Summary: Costello EJ, Erkanli A, Fairbank JA, and Angold A. "The prevalence of potentially traumatic events in childhood and adolescence," Journal of Traumatic Stress vol 15(2): 99-112. 2002.

This study examined the prevalence of stressful life events in a group of 1,420 children living in a fairly poor, rural area of North Carolina. Researchers conducted detailed interviews with each child and one of their parents to measure their exposure to a variety of stressful and potentially stressful events. In addition to looking at events like physical violence or abuse, natural disasters, and severe accidents-which the researchers refer to as high-magnitude events-researchers also asked about low magnitude events, such as the death of a distant relative.

Interviewers also asked about factors that are known to increase children's vulnerability to traumatic events, or make it difficult to receive support after the events. These vulnerability factors fell into three areas: parents' mental health problems; family relationship problems; and family environment problems, such as poverty and disorganization in the home.

Over the course of their lifetimes, one-quarter of the children had experienced at least one high-magnitude event. The most common events were death of a loved one, witnessing or learning about a traumatic event, and sexual abuse. Of these children, 10 percent had experienced three or more serious potentially traumatizing events. Almost 30 percent of the children had undergone a low-magnitude traumatic event, with moving from home, changing schools, breaking up with a boyfriend or girlfriend, and experiencing a substantial drop in the family's standard of living being the most common events. These low-magnitude events were more common among children who had experienced at least one high-magnitude event.

The relationship between vulnerability and potentially traumatic events was clear. The children with higher vulnerability factors experienced more potentially-traumatic events overall. While some individual events-serious illness and death of a loved one, for example-occurred throughout the population, sexual abuse and events occurring to people the child knew increased significantly in the most vulnerable of the children. Having a family history of mental illness doubled the likelihood of experiencing a traumatic event.

Extreme stressors are, unfortunately, not rare in the lives of children. Given that previous studies have shown that only about 4 percent of children see a mental health professional for any reason within a three-month period, it is likely that only a fraction of children who need mental health services are receiving treatment.