PTSD in Children Following Dog Bites

A physician acquaintance of mine is on a mission to promote awareness, especially amongst emergency physicians, of the potential for post-traumatic stress disorder in children who have been attacked and/or bitten by dogs.  Thus this blog post.  As a practicing psychiatrist, he has treated a number of such children, and he believes that it is very important for physicians who are treating these children for their bite wounds to inform parents to actively watch for signs of PTSD and to obtain evaluation and treatment if indicated.  Dr. Schmitt has lectured and published on this topic (Larry Schmitt, MD, Dog bites in children: Focus on posttraumatic stress disorder, Contemporary Pediatrics, Jul 1, 2011).  He makes a good case for the need for parents and pediatricians to monitor these children closely after their injury, and for incorporating information about PTSD into post-treatment ED and inpatient discharge instructions.

One may not readily consider the diagnosis of PTSD in children, but after dog bites it appears that children pick up on the guilt and sadness in their parents’ faces, and tend to bury their feelings and avoid discussion of the attack.  This of course may precipitate PTSD, and make it more difficult to identify this pathology unless one recognizes the symptoms (excessive anxiety, irritability, decreased school performance, sleep disturbance, reduced creativity, withdrawal, altered appetite, depression, physical complaints, pronounced startle responses, and behavior problems), and relates them back to the attack.  Parents need to know not only how to recognize PTSD, but also what to do to mitigate the potential for their child to develop PTSD.  Preemptive psychological management is likely to be helpful, and parents need to participate in helping their children cope with this trauma and its psychological impact.

Dr. Stanley Goodman published a pdf on the web which provides an extensive outline of this issue; and he suggests that ‘children need to be helped to understand the following, in order to lessen their feelings of vulnerability and helplessness:

1. that many children become fearful whenever they have reminders of the incident, such as seeing other dogs or even watching movies/TV shows with dogs.

2. that they may feel more nervous when they leave their house, fearing they may be attacked and bitten again by a dog.

3. that they may experience depressive symptoms, such as feelings of helplessness, frustration, and diminished social and/or educational functioning; but these feelings are not a sign of weakness.  Rather, they are a foreseeable reaction to having been bitten.’

Emergency physicians treat a lot of children with dog bites, and they have an important role to play beyond caring for the injuries themselves.  Making parents aware of the potential for PTSD, providing information about the signs and symptoms of PTSD in written dog-bite discharge instructions, and suggesting referrals for preemptive psychological counseling can all make a significant contribution to the child’s successful recovery from this kind of trauma.

This post also appears in The Fickle Finger

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  1. #1 by Carrol Hillis - January 20th, 2013 at 17:09

    I found this article on a search for ptsd related to dog bitesm and wish to add…

    I am a healthy 64-year-old woman who was nipped by a neighbor’s dog the other day. Although it was a very mild nip, the experience (the vicious behavior of the dog, the unexpectedness, the fear that he would do more damage as I waited for the dog’s owner to persuade him to come in the house) was really scarey. Today, avoiding that route, I was approached by another unleashed dog (quite neutrally, I realize in retrospect) and was really afraid. Fortunately the owner came and got the dog. I was quite upset. Usually I have been quite relaxed with dogs, but now I plan to get pepper spray, maybe carry a large stick when I walk. If I can react like this, I am certain that children would be traumatized by such a dog-bite, or even a near-bite.

  2. #2 by Marie - May 18th, 2016 at 03:26

    I was bitten by a dog on the loose four months ago. He approached my tiny dog and attacked him and I tried to protect him and got bit by the JRT. NOw I am afraid of dogs that are off lease. Police have not been good in enforcing this law.

  3. #3 by JL - August 17th, 2020 at 18:26

    I am very lucky to not have had such interactions with any dogs, but I can completely understand others, especially children, having such trauma after such negative interactions. We are so used to interacting with happy dogs with wagging tails, that a snarling, biting one feels very alien.

  4. #4 by Samuel - October 30th, 2020 at 19:07

    My mother was bitten by a dog when she was younger. Ever since she has been pretty much afraid of big dogs. She is working on it.

  5. #5 by Inspection Maison - November 30th, 2020 at 18:49

    The world of PTSDs I get when I come across an over excited dog is unexplainable. I once was bitten by a doberman pinscher, and have been scared since.

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