PTSD in Children Below the Age of 6 Years

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This chapter provides a comprehensive review of the latest reseach regarding the diagnosis, assessment, and treatment of PTSD in children under 6 years of age. •• Haag A-C, Celi S, Landolt MA. Trauma and PTSD in preschool-aged children. In: Barrett BFP, editor. Anxiety in Preschool Children: Assessment, Prevention, & Treatment. New York: Taylor & Francis/Routledge.in press. This chapter provides a comprehensive review of the latest reseach regarding the diagnosis, assessment, and treatment of PTSD in children under 6 years of age. American Psychiatric Association. Diagnostic and statistical manual of mental disorders. 5th ed. Arlington: American Psychiatric Publishing; 2013. Postert C, Averbeck-Holocher M, Beyer T, Muller J, Furniss T. Five systems of psychiatric classification for preschool children: do differences in validity, usefulness and reliability make for competitive or complimentary constellations? Child Psychiatry Hum Dev. 2009;40(1):25–41. Egger HL, Emde RN. 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Research diagnostic criteria for infants and preschool children: the process and empirical support. J Am Acad Child Adolesc Psychiatry. 2003;42(12):1504–12. Scheeringa MS. PTSD in children younger than the age of 13: toward developmentally sensitive assessment and management. J Child Adolesc Trauma. 2011;4(3):181–97. https://doi.org/10.1080/19361521.2011.597079. Friedman MJ. Finalizing PTSD in DSM-5: getting here from there and where to go next. J Trauma Stress. 2013;26(5):548–56. https://doi.org/10.1002/jts.21840. World Health Organization. ICD-11: International classification for mortality and morbidity statistics. Eleventh Revision. https://icd.who.int/browse11/l-m/en. 2018. •• Vasileva M, Haag AC, Landolt MA, Petermann F. Posttraumatic stress disorder in very young children: diagnostic agreement between ICD-11 and DSM-5. J Traum Stress. in press. This is the first study to examine the validity of the ICD-11 criteria for diagnosing PTSD in young children. Zero To Three. DC:0-5TM Diagnostic classification of mental health and developmental disorders of infancy and early childhood. Washington, DC: Author; 2016. Zeanah CH, Carter AS, Cohen J, Egger H, Gleason MM, Keren M, et al. Diagnostic classification of mental health and developmental disorders of infancy and early childhood DC:0-5: selective reviews from a new nosology for early childhood psychopathology. Infant Ment Health J. 2016;37(5):471–5. https://doi.org/10.1002/imhj.21591. •• Scheeringa MS, Zeanah CH, Cohen JA. PTSD in children and adolescents: toward an empirically based algorithm. Depress Anxiety. 2011;28(9):770–82. https://doi.org/10.1002/da.20736. An important review article commissioned by the DSM-V working groups to provide recommendations regarding the diagnosis of PTSD in preschool and school aged children and adolescents. Stoddard FJ, Saxe G, Ronfeldt H, Drake JE, Burns J, Edgren C, et al. Acute stress symptoms in young children with burns. J Am Acad Child Adolesc Psychiatry. 2006;45(1):87–93. Haag AC, Landolt MA. Young children's acute stress after a burn injury: disentangling the role of injury severity and parental acute stress. J Pediatr Psychol. 2017;42(8):861–70. https://doi.org/10.1093/jpepsy/jsx059. Meiser-Stedman R, Smith P, Glucksman E, Yule W, Dalgleish T. The posttraumatic stress disorder diagnosis in preschool- and elementary school-age children exposed to motor vehicle accidents. Am J Psychiatry. 2008;165(10):1326–37. Stoddard FJ Jr, Sorrentino E, Drake JE, Murphy JM, Kim AJ, Romo S, et al. Posttraumatic stress disorder diagnosis in young children with burns. J Burn Care Res. 2017;38(1):e343–e51. https://doi.org/10.1097/bcr.0000000000000386. •• De Young AC, Kenardy JA, Cobham VE. Diagnosis of posttraumatic stress disorder in preschool children. J Clin Child Adolesc Psychol. 2011;40(3):375–84. https://doi.org/10.1080/15374416.2011.563474. This study reported on the first empirical validation of the DSM-5 PTSD<6Y subtype in a sample of young burn-injured children. Scheeringa MS, Wright M, Hunt JP, Zeanah CH. Factors affecting the diagnosis and prediction of PTSD symptomatology in children and adolescents. Am J Psychiatr. 