ABSTRACT
Children can react adversely to catastrophes such as a car crash or an episode of extreme violence. Symptoms may include nightmares or flashbacks, avoidance of similar situations, and increased arousal. In cases of post-traumatic stress disorder, it may be helpful to tell the parents that talking about the trauma will help them to deal with the memories and associated emotions. Symptoms often seem to be prolonged when something is holding up emotional processing, and the feelings and thoughts may recur unchanged until they can be understood and tolerated. The prognosis is usually good once communication within the family about the events has been established. Teenagers who bottle things up for years can be an exception to this, an extreme example being rape, which often seems to dictate secrecy. In post-traumatic stress disorder, referral for therapeutic input should only be made if the child appears to be willing to talk to someone outside the family.
