Posted September, 2001

Robert S. Pynoos and Kathi Nader of the Counseling and Readjustment Services, Columbia, South Carolina, list symptoms that an adolescent child in grades six and up might exhibit after exposure to trauma, and what you can do to help the child.

1. Detachment, shame, and guilt (similar to an adult response)



2. Self-consciousness about their fears, sense of vulnerability, and other emotional responses: fear of being labeled abnormal



3. Post-traumatic acting out (e.g., drug use, delinquent behavior, sexual acting-out)



4. Life threatening re-enactment: self-destructive or accident-prone behavior



5. Abrupt shifts in interpersonal relationships



6. Desires and plans to take revenge



7. Radical changes in life attitudes which influence identity formation


8. Premature entrance into adulthood (e.g., leaving school or getting married), or reluctance to leave home



9. Somatic complaints



10. Close monitoring of parent’s responses and recovery; hesitation to disturb parent with own anxieties



11. Concern for other victims and their families



12. Feeling disturbed, confused, and frightened by their grief responses: fear of ghosts

1. Encourage discussion of the event, feelings about it, and realistic expectations of what could have been done



2. Help them understand the adult nature of these feelings: encourage peer understanding and support



3. Help to understand the acting out behavior as an effort to numb their responses to the event, or to voice their anger over the event.



4. Address the impulse toward reckless behavior in the acute aftermath; link it to the challenge to impulse control associated with violence



5. Discuss the expectable strain on relationships with family and peers



6. Elicit their actual plans of revenge: address the realistic consequences of these actions: encourage constructive alternatives that lessen the traumatic sense of helplessness



7. Link attitude changes to event’s impact



8. Encourage postponing radical decisions, in order to allow time to work through their responses to the event and to grieve



9. Help to identify the physical sensations they felt during the event



10. Offer to meet with children and parent(s), to help children let parents know how they are feeling



11. Encourage constructive activities on behalf of the injured and deceased



12. Help to retain positive memories as they work through the more intrusive traumatic memories