Traumatic exposure is a common experience among children and may have severe and long lasting effects on child’s mental well-being and development. We reported on children who have been exposed to one or more potentially traumatic events during their lives and focused on identifying those children suff ering from psychological trauma. It was found that exposure to single trauma and child maltreatment leads to diff erent traumatic stress profi les and that the eff ects of child maltreatment tend to extend symptoms of PTSD. Furthermore, the results provided support for the reliability and validity of the CRIES, a screening tool for child’s posttraumatic stress. This screening tool may help clinicians to identify children suff ering from psychological trauma and to assign appropriate follow-up diagnostic and clinical care.

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Kinderen worden geregeld blootgesteld aan schokkende gebeurtenissen zoals verkeersongelukken, geweld op school, seksueel misbruik of kindermishandeling. Dit kan ernstige psychische gevolgen met zich meebrengen. Nog al te vaak worden deze psychische gevolgen niet onderkend. Kinderen blijven daardoor langdurig rondlopen met klachten of krijgen een verkeerde diagnose toegeschreven. Hoe kunnen we de psychische gevolgen van een schokkende gebeurtenis vroegtijdig herkennen? Eva Verlinden zoekt antwoord op deze vraag.


Kinderen en adolescenten worden regelmatig geconfronteerd met schokkende gebeurtenissen. Soms betreft het een eenmalige gebeurtenis, zoals een verkeersongeluk of een brand. Andere gebeurtenissen zijn langdurig van aard, denk aan huiselijk geweld of seksueel misbruik. Na het meemaken van een schokkende gebeurtenis hebben vrijwel alle kinderen en adolescenten in meer of mindere mate last van stressreacties. Voorbeelden hiervan zijn prikkelbaarheid, somberheid, inslaapproblemen, nachtmerries of woedeuitbarstingen (American Psychiatric Association, 2008; Gurwitch et al., 2008)220. Deze stressreacties zijn in de eerste weken na het meemaken van een schokkende gebeurtenis heel normaal. Bij de meeste kinderen verdwijnen deze reacties weer na verloop van tijd. Het meemaken van één of meer schokkende gebeurtenissen kan echter ook tot blijvende psychische schade leiden; dan spreken we van een trauma (Copeland et al., 2007; De Bellis & Van Dillen, 2005)89.

Het woord ‘trauma’ is afkomstig uit het Grieks en betekent letterlijk ‘wond’ of ‘verwonding’. In de


  1. Alisic, E., Zalta, A.K, Wesel, F. van Larsen, S.E., Hafstad, G.S. et al. (2014). Rates of post-traumatic stress disorder in trauma-exposed children and adolescents: meta-analysis. The British Journal of Psychiatry, 204, 335-340.
  2. American Psychological Association Presidential Task Force on Posttraumatic Stress Disorder and Trauma in Children and Adolescents (2008). Children and Trauma. Update for Mental Health Professionals. Washington: American Psychological Association.
  3. American Psychiatric Association (2014). Handboek voor de classifi catie van psychische stoornissen (DSM-5); Nederlandse vertaling van Diagnostic and Statistical Manual of Mental Disorders (5th ed.). Amsterdam: Boom.
  4. Bird, H.R., Gould, M.S. & Staghezza, B. (1992). Aggregating data from multiple informants in child psychiatry epidemiological research. Journal of the American Academy of Child and Adolescent Psychiatry, 31, 78-85. doi: 10.1097/00004583- 199201000-00012
  5. Children and War Foundation. (1998). The Children’s Revised Impact of Event Scale (13): CRIES-13. Geraadpleegd in juni 2008 van children%E2%80%99s-revised-impact-ofeventscale-8-%E2%80%93-CRIES-8/ies13/.
  6. Cloitre, M., Miranda, R., Stovall-McClough, K. & Han, H. (2005). Beyond ptsd: Emotion regulation and interpersonal problems as predictors of functional impairment in survivors of childhood abuse. Behavior Therapy, 36, 119-124
  7. Cook, A., Blaustein, M., Spinazolla, J. & Van der Kolk, B. (2003). Complex Trauma in Children and Adolescents. White Paper from the National Child Traumatic Stress Network Complex Trauma Task Force. Los Angeles, ca: National Center for Child Traumatic Stress.
  8. Copeland, W.E., Keeler, G., Angold, A. & Costello, E.J. (2007). Traumatic events and posttraumatic stress in childhood. Archives of General Psychiatry, 64, 577–584. doi:10.1001/archpsyc.64.5.577
  9. De Bellis, M.D. & Van Dillen, T. (2005). Childhood post-traumatic stress disorder: An overview. Child and Adolescent Psychiatric Clinics of North America, 14, 745-722.
  10. Diehle, J., Opmeer, B.C., Boer, F., Mannarino, A.P. & Lindauer, R.J L. (2014). Trauma-focused cognitive behavioral therapy or eye movement desensitization and reprocessing: what works in children with posttraumatic stress symptoms? A randomized controlled trial. European Child & Adolescent Psychiatry, 227-236.
  11. Dow, B.L., Kenardy, J. A., Le Brocque, R.M. & Long, D. A. (2012). The utility of the Children’s Revised Impact of Event Scale in screening for concurrent ptsd following admission to intensive care. Journal of Traumatic Stress, 25, 602-605. doi: 10.1002/ jts.21742.
  12. Earls, F., Smith, E., Reich, W. & Jung, K.G. (1988). Investigating psychopathological consequences of disaster in children: A pilot study incorporating a structured diagnostic interview. Journal of the American Academy of Child and Adolescent Psychiatry, 27, 90-95. doi: 10.1097/00004583-198801000- 00014
  13. Fairbank, J. A. & Fairbank, D.W. (2009). Epidemiology of child traumatic stress. Current Psychiatry Reports, 11(4), 289-295. doi: 10.1007/s11920-009- 0042-9
  14. Gabbay, V., Oatis, M.D., Silva, R.R. & Hirsch, G. (2004). Epidemiological aspects of ptsd in children and adolescents. In R. R. Silva (Ed.), Posttraumatic stress disorder in children and adolescents: Handbook. New York: Norton.
  15. Galea, S., Nandi, A, & Vlahov, D. (2005). The epidemiology of post-traumatic stress disorder after disasters. Epidemiologic Reviews, 27, 78-91. doi:10.1093/epirev/mxi003
  16. Giannopoulou, I., Strouthos, M., Smith, P., Dikaiajou, A., Galanopulou, V. & Yule, W. (2006). Post-traumatic stress reactions of children and adolescents exposed to the Athens 1999 earthquake. European Psychiatry, 21, 160-166. doi: 10.1016/j.eurpsy.2005.09.005
  17. Ghesquiere, A., Fan, M.Y., Berliner, L., Rivara, F.P., Jurkovich, G.J. et al. (2008). Adolescents’ and parents’ agreement on posttraumatic stress disorder symptoms and functioning after adolescent injury. Journal of Traumatic Stress, 21, 487–491. doi:10.1002/jts.20364
  18. Greif Green, J.G., McLaughin, K. A., Berglund, P. A., Gruber, M.J., Sampson, N. A. et al. (2010). Childhood Adversities and Adult Psychiatric Disorders in the National Comorbidity Survey Replication II. Associations With First Onset of DSM-iV-Disorders. Archives of General Psychiatry, 67(2), 113-123.
  19. Grills, A.E. & Ollendick, T.H. (2003). Multiple informant agreement and the anxiety disorders interview schedule for parents and children. Journal of the American Academy of Child and Adolescent Psychiatry, 42, 30-40. doi: 10.1097/00004583- 200301000-00008
  20. Gurwitch, R.H., Silovsky, J.F., Schultz, S., Kees, M. & Burlingame, S. (2008). Reactions and guidelines for children following trauma and disaster. Washington: American Psychological Association.
  21. Jensen, P.S., Rubio-Stipec, M., Canino, G., Bird, H. R., Dulcan, M. K. et al. (1999). Parent and child contributions to diagnosis of mental disorder: are both informants always necessary? Journal of the American Academy of Child and Adolescent Psychiatry, 38, 1569-79. doi: 10.1097/00004583- 199912000-00019
  22. Kilpatrick, D.G., Ruggiero, K.J., Acierno, R., Saunders, B.E., Resnick, H.S. & Best, C.L. (2003). Violence and risk of ptsd, major depression, substance abuse/dependence, and comorbidity: Results from the National Survey of Adolescents. Journal of Consulting and Clinical Psychology, 71, 692-700.
