There are no specific criteria for PTSD with onset in childhood. DSM-IV notes that children's responses to severe trauma may be more disorganized than adults and can involve agitated behaviour. However, the diagnosis is made using the adult criteria, even in young children. Thus children or adolescents must have been exposed to a traumatic event, such as an actual or near-death experience or serious injury, and their response should include intense fear, helplessness, or horror. The event must be persistently remembered and 'relived' with concomitant distress, particularly (but not exclusively) when current circumstances are associated with the original event.
Until 15 years ago it was widely considered that children mainly responded to acute traumatic events with a transient brief reaction. However, data on the full syndrome in childhood have only recently been available following direct interviews with children and adolescents, rather than relying solely on parental or other adult reports.
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