ANN ARBOR, Mich.-Preschool children exposed to domestic violence and additional traumatic events are at increased risk for developing traumatic stress disorder, a new University of Michigan study shows.

Researchers sampled 120 children between ages 4-6 who were exposed to domestic violence in the past two years. About 38 percent of the kids were faced with additional traumatic events, such as sexual assaults by family members, physical assaults or life-threatening illnesses.

Those children had higher rates of post-traumatic stress disorder than the other children who were exposed to domestic violence.

The research involved children who lived in low-income households (less than $7,500 annually), where domestic violence incidents happen more often than in families with other economic backgrounds. Through flyers and brochures, women in a Midwest state were recruited and they chose where interviews would be conducted, such as a shelter or a home, if the woman was not living with an abusive partner.

Respondents answered questions about the frequency of being abused within the last year and what their child's behavior was after being exposed to domestic violence and any other potentially traumatic events.

Overall, no significant differences were found based on race (38 percent white, 37 percent black), gender (53 percent boys), age, mother's education (60 percent completed some college, 40 percent high school education or less) or income.

Of the 120 children, the research indicated that 74 (or 62 percent) never experienced an additional traumatic event beyond exposure to domestic violence. The remaining 46 children experienced at least one additional traumatic event, resulting in behavior problems such as becoming anxious, depressed or more aggressive.

These results, as well as other studies on multiple trauma exposure, indicate the challenges for children adapting to their situations that could affect their school performance and social development.

"Such findings draw attention to an at-risk sample of children who may be labeled as aggressive due to their behavior problems, but are in fact highly traumatized," Sandra Graham-Bermann, the study's lead author and professor of psychology and psychiatry. "It is especially important to accurately diagnose these children so they gain access to appropriate treatment services."

Graham-Bermann collaborated on the study, published this month in the Journal of Traumatic Stress, with U-M graduate Lana Castor; Laura Miller, a doctoral candidate in the clinical science program; and Kathryn Howell, a postdoctoral fellow in the Department of Psychiatry.

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