PTSD and the Bereaved Parent
was once asked by a bereaved parent if the death of a child can cause
PTSD (Post-traumatic Stress Disorder). My answer was, "ABSOLUTELY!" The
essential feature of this disorder is the development of characteristic
symptoms following exposure to an extreme traumatic stressor. What
could be more extreme for parents than the death of their child? This
is the greatest nightmare of any parent.
In this article
I will identify the criteria needed to make this diagnosis and in the
next newsletter, I will address ways parents can be helped. For
grieving parents, PTSD can be especially severe when the death of their
child was of human design, as in murder or suicide. This disorder can
occur at any age including childhood and can develop in individuals
without any predisposing conditions.
The bible for mental health clinicians is the DSM-IV. The criteria that validates this diagnosis in a bereaved parent is:
(1) The death of one's child as experienced by the parent is considered
a traumatic event and (2) due to the death, the parent has experienced
intense fear, helplessness, or horror. In children this may be
expressed instead by disorganized or agitated behavior.
The trauma of the death is persistently reexperienced in one (or more)
of the following ways: (1) Recurrent and intrusive distressing
recollections of the event. In young children, repetitive play may
occur where themes or aspects of the death are acted out. (2)
Distressing dreams and with children this may occur without
recognizable content. (3) Flashbacks of the event including a sense of
reliving the experience. (4) Intense psychological distress at exposure
to internal or external cues that resemble the death. (5) Physiological
reactivity when exposed to these cues.
Avoidance of stimuli associated with the trauma and a general numbing
of responsiveness that wasn't experienced before the child's death that
includes three or more of the following: (1) Avoidance of thoughts,
feelings or conversations associated with death. (2) Avoidance of
activities, places or people associated. (3) Inability to recall an
important aspect of the death. (4) Markedly diminished interest or
participation in significant activities. (5) Feelings of detachment or
estrangement (6) A restricted range of affect (e.g. unable to have
loving feelings). (7) A sense of a foreshortened future.
Persistent symptoms of increased arousal that includes two or more of
the following: (1) Sleep difficulties. (2) Irritability or anger
outbursts. (3) Difficulty concentrating. (4) Hypervigilance. (5)
Exaggerated startle response.
- E. Duration of the disturbances in B, C, and D last more than one month.
- F. The disturbances cause significant distress in areas of functioning from social to career.