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Summary
Summary
An award-winning research psychiatrist exposes myths about childhood trauma and PTSD and provides evidence-based solutions.
A compassionate and accessible guide for parents whose children have experienced traumatic or life-threatening events written by one of the foremost authorities on post-traumatic stress disorder (PTSD) in children and adolescents. Dr. Scheeringa understands the desperation many parents feel and explains the impact of trauma, simplifies the science into layman's terms, debunks the myths, and provides direction on navigating the confusing maze of the mental health world to find appropriate care.
Author Notes
Michael S. Scheeringa, MD, currently works as a tenured professor at Tulane University School of Medicine (New Orleans) as an endowed chair and the Vice Chair of Research. He has been active as both a practicing clinician and a researcher for over twenty-three years as the principal investigator on five large, federally funded research projects on the topic of PTSD in children and adolescents. He has developed multiple assessment measures that have been translated into seven languages. He has been a consultant to several national efforts, including the National Academy of Sciences and the DSM-5.
Reviews (1)
Publisher's Weekly Review
Scheeringa, a psychiatrist and professor at Tulane University School of Medicine, brings more than 20 years of clinical practice and research in the field of post-traumatic stress disorder to this informative if somewhat acerbic guide. He clarifies the symptoms for parents while pointing a finger at clinicians who fail to diagnose or properly treat the disorder. According to Scheeringa, PTSD is a chronic disorder from which most never fully recover, even with treatment (thus, the ominous title). The author lays out how PTSD is diagnosed, and emphasizes the importance of its updated inclusion in the DSM-III. (This particular information may be less relevant to parents than to clinicians who require a reliable definition.) Scheeringa clearly explains how PTSD differs from stress, observing that the disorder is unique in that it occurs suddenly, following a life-threatening event. He urges parents to wait no more than one month before seeking professional help for their child, preferably from a clinician who offers cognitive behavioral therapy. The FAQ chapter should be particularly useful for parents, as should an appendix that addresses talking with children who have experienced trauma. As a whole, the text offers parents valuable guidance on finding help promptly and wisely. (Apr.) © Copyright PWxyz, LLC. All rights reserved.
Table of Contents
| Preface | p. xiii |
| Acknowledgments | p. xv |
| Chapter 1 Paths to Acceptance: A Beginning | p. 1 |
| Lisa: Hurricane Katrina Survivor | p. 3 |
| A Very Brief History of PTSD in Children | p. 6 |
| Children Can Develop PTSD: "Your Data Must Be Wrong." | p. 7 |
| My Beginning: Young Children and the PTSD Diagnosis | p. 8 |
| The Case of Tommy: "I Want My Boy Back." | p. 9 |
| Very Young Children Do Indeed Develop PTSD | p. 11 |
| You Do Not Recover from PTSD on Your Own | p. 12 |
| The Long Shadow | p. 13 |
| Recap | p. 14 |
| For Parents to Do | p. 14 |
| Chapter 2 Life Threat Is Trauma | p. 15 |
