Psychic trauma in children: review of an article

AM J Psychiatry 138:1 January 1981 by Lenore C. Terr, M.D.

Background:
This article discusses the response to psychic trauma in children who were exposed to the kidnapping in Chowchilla.
The story of the kidnapping goes something like this: July 1976, 26 children (5-14 year) disappeared for 27 hours and they eventually escaped their captors. The school bus had been stopped by a van blocking the road and masked men had taken over the bus at gun point. The children were transferred to boarded over vans in which they were driven for 11 hours and then transferred into a "hole" (actually a buried truck trailer). The kidnappers covered the truck-trailer with earth. The children were buried for 16 hours until two of the oldest and the strongest boys 14 and 10 dug them out. By then the kidnappers had left the vicinity.

Methods:
The children were interviewed by the author and one or both of the parents had also been interviewed. The school bus driver and the kidnappers were not interviewed. This interview took place between 5-13 months.

Notes:
Initial signs of traumatic disruption (the breach of the ego):
-Omens: Children tend to associate things that happened before the incident and related that as the causal factor of why they were kidnapped.
-Fear of further trauma: Traumatophobia. (am I going to be killed?)
-Disturbances in cognition: During trauma disturbance in cognitive function such as perception, time sense and thought.

Repetitive phenomena (Repetition compulsion):
-Traumatic dreams: 1)terror dreams 2)exact repetition of kidnapped events 3)modified repetitions of kidnapping events 4)deeply disguised dreams
-Post traumatic play
-Reenactment: Direct reenactments of attitudes, fears or actions that have occurred before or after the kidnapping.
-Absence of flashbacks: Adolescents exhibited "voluntary" visions in contrast to the involuntary intrusive thoughts that adults have. Children younger than 9 did not complain of having visions. The ability to day dream develops after 9 and that might be the reason why children below 9 did not have flash backs.

Fears: (Kidnap related fears)
-All children had kidnapping related fears.

Personal Commentary:
Note that the DSM required criteria of a distressing event, re experience, avoidance and increased arousal are necessary for PTSD. Children in this incident also displayed re experience (exeplified by the repetitive phenomena), avoidance (is an end point of multiple psychological factors including omens and fears) and hyperarousal (exemplified by fears) .