Child Abuse Law - Developments in law, medicine, and psychology affecting child abuse cases

Wed October 1 2008

PTSD Symptoms Without Trauma

Checklists of Post-Traumatic Stress Disorder symptoms are insufficient to determine that a person has suffered a traumatic event. That was an implication of the message given by Melvin Guyer September 19th at the National Child Abuse Defense & Resource Center's conference in Las Vegas. Guyer is a professor of psychiatry at the University of Michigan.

PTSD is the only psychiatric condition whose definition includes the patient's having experienced a specific event—some sort of trauma. Sometimes when a young person reports sex abuse, she or he is taken to a mental health professional and given a checklist of PTSD symptoms-- recurring feelings of reliving the event, nightmares, irritability, poor sleep, difficulty concentrating, etc. Some mental health professionals will diagnose PTSD on the basis of the young patient's report of the event and entries on the checklist. In making such a diagnosis, the mental health professional accepts the abuse report as true. And the diagnosis itself can be accepted by others, including judges and juries, as confirmation that the abuse happened.

Guyer pointed out that a study in the Netherlands suggests such an inference is unsound. In that study, persons who said they had never experienced serious trauma reported more PTSD symptoms than persons who had suffered such trauma reported.

The findings from the Netherlands study, reported in the article, "Symptoms of Post-Traumatic Stress Disorder After Non-Traumatic Events: Evidence From An Open Population Study," published in the British Journal of Psychiatry (2005) 186: 494-499, came after comparing PTSD symptoms reported by persons who had experienced a traumatic event with those who had experienced more common stressors, termed "life events" by the researchers. Traumatic events were defined as events such as accidents, robbery, sudden death of a loved one, or physical or sexual abuse of an adult or child. Life events included chronic diseases, serious problems with work or relationships, and events that upset the normal order of things in a person's life.

In the study, the average number of PTSD symptoms participants said they had experienced was higher for those who did not report ever suffering a traumatic event. Further, those who had never suffered a traumatic event stated they experienced PTSD symptoms as severe as the symptoms experienced by those who had suffered a traumatic event.

Persons who had suffered child sexual or physical abuse or adult sexual abuse were the most likely study subjects to report PTSD symptoms. This finding, though, does not validate using a PTSD checklist to confirm a subject's report of abuse since, according to the study, PTSD symptoms do not discriminate well between persons who have suffered traumatic events and those who have not.