Post-traumatic stress disorder in children exposed to violence

Objectives. To investigate to what extent local children exposed to community violence develop post-traumatic stress disorder (PTSD), whether the symptom profile is typical or atypical, and how detection can be improved.Design. A cross-sectional study of two samples of children with a high risk of past exposure to violence.Setting and subjects. Sixty Xhosa-speaking children aged 10 - 16 years; 30 from the Children's Home which serves Khayelitsha, and 30 from a school in a violent area of KhayelitshaOutcome measures. A shortened version of the Survey of Exposure to Community Violence (SECV) was administered to determine exposure to violence. Structured questionnaires and a clinical assessment were used to elicit symptoms and make psychiatric diagnoses.Results. All 60 children reported exposure to indirect violence, 57 (95%) had witnessed violence, and 34 (56%) had experienced violence themselves. Twenty-four (40%) met the criteria for one or more DSM-III-R diagnoses and 13 (21.7%) met the criteria lor PTSD.Conclusions. Community violence places children at a high risk of developing serious psychiatric disorders and many children develop PTSD. None of the children in the school sample had received intervention prior to the study, pointing towards an urgent need for increased community and professional awareness of children at risk