Posttraumatic stress disorder in early childhood: classification and diagnostic issues

Abstract

The 0–3 diagnostic classification of infant mental health, on the basis of DSM-IV-R, describes posttraumatic stress disorder (PTSD) as a pattern of symptoms that may be shown by children who have experienced a single traumatic event, a series of connected traumatic events, or chronic, enduring stress situations. This definition, related to young children, needs the consideration of several factors to understand the child's symptoms, organize the diagnostic process, and realize clinical interventions. In this sense, the clinician must appreciate the classification criteria of PTSD in early childhood in the context of the child's age, temperament, and developmental level. This report presents a review of the research in the domain of the PTSD in early childhood with particular attention to the developmental considerations to define critical diagnostic criteria, specifically organized on the child characteristics, competences, and needs. Along this line, it will describe two proposed modifications of the diagnostic classification in childhood: the Post Traumatic Stress Disorder Alternative Algorithm (PTSD-AA) and the definition of developmental trauma disorder (DTD).

The Role of Father Involvement and Marital Satisfaction in the Development of Family Interactive Abilities: A Multilevel Approach

“…Finally, with reference to Belsky’s (1984) model of parenting, the present study does not include other important factors, besides child normative and clinical characteristics detected by early assessment (Simonelli, 2013). Other factors include contextual sources regarding parent’s work and social support, and other adults’ variables, such as personality.…”

Current Psychopathological Symptoms in Children and Adolescents Who Suffered Different Forms of Maltreatment

“…A possible interpretation for this discrepancy is that PTSD diagnosis derived from criteria developed for adults (DSM-IV-TR) [ 33 ] and that these criteria may not accurately reflect responses to trauma in children. Indeed, PTSD criteria do not capture some reactions of infants and children, who suffered different forms of abuse, often experienced as developmental delays, complex disruption of affect regulation, disturbed attachment patterns, rapid behavioral regressions, and emotional shifting [ 45 ]. Accordingly, studies indicate low reliability of PTSD symptoms in children [ 46 , 47 ] and low diagnostic efficacy of arousal symptoms [ 48 ].…”

Anxiety Disorder in Children: Review

“…These children frequently try to avoid any activities related to the traumatic event. They also frequently suffer failure to progress or have regression in their developmental skills, such as toilet learning, language development, socializing, and learning in school; with difficult concentration [76,77]. Adolescents may have distressing dreams of the traumatic event or flashbacks to the traumatic event with persistent re-experiencing of the traumatic event, sometimes through risk-taking behavior with avoidance of activities related to the traumatic event.…”