand details
  • Don’t downplay their disclosure because you’re trying to minimize their feelings (or yours)
  • Do listen calmly and keep in mind that children seldom lie about sexual abuse
  • Do assure the child it is not their fault
  • If necessary, seek appropriate medical care for the child
  • Notify local law enforcement, as well as the appropriate child services organizations. You can call ChildHelp: 1-800-4-A-CHILD (1-800-422-4453) or RAINN, the national sexual assault hotline: 1-800-656-HOPE (4673).

A Child Psychologist at our Children’s Center Can Help

Child victims of sexual misconduct often experience anxiety and/or depression, as well as feelings of guilt and symptoms of posttraumatic stress disorder (PTSD). For this reason, consider making an appointment for your child to speak with a mental health professional who is experienced in dealing with child sexual abuse victims.

Psychotherapy can help them find a safe place to share their feelings and allows them to talk through things they might not want to tell a parent or family member. It will help the child learn coping strategies so they can deal with the emotions surrounding their exploitation. Therapy will also teach them how to better manage the stress of the situation.

For more information about how our child psychologist can help, contact the Children’s Center for Psychiatry Psychology and Related Services in Delray Beach, Florida or call us today at (561) 223-6568.

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Help for School Refusal

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For some children, going to school can be emotionally traumatic. Their school anxiety may stem from such things as their dread of encountering a particular child or teacher, their worry about not doing well in school, or the fear of failing a test or “looking stupid.” While many of these worries are a normal part of growing up, they may also be triggered by stressful events like moving, changing schools, or being bullied.

Just about every child goes through a day here and there when they don’t want to go to school,  but the Anxiety and Depression Association of America notes that about 2-5% of children regularly experience school refusal due to severe stress or emotional concerns. School refusal is not the same as truancy: truant children skip school, then go out to play. They aren’t afraid of going to school and they try to hide their absence from school from their parents.

On the other hand, children experiencing a school refusal disorder will stay home (where it is safe), are fearful of going to school, and will try to talk their parents into letting them stay home. Often, the children with school avoidance also suffer from mood and anxiety disorders, such as post-traumatic stress disorder (PTSD), social anxiety, depression, or panic disorders.

Symptoms of School Refusal

School refusal is most common in children ages five, six, ten, and eleven, according to the American Academy of Family Physicians. The pattern of rejecting school isn’t the same for every child. Some kids will go off to school without a problem, but become more anxious as they get closer to the building. Some children have no trouble until a holiday comes up, then they become depressed or anxious when the time comes to go back to school. Others will go to school willingly, but frequently ask to visit the school nurse. Still others are chronically tardy, skip a certain class most days, or simply decline to go to school.

Frequently allowing your child to stay home from school keeps them from learning and advancing with their peers. Additionally, a child’s symptoms may increase or they may suffer from additional symptoms the longer they stay out of school.

Just as school refusal patterns aren’t the same for each child, the symptoms of school anxiety can be different, as well. Your child may experience some of these signs of school refusal:

  • Sleep issues
  • Temper tantrums, defiance
  • Crying or exhibiting fearfulness
  • Panic symptoms
  • Threats to harm themselves if they have to go to school
  • Headaches, stomach aches
  • Nausea, vomiting, diarrhea
  • Heart palpitations
  • Separation anxiety

School Anxiety Treatment

School refusal is best treated as a collaborative effort. The first objective is to get the child back into the classroom because the longer they stay out of school, the harder it can be to go back.

With that goal in mind, the child’s physician should do a thorough exam to be sure any physical complaints, such as headaches and abdominal pain, don’t stem from a medical condition. Once medical concerns have been ruled out, your child’s teacher will be asked to evaluate for behavioral issues and things like problems with report cards and tests, or the possibility of the child being bullied.

Armed with this information, a child psychologist or other mental health professional will evaluate your child to look for any emotional or psychiatric difficulties. These results, combined with the medical and school evaluations will help them develop the most effective plan of treatment.

School refusal can be addressed through several types of psychological therapy. For example, exposure therapy can ease your child back into school by allowing them (with cooperation from the school) to attend school part of the day and gradually increasing the time they spend there.

Cognitive behavior therapy can teach the child how to change their destructive behavior patterns. This therapy helps them develop coping techniques, and challenge their negative thoughts through strategies like role playing, relaxation techniques, and guided imagery. Operant behavior techniques can also be used to reward the child for attending or staying in school.

