Post-traumatic stress disorder (PTSD) is a diagnosis that is understood by the general public to be associated with exposure to large-scale situations, such as soldiers returning from deployment in combat zones. However, PTSD can occur in any situation in which a person experiences or witnesses a tragic event. These events could include anything from a mother having a particularly traumatic labor to witnessing a person being assaulted to being involved in a severe car accident. The symptoms of PTSD can vary widely. Characteristics of the disorder can include flashbacks, insomnia, anxiety and depression, but each case can be different and carry a unique combination of symptoms. A recent study focused on the development of PTSD in children and teens. The researchers at Boston Children’s Hospital sought to determine whether they could evaluate which children were most at risk for PTSD and then target those individuals for preventive treatment. The findings appear in a recent issue of the Journal of the American Academy of Child & Adolescent Psychiatry. Led by Katie McLaughlin, Ph.D., the study included 6,483 pairs of teens and their parents. The data was gathered from the National Comorbidity Survey Replication Adolescent Supplement, which examined the prevalence of mental health symptoms across a national sample. The results indicated that among those 13 to 17, 61 percent of the respondents had been exposed to a potentially traumatic situation during their lifetime. Examples included injuries, the death of a close friend or family member, natural disasters or interpersonal violence which could be rape, abuse or being a witness to domestic violence. The results also indicated that approximately 19 percent of the teens had been exposed to three or more traumatic events. The researchers were able to identify particular factors that increased the likelihood that a teen would be exposed to a traumatic event, such as having a mental disorder (anxiety, mood disorders, attention-deficit hyperactivity disorder) or no biological parent in the home. Among those who had been exposed to a trauma, 4.7 percent experienced symptoms of PTSD to meet the criteria for diagnosis under DSM-IV guidelines. The risk factors for the development of PTSD included gender, with females diagnosed at a rate of 7.3 percent versus males at 2.2 percent. This measurement reflects lifetime prevalence. PTSD diagnosis was most common in situations that included interpersonal violence. Thirty-nine percent of teens that had been raped and 25 percent of those who had been abused by a caregiver met criteria for PTSD. In some cases, teens struggled to recover from the symptoms of PTSD. Teens that were more likely to experience symptoms resistant to treatment had a diagnosis of bipolar disorder or were exposed to additional trauma. Those who were living in poverty were also more likely to have difficulty recovering from PTSD. Parents who suspect that their teen has been exposed to a traumatic event should seek out help immediately. A school counselor may be able to provide information about local treatment options to screen for PTSD and help in removing the child from the trauma if it still exists. In situations where a parent is not able to help the teen get treatment, educators and other adults may be able to use the information gathered in this study to identify teens that have been exposed to a traumatic situation and assist them in getting treatment.