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See Inside August/September 2007

Trauma in Disguise

A child's hyperactivity may be a symptom of distress

To most children, the picture of Davy Crockett's rifle in their history book is like many aspects of school: boring. For a child who saw his father threaten his mother with a shotgun, however, the picture can trigger traumatic memories—and the resulting fidgeting and jumpiness can look to teachers and doctors like attention-deficit hyperactivity disorder (ADHD). In such cases, standard treatment with stimulants (which help to focus the ADHD brain) may do more harm than good. And according to some experts, misdiagnosis of trauma-related attention problems may not be uncommon: in children, trauma produces different symptoms than it does in adults.

Recent research by Duke University psychiatrists found that by age 16, more than two thirds of children are exposed to at least one potentially traumatic event, such as abuse or a natural disaster. But fewer than 1 percent of the 1,420 children studied met the criteria for post-traumatic stress disorder. In childhood, trauma was more likely to lead to depression, anxiety and behavior problems.

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