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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.

Authors
  • Hitchcock, Caitlin1
  • Goodall, Benjamin1
  • Sharples, Olivia2
  • Meiser-Stedman, Richard3
  • Watson, Peter4
  • Ford, Tamsin5
  • Dalgleish, Tim6
  • 1 Medical Research Council Cognition and Brain Sciences Unit, University of Cambridge, United Kingdom; Cambridgeshire and Peterborough NHS Foundation Trust, Cambridge, United Kingdom. , (United Kingdom)
  • 2 University of Exeter, United Kingdom. , (United Kingdom)
  • 3 University of East Anglia, Norwich, United Kingdom. , (United Kingdom)
  • 4 Medical Research Council Cognition and Brain Sciences Unit, University of Cambridge, United Kingdom. , (United Kingdom)
  • 5 University of Cambridge, United Kingdom. , (United Kingdom)
  • 6 Medical Research Council Cognition and Brain Sciences Unit, University of Cambridge, United Kingdom; Cambridgeshire and Peterborough NHS Foundation Trust, Cambridge, United Kingdom. Electronic address: [email protected] , (United Kingdom)
Type
Published Article
Journal
Journal of the American Academy of Child and Adolescent Psychiatry
Publication Date
Oct 01, 2021
Volume
60
Issue
10
Identifiers
DOI: 10.1016/j.jaac.2020.12.036
PMID: 33667605
Source
Medline
Keywords
Language
English
License
Unknown

Abstract

Posttraumatic stress disorder (PTSD) is a debilitating condition that when left untreated can have severe lifelong consequences for psychological, social, and occupational functioning. Initial conceptualizations of PTSD were centered on adult presentations. However, the instantiation of developmentally appropriate PTSD in young children (PTSD-YC) criteria, tailored to preschool (6 years old and younger) children, represents an important step toward identifying more young children experiencing distress. This study explored population-level prevalence of PTSD-YC indexed via an alternative algorithm for DSM-IV PTSD (AA-PTSD). Representative population data were used to test whether application of AA-PTSD criteria, relative to the DSM-IV PTSD algorithm, increased identification of 5- to 6-year-old children with clinical needs in both the general population (n = 3,202) and among looked after children (ie, in Britain, foster children are called looked after children [more commonly referred to as children in care].) (n = 137), in whom the risk of mental health issues is greater. Notably, no 5- to 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-based DSM-IV criteria to 14% when using AA-PTSD criteria. Of trauma-exposed looked after children, 2.7% met criteria for DSM-IV PTSD compared with 57.0% when applying AA-PTSD criteria. In both samples, use of the alternative algorithm to index PTSD-YC criteria markedly increased identification of children experiencing functional impairment owing to symptoms. Results demonstrate the utility of the PTSD-YC diagnosis beyond at-risk and treatment-seeking samples. Use of PTSD-YC criteria substantially improves identification of 5- to 6-year-old children burdened by PTSD at the population level. Copyright © 2021 The Authors. Published by Elsevier Inc. All rights reserved.

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