Abstract
Zusammenfassung.Theoretischer Hintergrund: Bislang liegen im Vergleich zur Forschung zur Posttraumatischen Belastungsstörung (PTB) bei Erwachsenen erst wenige Studien zur Epidemiologie und zur Behandlung der Störung bei Kindern und Jugendlichen vor. Ätiologische Modelle berücksichtigen bislang nur wenig entwicklungsbedingte Besonderheiten der Traumatisierung im frühen Lebensalter. Fragestellung: Überblick zum Stand der Forschung zu Häufigkeit, Entstehung, Aufrechterhaltung und Behandlung der PTB im Kindes- und Jugendalter. Methode: Analyse bislang vorliegender empirischer und theoretischer Arbeiten. Ergebnisse: Das Symptombild bei Kindern unterscheidet sich deutlich von dem der Erwachsenen, Unterschiede sowie diagnostische Instrumente werden beschrieben. Nach dem Erleben von Gewalt, besonders sexueller Art, erkranken Kinder und Jugendliche im Vergleich zu anderen Formen der Traumatisierung am häufigsten an einer PTB. Jungen sind insgesamt nach einer Traumatisierung weniger stark von posttraumatischer Symptomatik betroffen als Mädchen. Das Risiko, an PTB zu erkranken, steigt mit sinkendem Lebensalter bei Traumatisierung. Behandlungsprogramme beziehen diese besondere Vulnerabilität bislang nur wenig ein. Kontrollierte und randomisierte Studien zur Überprüfung ihrer Wirksamkeit fehlen. Schlussfolgerung: Kognitive Modelle, welche Besonderheiten der Wahrnehmung, Verarbeitung und Speicherung traumatischer Informationen in den Mittelpunkt stellen, liefern - durch die Berücksichtigung der Entwicklung kognitiver Fähigkeiten - Erklärungsmöglichkeiten für die negative Assoziation zwischen Lebensalter bei Traumatisierung und Vulnerabilität für PTB und Behandlungsansätze für die PTB im Kindes- und Jugendalter.
Abstract.Background: Compared to research on posttraumatic stress disorder (PTSD) in adults, so far there have only been a small number of studies on the epidemiology and treatment of the disorder in children and adolescents. Etiological models tend to neglect developmental aspects of traumatization in early life. Objective: To obtain an overview on prevalence, etiology, maintenance, and treatment of PTSD in children and adolescents. Methods: Analysis of empirical and theoretical publications. Results: Symptoms in children differ from those in adults, and a description of these differences and assessment instruments is given. Survivors of interpersonal violence, particularly sexual assault, show the highest risk of PTSD, compared to other forms of traumatization. Boys appear to be less affected by traumatization than girls. German assessment instruments for PTSD in children and adolescents are lacking. The risk of developing PTSD decreases with age at traumatization. Treatment programs so far tended to neglect the particular vulnerability of young children. Randomized and controlled treatment trials are lacking. Conclusions: In cognitive theories of PTSD the perception, processing and storing of traumatic information are central features. They may explain the negative association between age at traumatization and PTSD vulnerability by taking into account the development of cognitive capacities. Treatment programs based on cognitive-behavioural intervention show promising efficacy.
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