Traumas trip up inner-city girls.

Teenagers living in poor, inner-city areas witness or become victims of violence much more often than their middle-class counterparts in suburbs or rural areas. A new study shows that inner-city girls who routinely encounter violence often develop a severe stress reaction that may make it harder for them to succeed in school and more likely to be suspended or arrested.

Inner-city girls who suffer from this reaction, known as post-traumatic stress disorder (PTSD), also appear more vulnerable to depression and anxiety and more prone to cigarette and marijuana use, report psychiatrist Deborah S. Lipschitz of Yale University School of Medicine and her coworkers.

The researchers recruited 90 females, ranging in age from 12 to 21, who registered for routine medical appointments at an inner-city primary-care clinic. Of that number, 78 were black and the rest were Hispanic, white, or from other ethnic backgrounds. Most participants attended high school and lived with a single adult caretaker, usually their mother.

Each volunteer completed a battery of questionnaires and a psychiatric interview with an experimenter.

A total of 83 girls had experienced at least one trauma. Most often they had witnessed a stabbing, shooting, or murder or had learned about the murder of a friend or family member.

Twelve girls, or 14 percent of the group, suffered from PTSD most of the time, the scientists report in the September JOURNAL OF THE AMERICAN ACADEMY OF CHILD AND ADOLESCENT PSYCHIATRY. Half the girls experienced PTSD some of the time. Prior estimates of PTSD rates among the general population of teens and young adults range from 2 percent to 9 percent.

PTSD consists of three sets of symptoms that appear after a traumatic experience. One set involves reexperiencing a horrifying event in ways such as having nightmares or intrusive thoughts. The second set includes avoiding people or places linked to a trauma and becoming detached from loved ones and emotions. The third set consists of signs of arousal, such as having difficulty concentrating and flying into sudden rages.

Another 10 girls in the study displayed several of these symptoms, although they didn't suffer from full-blown PTSD, Lipschitz and her colleagues hold.

The girls with PTSD most of the time usually had encountered several types of trauma, including sexual and physical abuse and neglect by caretakers. Many also reported having used guns or knives themselves in fights. The strong correlation in this group between PTSD and school suspensions, failed courses, and police arrests leads Lipschitz and her colleagues to theorize that PTSD is a major root of these troubles.