(RxWiki News) The trauma of seeing violence in the home firsthand takes its toll on children as it is. When they experience more traumatic events, their risk of mental health concerns is even greater.
"Being abused? Call for help."
The study, led by Sandra A. Graham-Bermann, PhD, of the Department of Psychology at the University of Michigan in Ann Arbor, aimed to find out how multiple traumatic events affects children in homes with domestic abuse.
The study involved 120 preschool children who had been exposed to "intimate partner violence" within the past two years.
The children were all between 4 and 6 years old and included a little over a third white children, a little over a third black children, 5 percent Latino children and 20 percent of mixed race.
Most of the children lived in homes of single or separated parents; only 16 percent lived in homes of married couples.
Intimate partner violence is any kind of domestic abuse that occurs between two romantic partners, regardless of their gender or their relationship to the child.
Over a third — 38 percent — of the children had experienced additional traumatic events aside from witnessing the domestic violence.
These other traumatic events included being sexually assaulted by other family members, being physically abused, being in serious accidents or having life-threatening illnesses.
When the researchers compared the children who had experienced additional trauma to those who had only witnessed domestic violence, they found that these children had higher rates of PTSD diagnoses and overall symptoms.
A majority of all the children — 71 percent — showed symptoms of PTSD for at least one month.
But when using the official diagnostic definition of PTSD, 8 percent of the children who had been exposed only to domestic abuse had PTSD compared to 28 percent of the children who had been exposed to other traumatic events as well.
They were also more likely to have problems managing their emotions or having appropriate behavior than the children not exposed to additional traumatic events.
Background research in the study points out that children exposed to intimate partner violence are also more likely to experience other times of trauma.
For example, they are 2.5 times more likely to be physically abused themselves, and they are nearly 5 times more likely to be sexually abused.
It is this repeated exposure to trauma that LuAnn Pierce, a clinical social worker in Colorado, points out is especially concerning.
"The fact that such a high percentage of these child witnesses also experience multiple direct traumatic events is frightening," Pierce said. "It is the recognition of how readily one who has already been traumatized is re-traumatized that seems important here."
Pierce added that the additional events that can further traumatize a child are not always obvious, but their impact can be significant.
"Once triggered, children and adults experience overwhelming and often paralyzing fear, anxiety and panic," she said. "In many cases, especially with children and those who are undiagnosed, the person does not know what triggered the emotions, which is very scary."
She added, "We must do a better job of preventing these long-term mental and physical health problems by addressing the causes earlier in life, and preventing those that can be prevented — particularly in children."
One limitation of this study is that the symptoms in the children were reported by the mothers, which means there could actually be more children affected with PTSD symptoms that the mothers did not report.
The authors conclude that it is important to screen and diagnose children with PTSD symptoms to ensure they receive proper treatment.
The study was published in the August issue of the Journal of Traumatic Stress. The research was funded by the Blue Cross Blue Shield of Michigan Foundation and the James. A. and Faith Knight Foundation.