If your child’s school anxiety is new, often working with the teacher to identify and eliminate triggers can be enough to reverse it. However, if the school refusal has become significant, the therapies discussed above offer excellent outcomes for getting your child back into the classroom.

Our Children’s Center Can Help

For more information about how a child psychologist can help with your child’s school avoidance, contact the Children’s Center for Psychiatry Psychology and Related Services in Delray Beach, Florida or call us today at (561) 223-6568

Resources:

American Academy of Family Physicians: http://www.aafp.org/afp/2003/1015/p1555.html

Anxiety and Depression Association of America: https://www.adaa.org/living-with-anxiety/children/school-refusal

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Children’s Mental Health – Psychiatric Help for Children

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While we tend to think of childhood as a carefree time of life, the fact is that many children suffer from mental conditions and disorders, just the same as adults. Among other things, children’s mental health concerns can include emotional, behavioral, and mental disorders such as eating disorders, learning and developmental disabilities, Attention Deficit Hyperactive Disorder (ADHA), and autism. And, similar to adults, children can be impacted by conditions like anxiety, depression, Obsessive Compulsive Disorder (OCD) and Post-traumatic Stress Disorder (PTSD). Additionally, as children grow and mature into young adults, they can develop other problems associated with adolescence, such as underage drinking and substance abuse.

Left untreated, any of these conditions or disorders can result in difficulties with making friends, and behavior issues in school and at home. What is most troubling, however, is that research has shown that a majority of adult mental disorders start early in life. This makes it critical that children’s mental health conditions be caught promptly and treated appropriately.

Symptoms of Child Psychological Disorders

Child psychological disorders and conditions can affect any ethnic group, and income level, and those living in any region of the country. In fact, the Centers for Disease Control (CDC) cites a study from a National Research Council and Institute for Medicine report that estimates about 1 in 5 children across the United States will experience a mental disorder in any given year.

Symptoms often change as a child grows and matures, so the signs of a problem may be difficult to spot in the early stages. Often, parents are the first to recognize that there is an issue with their children’s emotions or behavior, however problems may also be brought to your attention by your child’s educators or another adult who knows your child well. Some general signs to look for include:

  • Marked decline in school performance
  • Strong worries or anxiety that causes problems at home or at school
  • Random, frequent physical aches and pains, such as headaches or an upset stomach
  • Difficulty sleeping, nightmares
  • Marked changes in eating habits
  • Feeling hopeless
  • Having low or no energy
  • Aggressive behavior, disobedience, and/or confrontations with or defiance of authority figures
  • Temper tantrums or outbursts of anger
  • Thoughts of suicide or thoughts of harming themselves or others

Psychiatric Help for Children

  • Please get immediate assistance if you think your child may be in danger of harming themselves or someone else.  Call a crisis line or the National Suicide Prevention Line at 1.800.273.TALK (8255).

Getting psychiatric help for children, in the form of early diagnosis and receiving the correct treatment, is essential for your child’s well being, both now and throughout their life.

If your child’s problems persist across a variety of settings (for example: home, school, and with peers), some of the steps to get help include:

  • Talk to your child about how they are feeling. Find out if they would like to discuss a problem with you or another adult. Actively listen to their responses and concerns.
  • Talk to your child’s pediatrician, school counselor or school nurse, or a mental health professional if you see behaviors or problems in your child or teen that worry you.
  • Seek evaluation from a specialist who deals with children’s mental health concerns.
  • Ask the specialist if they have experience with treating the problem or behavior you see in your child.
  • Don’t delay in seeking help – early treatment generally gives better results.

Children can be treated in a variety of settings that range from one-on-one (or with a parent) sessions with a mental health professional to a group setting with a therapist and the child’s peers. Talk therapy can help change behaviors and may be used in combination with other treatments. Cognitive Behavioral Therapy (CBT) has been shown to be very effective in helping children learn coping strategies so they can change unhealthy behavior patterns and distorted thinking. Additionally, medications may be recommended for disorders such as ADHD or may be given for other types of severe or difficult cases.

Need More Information on Children’s Mental Health?

If you have questions or need more information about psychiatric help for children, we can help. For more information, contact The Children’s Center for Psychiatry, Psychology, & Related Services in Delray Beach, Florida or call us today at 561-223-6568.

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