Meeting abstract

https://doi.org/10.24869/spsih.2026.314

Unresolved Grief, Cumulative Trauma, and the Development of PTSD in Adolescence: A Case Report

Karla Aleksandra Župa ; University Hospital of Split, Spinčićeva 1, 21000 Split, Croatia *
Nina Rančić ; University Hospital of Split, Spinčićeva 1, 21000 Split, Croatia
Anđela Kovačević ; University Hospital of Split, Spinčićeva 1, 21000 Split, Croatia
Neda Pleić ; University Hospital of Split, Spinčićeva 1, 21000 Split, Croatia
Ivona Karlušić ; University Hospital of Split, Spinčićeva 1, 21000 Split, Croatia
Trpimir Glavina ; University Hospital of Split, Spinčićeva 1, 21000 Split, Croatia; Department of Psychiatry, School of Medicine, University of Split, Šoltanska 2, 21000 Split, Croatia

* Corresponding author.

Abstract

Posttraumatic stress disorder (PTSD) in children
and adolescents can present in a developmentally
specific way, often with a clinical picture that is
atypical compared with adulthood. Meta-analytic
data show that PTSD develops in approximately
one-fifth of traumatized children and adolescents,
especially after interpersonal and repeated
exposure to traumatic events. The aim of this paper
is to present developmentally different manifestations
of psychotrauma in a female adolescent
in whom the full clinical picture of PTSD developed
on the basis of cumulative traumatization
and multiple unresolved grief reactions after successive
losses in the family. We present the case of
a seventeen-year-old patient with unremarkable
perinatal history and psychomotor development,
growing up in an intact seven-member family burdened by her father’s long-standing alcoholism.
At the age of ten, she witnessed the sudden death
of a close family member, after which she developed
somatic symptoms in the form of abdominal
pain, nausea, and vomiting, accompanied by
a pronounced sense of guilt and helplessness and
partial amnesia related to the traumatic event.
Several years later, after another tragic loss in the
immediate family, her difficulties intensified in
the form of migraine headaches, anxiety, difficulty
falling asleep, and panic attacks. Four months
thereafter, the patient experienced yet another
tragic loss within the extended family, leading to
retraumatization and the development of the full
clinical picture of PTSD with intrusive memories,
nightmares, psychophysiological arousal, autonomic
symptoms when reminded of the trauma,
psychomotor agitation, concentration difficulties,
forgetfulness, and a persistent sense of guilt. The
patient was referred for psychiatric evaluation
only several months after the last tragic event,
due to frequent panic attacks and insomnia. The
presented case illustrates how the consequences
of trauma during development can manifest from
somatization symptoms in childhood to the full
symptomatology of PTSD in adolescence. The cumulative
effect of multiple losses, retraumatization,
and unresolved grief likely contributed to
the progression of symptoms, underscoring the
importance of early recognition of developmentally
specific manifestations of trauma and timely
treatment.

Keywords

grief; trauma; PTSD; adolescent

Hrčak ID:

353011

URI

https://hrcak.srce.hr/353011

Publication date:

15.6.2026.

Article data in other languages: croatian

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