A case of post-traumatic stress in a five-month-old baby
Babies can experience post-traumatic stress disorder (PTSD) just as older children and adults can, reports Aletha Solter, a former student of Jean Piaget.
Solter describes the case of Michael, a five-month-old who showed signs of traumatic stress after a three-day hospital stay for surgery to correct the shape of his head. Babies can’t meet the usual adult criteria for PTSD, which relies on verbal reports of symptoms. But Solter says that after returning home, Michael cried more, experienced night terrors, displayed a regression in his motor skills (he stopped rolling from his back to his stomach as he had previously learned to do), he displayed terror when lying on his back, and had become fearful of strangers. “The implication is that surgery followed by a fairly short hospital stay can be emotionally traumatising to an infant”, Solter said.
Solter prescribed ‘flooding’, a behaviourist term to describe exposing someone to that which they find frightening, until their terror subsides as what’s feared fails to materialise. In this case, the baby was left lying on his back to scream to exhaustion, while his father stayed close by offering comfort. After about 20 minutes Michael calmed down and from that point on he was far happier lying on his back. Occasionally lying on his back again triggered terror in Michael, in which case his parents left him on his back, but stayed close, offering comfort. Gradually Michael’s other problems reduced too and a year later all was well again. However, as Solter acknowledges, this is a single case study, so there’s no evidence Michael would have remained traumatised had the flooding technique not been used.
Flooding should only be used if the trauma is very specific and relatively minor, Solter advises, otherwise gradual desensitisation is recommended. And she warns that a traumatised infant should never be exposed to a situation that an un-traumatised baby would resist.
“It would be useful for paediatric surgeons to warn parents of the possible emotional and behaviour sequelae in their infants following surgery”, Solter concludes.
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Solter, A. (2007). A case study of traumatic stress disorder in a five-month-old infant following surgery. Infant Mental Health Journal, 28, 76-96.
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2 comments:
This is a piece of interesting research.. in theory but i have some difficulty with excepting that this type of expereince leads a child to have PTSD. As the authors indicate infants of tbhis age cannot forefill the more verbal criteria perscribed for adults with PTSD. In this case then how can we be sure that Micheal's problems were not the result of pain after sugery.. or related to his condition prior to operation?
I have an 8 year old child that underwent similar surgery at 10 weeks, 8 months and 23 months. He displayed similar behaviours as an infant and was subsequently diagnosed with autism.I have only recently began to appreciate that many of his symptoms and behaviours may be attributed to PTSD. His extreme fear associated with medical/institutional environments,distrust of adults, hypervigilance and anxiety in new environments, negative reactions to children crying, extreme negative reactions to sounds associated with sawing and drilling all indicate memories of his experience which he has until recently been able to verbalise due to language delay. What really has indicated that PTSD could be a contributor to his condition is his recent role-play in drama therapy in which he uses puppets to express his fear about doctors (his language has improved over the last 12 months), and finding him watching and weeping over a hospital reality television program that was showing an operation.
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