| Trauma Is Sudden, Unexpected Moments of Life-Threatening Panic | p. 15 |
| Joe: Combat Trauma | p. 16 |
| Yvonne: Sexual Trauma | p. 17 |
| Carl: Motor Vehicle Trauma | p. 17 |
| Trauma Is Different from Stress. There Really Are Not Many Exceptions | p. 18 |
| A Very Short History Lesson: 1867-1980 | p. 19 |
| 1980: The DSM-III Changed Everything | p. 21 |
| Trauma Is a Sudden, Life-Threatening Event | p. 23 |
| Encounters with Very Young Children | p. 24 |
| Recap | p. 26 |
| For Parents to Do | p. 27 |
| Chapter 3 Not All Stress Is Trauma | p. 29 |
| "Hey, Pay Attention! I Think This Causes PTSD!" | p. 31 |
| Do Separations, Neglect, Divorce, and (Insert Your Own Life Problem Here) Cause PTSD? | p. 33 |
| Gus: A Playground in Shambles | p. 37 |
| Ignorance or Propaganda | p. 38 |
| What's the Harm? | p. 39 |
| Recap | p. 42 |
| Chapter 4 Symptoms | p. 43 |
| The Diagnosis of PTSD | p. 44 |
| Jade: A Girl on the Edge of Suicide | p. 48 |
| Enrique: Exhausted by What He Saw | p. 50 |
| Post-trauma Symptoms in Very Young Children | p. 51 |
| Special Considerations for Seven- to Twelve-Year-Old Children | p. 54 |
| When to Seek Treatment? One Month of Watch-and-Wait Is Long Enough | p. 55 |
| Recap | p. 56 |
| For Parents to Do | p. 56 |
| Chapter 5 Seven Reasons Why PTSD Is Under-Recognized | p. 57 |
| The Girl Who Wouldn't Cross the Street | p. 57 |
| The Miele and O'Brien Study | p. 59 |
| Seven Reasons Why PTSD Is Under-Recognized | p. 60 |
| PTSD Is Common | p. 69 |
| Recap | p. 70 |
| For Parents to Do | p. 71 |
| Chapter 6 Proper Assessment | p. 73 |
| 1 "This Is Our Business" Approach | p. 73 |
| 2 Standardized Questionnaire | p. 74 |
| You Cannot Tell Who Has PTSD by Looking at Them | p. 75 |
| 3 Educational Interviewing. You Must "Lead the Witness." | p. 76 |
| The Misjudgment of Parents | p. 79 |
| 4 Patience | p. 81 |
| Recap | p. 82 |
| For Parents to Do | p. 82 |
| Chapter 7 Complex Problems | p. 83 |
| Combinations of Symptoms of PTSD | p. 83 |
| Co-occurrence of Other Disorders | p. 83 |
| Luke: PTSD Manifest as ADHD | p. 86 |
| Liam: PTSD Masked by Defiant Behavior and Inattention | p. 87 |
| Overlap of Symptoms Between Disorders | p. 88 |
| Doctor, Please Teach Me | p. 89 |
| The Eye of the Beholder | p. 90 |
| Recap | p. 92 |
| For Parents to Do | p. 93 |
| Chapter 8 Facing the Disinformation Critics of the DSM-5 | p. 95 |
| 1 Is the DSM Classification System Inherently Flawed? | p. 96 |
| 2 Do We Give Patients Too Many Diagnoses? | p. 99 |
| 3 Do We Need a New Diagnosis to Replace or Complement PTSD? | p. 102 |
| The DSM Developers Should Be Saying, "You're Welcome." | p. 105 |
| Recap | p. 107 |
| For Parents to Do | p. 108 |
| Chapter 9 Blame the Mother | p. 109 |
| Wanda and the Unabomber | p. 109 |
| Psychiatric Disorders | p. 111 |
| Posttraumatic Stress Disorder | p. 113 |
| What Is It Like to Feel Blamed for Your Children's Problems? | p. 113 |
| Blame-the-Mother Theories | p. 117 |
| Yvonne: A Therapist Encounters a Mother Who Is Mad | p. 117 |
| Lena: A Mother Afraid of Losing | p. 119 |
| The Research Data: The Correlation | p. 120 |
| The "Imply-Suggest-and-Hint" Problem | p. 122 |
| Why Do They Do This? | p. 124 |
| Normal Child Development | p. 125 |
| In the Shoes of Therapists | p. 127 |
| Chapter 10 The Facts on Parents: Do They Help, Hurt, or Make No Difference? | p. 129 |
