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Population prevalence of the posttraumatic stress disorder subtype for young children in nationwide surveys of the British general population and of children-in-care
HITCHCOCK, C., GOODALL, B., Sharples, o., Meiser-Stedman, R., WATSON, P., Ford, T., DALGLEISH, T.
Journal of the American Academy of Child and Adolescent Psychiatry, 60(10), 1278-1287 e3
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Objective: Posttraumatic stress disorder (PTSD) is a debilitating condition which when left untreated, can have severe life-long consequences for an individual’s psychological, social and occupational functioning. Initial conceptualizations of PTSD were centered on adult presentations. However, the instantiation of developmentally appropriate PTSD for Young Children (PTSD-YC) criteria, tailored to preschool (aged 6 years old and under) children, represents an important step towards identifying more young children experiencing distress. Here we explore population-level prevalence of PTSD-YC, indexed via the Alternative Algorithm for PTSD (AA-PTSD). Method: We utilize population-representative data to test whether application of AA-PTSD criteria, relative to the DSM-IV PTSD algorithm, increases identification of 5-6 year old children with clinical needs, in both the general population (N=3202), and among looked-after-children (i.e., children-in-care; N=137) where the risk of mental health issues is greater. Results: Notably, no 5-6 year old children in the general population sample were diagnosed with PTSD using adult-based DSM-IV criteria. In contrast, AA-PTSD prevalence was 0.4% overall, rising to 5.4% in trauma-exposed children. In looked-after-children, overall PTSD prevalence rose from 1.2% when applying adult-led DSM-IV criteria to 14% when using AA-PTSD. Of trauma-exposed looked-after-children, 2.7% met criteria for DSM-IV PTSD, compared to 57.0% when applying AA-PTSD. In both samples, use of the Alternative Algorithm to index PTSD-YC criteria markedly increased identification of children experiencing functional impairment due to symptoms. Conclusion: Results demonstrate the utility of the PTSD-YC diagnosis beyond at-risk and treatment-seeking samples. Use of PTSD-YC criteria very substantially improves identification of 5-6 year old children burdened by PTSD at the population-level.
Data for this project is available at: