Posttraumatic Stress Disorder (PTSD) has been referred to as shell shock, war neurosis, rape trauma syndrome and other situational titles for over a century. After gaining validity through time, PTSD was finally categorized in the diagnostic nomenclature in the third edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-III), which was published by the American Psychiatric Association in 1980 (Foa & Meadows, 1997). Today, extensive research studies and reviews are still processing the disorder, as many aspects of its nature remain undetermined.

Children with PTSD introduce another special-case treatment scenario. In fact, many provisions are made for diagnosing children with PTSD in the DSM-IV-TR (DSM-IV-TR, 2000). Children who experience trauma especially early in life pose serious developmental challenges. When a child is only familiar with a dysfunctional way of life, it may be necessary to employ educational techniques so that the child may learn and practice “normal” adaptive skills (Foa & Meadows, 1997).

Because PTSD is so similar to, and easily confused with other anxiety disorders, one must take into consideration any psychologically dysfunctional tendencies present before exposure to the stressor, which may indicate interference from some other mental disorder. For example, one might experience recurrent intrusive thoughts, but they might not be related to any traumatic event, and one might also experience flashback-like hallucinations that are actually caused by another psychotic disorder, instead of PTSD (DSM-IV-TR, 2000).

Eye Movement Desensitization and Reprocessing (EMDR) is a new and highly controversial form of exposure therapy. In EMDR, the patient is told to focus on whatever traumatic experience he or she finds disturbing while the therapist guides the eye movements of the patient with the waive of a finger, hand, or lighted wand (Foa & Meadows, 1997). After the therapist completes a dozen or two waives, the patient is asked to relax and forget the traumatic event. The severity of the patient’s symptoms is then rated and the technique is repeated until the symptoms are reduced considerably (Lilienfeld, 1996).

PTSD has three main symptom clusters: arousal, avoidance, and reexperiencing. Arousal symptoms involve problems concentrating, exaggerated startle response, sleep disturbance, and hypervigilance. Avoidance symptoms involve the avoidance of certain thoughts, feelings, and other things that serve as reminders of the traumatic experience. They also include a lack of emotion or interest in activities, distancing from others both mentally and physically, psychogenic amnesia, and fear of premature death. Reexperiencing symptoms include disruptive thoughts that cause avoidance or arousal symptoms through nightmares, flashbacks, or other dissociative states. Trauma is a fourth cluster of criteria for PTSD. The trauma must be an event that makes the individual feel extremely frightened and vulnerable. This threat must involve witnessed or experienced threat of death, injury or damage to physical integrity (Friedman et al., 1998).

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