| Problems with the Data about Blaming Mothers | p. 130 |
| The Results when Parenting Is Actually Measured | p. 131 |
| The Results when Symptoms Are Tracked over Time | p. 132 |
| Treatment: The Mother Does Not Have to Get Better | p. 135 |
| Chris: Unusual Homework in the Attic | p. 136 |
| Treatment: Parents Can Help Children Get Better | p. 138 |
| Alex: A Father's Tough Love | p. 138 |
| Clinical Intuition Is Notoriously Wrong | p. 140 |
| Recap | p. 142 |
| For Parents to Do | p. 144 |
| Chapter 11 The Decision to Get Help: If You Build It, They Won't Come | p. 145 |
| The Queensland Floods Story | p. 145 |
| Disasters in New York, Florida, and New Orleans | p. 146 |
| Why Don't They Come? | p. 148 |
| The Marketing of Mental Health | p. 150 |
| Chapter 12 How to Find Good Treatment | p. 153 |
| Evidence-Based Treatment | p. 154 |
| CBT Has Won the Horse Race So Far | p. 154 |
| What Is Cognitive Behavioral Therapy? | p. 155 |
| Chris | p. 157 |
| The Angry Play Therapist | p. 158 |
| What Makes a Good Treatment for PTSD? | p. 159 |
| Tammy and an Ice Cream Truck | p. 159 |
| Myths of CBT | p. 162 |
| What's Wrong with the Mental Health Business? | p. 169 |
| Recap | p. 170 |
| For Parents to Do | p. 171 |
| Chapter 13 Treatment for Complicated Cases | p. 173 |
| Liam: PTSD Diagnosis Missed for Years | p. 173 |
| It Is Always Complicated, but There Are Two Issues More Troubling than Most | p. 174 |
| 1 PTSD Does Not Like Being Alone: Two Types of Co-occurring Disorders | p. 174 |
| The Narrative Fallacy of Complex PTSD | p. 178 |
| Ella: Preexisting Personality Disorder and Drug Abuse | p. 179 |
| 2 Family Problems | p. 180 |
| The Constant Gardener | p. 181 |
| Recap | p. 183 |
| For Parents to Do | p. 183 |
| Chapter 14 Memory: The Unwelcome Guest and the Girl Who Forgot She Was Abused | p. 185 |
| PTSD Symptoms That Require Memory | p. 186 |
| Limitations of Research | p. 187 |
| Remembering Too Much May Be a Problem | p. 188 |
| Remembering Things That Never Happened May Be a Problem | p. 191 |
| Not Remembering May Be Protective | p. 194 |
| Enrique: Memories Remembered but Locked Away | p. 195 |
| Is Remembering Nothing Possible? | p. 195 |
| The Girl Who Forgot She Was Abused | p. 196 |
| Does Memory Predict Who Will Get Better with Treatment? | p. 198 |
| Rose: Too Hot and Too Cold | p. 199 |
| Conclusion: It's Impossible to Forget a Truly Traumatic Event | p. 201 |
| Recap | p. 201 |
| For Parents to Do | p. 202 |
| Chapter 15 Neurobiology: Does Traumatic Stress Damage the Brain? | p. 203 |
| Autonomic Nervous System | p. 204 |
| Hypothalamic-Pituitary-Adrenal Axis and Cortisol | p. 206 |
| How Did the Neurobiology Get There? | p. 208 |
| Correlation Does Not Equal Causation (Revisited) | p. 211 |
| HPA Axis and Cortisol | p. 212 |
| Wrapping Up with Some Balance | p. 213 |
| Recap | p. 216 |
| For Parents to Do | p. 217 |
| Chapter 16 Frequently Asked Questions | p. 219 |
| Cause-and-Effect Questions | p. 219 |
| Prevalence | p. 222 |
| Assessment and Diagnosis | p. 223 |
| Course | p. 225 |
| Parenting | p. 227 |
| Interventions | p. 227 |
| Appendix A How to Talk with Youths Following Traumas | p. 233 |
| Appendix B Elements of Cognitive Behavioral Therapy for PTSD | p. 235 |
| Appendix C Therapist Likeability Checklist | p. 237 |
| Chapter Notes | p. 239 |
