A study suggests that one in 13 adolescents in England develops post-traumatic stress disorder before their 18th birthday.
When one hears of post-traumatic stress disorder, many initially think of soldiers and war missions, but probably not of children and adolescents. They can also develop post-traumatic stress disorder (PTSD) if they experience terrible things. According to a study by King’s College London, 31 percent of young people have already had a traumatic experience in their childhood. One in four of these young people fulfilled the diagnostic criteria for post-traumatic stress disorder. A traumatic experience can range from the death of a loved one, war, flight, serious accidents, sexual assault, or physical violence.
After such an experience, many people – whether children or adults – develop psychological symptoms. In most cases, they disappear in the following weeks. For some, however, they remain and begin to change and burden the lives of those affected. A normal reaction to trauma becomes a stress disorder.
In order to find out what role trauma and stress disorders play in British adolescents, scientists around Stephanie Lewis worked with the participants in the E-Risk Study. A total of 2232 twins born between 1994 and 1995 in England or Wales participated in this study. When the twins were 18 years old, the scientists asked them if they had had any traumatic experiences in their lives. They also looked for signs of a mental disorder.
Almost one in three (31.1 percent) could remember traumatic experiences. These children and adolescents appeared to later develop a psychiatric disorder twice as often as children who have not had such an experience. Almost one in four children with traumatic experiences developed PTSD. One of the symptoms of this disorder is that one experiences the trauma over and over again, for example in nightmares. Others feel guilty, withdraw, are irritable, impulsive, or have difficulty concentrating and sleeping.
The most common stress disorder was in young people who had experienced physical or sexual assault. Those who struggled with a stress disorder even developed another mental disorder, depression, an addiction, or perhaps even a psychosis, with a probability almost five times as high. Half of the young people with PTSD already injured themselves once; one-fifth even tried to take their own lives.
If experts knew who is most likely to develop a stress disorder after a traumatic experience, they could help these people before they develop such problems. So far, however, it has been difficult to make such a prediction. For this reason, in a further step, the scientists investigated whether known risk factors could be used to determine the probability of PTSD. For their test, the scientists used a machine learning technique. In their study group, the risk calculator already worked quite well. Should such a test prove itself in other groups of people and studies, it could help experts to identify those people who need help after a traumatic experience. Of the twins examined, only one in five confided in an expert. Only a small proportion of boys and girls with PTSD recover without treatment.
“Our results should be a wake-up call,” said Andrea Danese, a researcher involved in the study. Young people with PTSD are falling through the care network; there is an urgent need for better mental health care. However, the researchers’ findings cannot be automatically transferred to populations in other countries. In a recent study, 6000 young people from the USA were examined. About 62 percent reported traumatic experiences. However, the prevalence of PTSD was below five percent (2).
This is part 38 of a series covering twin health provided by Paul Enck from the Tübingen University Hospital and science writer Nicole Simon. Further studies in twin research can be found at the TwinHealth website. Translation was done with the assistance of DeepL translator.
- Lewis SJ, Arseneault L, Caspi A, et al. The epidemiology of trauma and post-traumatic stress disorder in a representative cohort of young people in England and Wales. Lancet Psychiatry. 2019 Mar;6(3):247-256. doi: 10.1016/S2215-0366(19)30031-8.
- McLaughlin KA, Koenen KC, Hill ED, et al. Trauma exposure and posttraumatic stress disorder in a national sample of adolescents. J Am Acad Child Adolesc Psychiatry. 2013 Aug;52(8):815-830.e14. doi: 10.1016/j.jaac.2013.05.011.