한번의 심각한 외상 경험을 한 학령 전기 아동의 발달정신병리
Developmental Psychopathologies of Nine Preschool Children, Experiencing Single, Severe Trauma
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Objectives：It has been known that children reved symptoms of Posttraumatic Stress Disorder (PTSD) after experiencing traumas similar to adults. But there are a few studies regarding the psychopathologies of PTSD in preschool children. Considering more active brain and psychological development in preschool children, it is expected that trauma of preschool children causes more serious psychopathologies than those of children with older ages or adults. This study aims to investigate psychopathologies of 9 preschool children experiencing a single, severe trauma, specifically in the respect of PTSD diagnosis. Methods：Nine preschool children, 3-5 years old, experiencing physical injuries caused by attack from a psychotic patient during lunch time at kindergarten, were evaluated for clinical diagnoses through semi-structured interviews using Kiddie-Schedule for Affective Disorders and Schizophrenia (K-SADS) and Research Diagnostic Criteria (RDC for Kiddies) of PTSD for preschool children. Results：Five (56% by DSM-IV) and Six (67%, by RDC) out of 9 children were diagnosed as to have PTSD. Among those children with PTSD, four (44%) showed Separation Anxiety Disorder (SAD) and one (17%) showed Major Depressive disorder (MDD) as comorbid diagnoses. On subclinical level, two of 9 children (22%) suffered from separation anxiety, seven (78%) from aggressive behaviors, and two (22%) from depressive mood. Sleep disturbances (89%) and reexperiencing of trauma (89%) were the most prominent symptoms of PTSD in preschool children. Conclusion：While preschool children showed profiles of PTSD symptoms similar to those of adults, it was critical to use more developmentally sensitive diagnostic tools for a better detection of psychopathologies. Young children experiencing severe trauma showed other comorbid psychopathologies along with PTSD. For proper diagnosis and intervention, it is important to make an accurate clinical diagnosis based on developmentally appropriate diagnostic process and tools.
Abstract
Objectives：It has been known that children reved symptoms of Posttraumatic Stress Disorder (PTSD) after experiencing traumas similar to adults. But there are a few studies regarding the psychopathologies of PTSD in preschool children. Considering more active brain and psychological development in preschool children, it is expected that trauma of preschool children causes more serious psychopathologies than those of children with older ages or adults. This study aims to investigate psychopathologies of 9 preschool children experiencing a single, severe trauma, specifically in the respect of PTSD diagnosis. Methods：Nine preschool children, 3-5 years old, experiencing physical injuries caused by attack from a psychotic patient during lunch time at kindergarten, were evaluated for clinical diagnoses through semi-structured interviews using Kiddie-Schedule for Affective Disorders and Schizophrenia (K-SADS) and Research Diagnostic Criteria (RDC for Kiddies) of PTSD for preschool children. Results：Five (56% by DSM-IV) and Six (67%, by RDC) out of 9 children were diagnosed as to have PTSD. Among those children with PTSD, four (44%) showed Separation Anxiety Disorder (SAD) and one (17%) showed Major Depressive disorder (MDD) as comorbid diagnoses. On subclinical level, two of 9 children (22%) suffered from separation anxiety, seven (78%) from aggressive behaviors, and two (22%) from depressive mood. Sleep disturbances (89%) and reexperiencing of trauma (89%) were the most prominent symptoms of PTSD in preschool children. Conclusion：While preschool children showed profiles of PTSD symptoms similar to those of adults, it was critical to use more developmentally sensitive diagnostic tools for a better detection of psychopathologies. Young children experiencing severe trauma showed other comorbid psychopathologies along with PTSD. For proper diagnosis and intervention, it is important to make an accurate clinical diagnosis based on developmentally appropriate diagnostic process and tools.
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