2006;163(4):644–51. Ohmi H, Kojima S, Awai Y, Kamata S, Sasaki K, Tanaka Y, et al. Post-traumatic stress disorder in pre-school aged children after a gas explosion. Eur J Pediatr. 2002;161(12):643–8. DeVoe ER, Bannon WM Jr, Klein TP. Post-9/11 helpseeking by New York City parents on behalf of highly exposed young children. Am J Orthopsychiatry. 2006;76(2):167–75. Scheeringa MS, Zeanah CH. Reconsideration of harm’s way: onsets and comorbidity patterns of disorders in preschool children and their caregivers following hurricane Katrina. J Clin Child Adolesc Psychol. 2008;37(3):508–18. Graf A, Schiestl C, Landolt MA. Posttraumatic stress and behavior problems in infants and toddlers with burns. 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The impact of intimate partner violence and additional traumatic events on trauma symptoms and PTSD in preschool-aged children. J Trauma Stress. 2012;25(4):393–400. https://doi.org/10.1002/jts.21724. •• Koolick J, Galano M, Grogan-Kaylor A, Clark H, Montalvo-Liendo N, Graham-Bermann S. PTSD symptoms in young children exposed to intimate partner violence in four ethno-racial groups. J Child Adolesc Trauma. 2016;9:97–107. This is the first study to examine differences in PTSD symptoms across different ethno-racial groups. Scheeringa MS, Zeanah CH, Myers L, Putnam F. Predictive validity in a prospective follow-up of PTSD in preschool children. J Am Acad Child Adolesc Psychiatry. 2005;44(9):899–906. •• Scheeringa MS, Myers L, Putnam FW, Zeanah CH. Diagnosing PTSD in early childhood: an empirical assessment of four approaches. J Trauma Stress. 2012;25:359–67. https://doi.org/10.1002/jts.21723. This study examined four diagnostic criteria sets and found support for the DSM-5 PTSD<6Y subtype. Vasileva M, Petermann F. Posttraumatic stress symptoms in preschool children in foster care: the influence of placement and foster family environment. J Trauma Stress. 2017;30(5):472–81. https://doi.org/10.1002/jts.22217. De Young AC, Kenardy JA, Cobham VE, Kimble R. Prevalence, comorbidity and course of trauma reactions in young burn-injured children. J Child Psychol Psychiatry. 2012;53(1):56–63. https://doi.org/10.1111/j.1469-7610.2011.02431.x. Weathers FW, Keane TM. The criterion a problem revisited: controversies and challenges in defining and measuring psychological trauma. J Traum Stress. 2007;20(2):107–21. https://doi.org/10.1002/jts.20210. Friedman MJ, Resick PA, Bryant RA, Brewin CR. Considering PTSD for DSM-5. Depress Anxiety. 2011;28(9):750–69. https://doi.org/10.1002/da.20767. Alisic E, Jongmans MJ, van Wesel F, Kleber RJ. Building child trauma theory from longitudinal studies: a meta-analysis. Clin Psychol Rev. 2011;31(5):736–47. https://doi.org/10.1016/j.cpr.2011.03.001. •• De Young AC, Hendrikz J, Kenardy JA, Cobham VE, Kimble RM. Prospective evaluation of parent distress following pediatric burns and identification of risk factors for young child and parent posttraumatic stress disorder. J Child Adolesc Psychopharmacol. 2014;24(1):9–17. https://doi.org/10.1089/cap.2013.0066. This studies identified important risk factors for PTSD development in young children. Brown EA, De Young A, Kimble R, Kenardy J. Review of a parent’s influence on pediatric procedural distress and recovery. Clin Child Fam Psychol Rev. 2018;21:224–45. https://doi.org/10.1007/s10567-017-0252-3. Helpman L, Rachamim L, Aderka IM, Gabai-Daie A, Schindel-Allon I, Gilboa-Schechtman E. Posttraumatic symptom structure across age groups. J Clin Child Adolesc Psychol. 2015;44(4):630–9. https://doi.org/10.1080/15374416.2014.883928. 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Mitchell KS, Wolf EJ, Bovin MJ, Lee LO, Green JD, Rosen RC, et al. Network models of DSM-5 posttraumatic stress disorder: implications for ICD-11. J Abnorm Psychol. 2017;126(3):355–66. https://doi.org/10.1037/abn0000252. •• McNally RJ, Robinaugh DJ, Wu GWY, Wang L, Deserno MK, Borsboom D. Mental disorders as causal systems: a network approach to posttraumatic stress disorder. Clin Psychol Sci. 2015;3(6):836–49. https://doi.org/10.1177/2167702614553230. This study presents an interesting and novel approach for conceptualising PTSD as a causal system of interacting symptoms.