  23. Kramer, D. & Landolt, M. (2011). Characteristics and effi cacy of early psychological interventions in children and adolescents after single trauma: a meta-analysis. European Journal Of Psychotraumatology, 2. doi: 10.3402/ejpt. v2i0.7858.
  24. Litrownik, AJ., Lau, A., English, D., Briggs, E., Newton, R. et al. (2005). Measuring the severity of child maltreatment. Child Abuse & Neglect, 29, 553-573.
  25. Manly, J.T., Kim, J.E., Rogosch, F. A. & Cicchetti, D. (2001). Dimensions of child maltreatment and children’s adjustment: Contributions of developmental timing and subtype. Development and Psychopathology, 13, 759-782.
  26. McFarlane, A.C. (1987). Family functioning and overprotection following a natural disaster: The longitudinal eff ects of posttraumatic morbidity. Australian and New Zealand Journal of Psychiatry, 21, 210–218. doi: 10.3109/00048678709160914
  27. Meiser-Stedman, R., Smith, P., Glucksman, E., Yule, W. & Dalgleish, T. (2007). Parent and child agreement for acute stress disorder, post-traumatic stress disorder and other psychopathology in a prospective study of children and adolescents exposed to single-event trauma. Journal of Abnormal Child Psychology, 35, 191-201. doi:10.1007/s10802-006-9068-1
  28. Nauta, M.H., Scholing, A., Rapee, R. M., Abbott, M., Spence, S. H. & Waters, A. (2004). A parent-report measure of children’s anxiety: psychometric properties and comparison with child-report in a clinic and normal sample. Behaviour Research and Therapy, 42, 813-39. doi: 10.1016/S0005-7967(03)00200-6
  29. Pears, K.C. Kim, H.K. & Fisher, P. A. (2008). Psychosocial and cognitive functioning of children with specifi c profi les of maltreatment. Child Abuse & Neglect, 32, 958-971.
  30. Perrin, S., Meiser-Stedman, R. & Smith, P. (2005). The children’s revised impact of event scale (CRIES): Validity as a screening instrument for ptsd. Behavioural and Cognitive Psychotherapy, 33, 487-498. doi: 10.1017/ S1352465805002419
  31. Sack, W.H., Seeley, J.R., Him, C. & Clarke, G.N. (1998). Psychometric properties of the Impact of Events Scale in traumatized Cambodian refugee youth. Personality and Individual Diff erences, 25, 57-67. doi: 10.1016/S0191- 8869(98)00030-0
  32. Shemesh, E., Newcorn, J.H., Rockmore, L., Shneider, B.L., Emre, S. et al. (2005). Comparison of parent and child reports of emotional trauma symptoms in pediatric outpatient settings. Pediatrics, 115, e582-e589. doi:10.1542/ peds.2004-2201
  33. Siebelink, B.M. & Treff ers, Ph.D. A. (2001). Dutch translation of the Anxiety Disorders Interview Schedule for DSM-iv: Child and Parent Version. Lisse/Amsterdam: Swets & Zeitlinger.
  34. Silverman,W.K. & Albano, A.M. (1996). The Anxiety Disorders Interview Schedule for Children for DSM-iv: Child and Parent Version. San Antonia, the Psychological Corporation.
  35. Smith, P., Perrin, S., Dyregrov, A. & Yule, W. (2003). Principal components analysis of the Impact of Event Scale with children in war. Personality and Individual Diff erences, 34, 315-322. doi: 10.1016/S0191-8869(02)00047-8
  36. Verlinden E. (2104). Time does not heal all wounds. Identifying suff ering from psychological trauma. Academisch proefschrift, Universiteit van Amsterdam.
  37. Yule, W. & Williams, R. (1990). Posttraumatic stress reactions in children. Journal of Traumatic Stress, 3, 279–295. doi: 10.1002/ jts.2490030209
  38. Zeanah, C.H., Scheeringa, M., Boris, N.W., Hellers, S S., Smyke, A. T. & Trapani, J. (2004). Reactive attachment disorder in maltreated toddlers. Child Abuse and Neglect, 28, 877-888.
  39. Zhang N., Zhang, Y., Wu, K., Zhu, Z. & Dyregrov, A. (2011). Factor structure of the Children’s Revised Impact of Event Scale among children and adolescents who survived the 2008 Sichuan earthquake in China. Scandinavian Journal of Psychology, 52, 236-241. doi: 10.1111/j.1467- 9450.2010.00867.x