Psychiatric News August 20, 2004
Volume 39 Number 16
© 2004 American Psychiatric Association
p. 22
Age at Time of Trauma Predicts Type of Disorder Developed Later
Joan Arehart-Treichel
Girls who have been traumatized as children have a higher probability of
developing a major depression afterward than do adolescent girls.
What happens when children experience a traumatic event—say, a
serious accident, a serious illness, a fire, or a rape? Are they more likely
to develop a major depression or posttraumatic stress disorder (PTSD)? They
are more likely to develop the former.
And how about adolescents who experience a very traumatic event? They are
more likely to develop PTSD.
So suggests a study conducted in eastern Germany and headed by Andreas
Maercker, M.D., Ph.D., a professor of clinical psychology at the University of
Zurich in Switzerland. The results appeared in the June British Journal of
Psychiatry.
Maercker and his colleagues based their study on 1,966 women, average age
22 years, who lived in Dresden, Germany. The subjects were questioned about
traumatic events and their responses during both childhood and adolescence, as
well as whether they had experienced a major depression during childhood or
adolescence. The assessment was carried out using the Diagnostiches
Interview bei psychischen Storungen-Forschungsversion. It is a modified
version of the Anxiety Disorder Interview Schedule for
DSM-IV-Lifetime version.
Of the 1,966 subjects, 498 had experienced a traumatic event during either
childhood or adolescence. Of those 498 subjects, 210 had experienced a trauma
at age 12 years or younger (defined as children), and 288 after age 13
(defined as adolescents).
In the child trauma group, 41 (23 percent) had experienced a major
depression, and 30 (17 percent) had experienced posttraumatic stress disorder.
In the adolescent trauma group, 16 (7 percent) had experienced a major
depression, and 33 (13 percent) had experienced posttraumatic stress
disorder.
"We were able to show that experiencing a traumatic event in
childhood (up to age 12 years) is related to higher rates of major depression
than is experiencing a traumatic event in adolescence (after age 13
years)," the researchers observed in their report. "This
age-related difference could not be found for posttraumatic stress disorder.
In other words, there is a higher probability of developing major depressive
disorder if a trauma is suffered during childhood than if the trauma occurs in
adolescence."
Maercker told Psychiatric News, "The main result—the
high prevalence of major depression in children—surprised me."
Why might traumatized children be more likely to experience a major
depression rather than posttraumatic stress disorder? Perhaps because their
brains are not yet developed enough to experience posttraumatic stress
disorder. "We assume that development of posttraumatic stress disorder
requires a certain maturation of memory organization and arousal modulation,
which is not achieved before adolescence," the researchers explained in
their report.
Two limitations of the study were that it was conducted only on women and
that it was conducted retrospectively and might therefore be open to recall
bias. Nonetheless, a 1991 study produced similar results—after a
disaster, fewer posttraumatic stress disorder symptoms were found in children
than in adolescents.
An abstract of the study, "Age of Traumatisation as a
Predictor of Posttraumatic Stress Disorder or Major Depression in Young
Women," is posted online at
<http://bjp.rcpsych.org/cgi/content/abstract/184/6/482>.
Br J Psychiatry 2004 184 482[Abstract/Free Full Text]
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