Diagnosis Criteria for PTSD in Children
PTSD (post-traumatic stress disorder) can occur in people of all ages who live through traumatic situations or events. However, young children exposed to such events/situations may not have the same reactions to trauma as older children, teenagers or adults. For this reason, guidelines from the American Psychiatric Association require doctors to use different criteria when diagnosing PTSD in children under the age of seven.
Childhood PTSD Essentials
The National Center for PTSD reports that no one really knows how many young children develop diagnosable symptoms of post-traumatic stress disorder. However, figures indicate that roughly 5% of all teenagers will qualify for such a diagnosis at some point in time. Risks for the disorder in this age group are more than three times higher for girls than for boys. In addition, teenage girls’ chances of developing PTSD increase as they grow older. Like adults, adolescents and children share several common sources of traumatic stress. These sources include:
- Sexual assault/abuse
- Physical assault/abuse
- Exposure to fires, floods or other types of major disasters
- Major accidents, and
- Major illnesses
Unfortunately, in the modern world, increasing numbers of children can also face trauma caused by exposure to school shootings.
Diagnostic Criteria for Young Children
PTSD is only diagnosed a month or more after trauma exposure. (Symptoms that appear earlier may qualify for a diagnosis of acute stress disorder, or ASD). Classic symptoms of post-traumatic stress fall into several broad categories, including:
- Some form of reliving or re-experiencing of the source of trauma
- An urge to avoid anything that could reignite memories of a traumatic event, and
- An inability to control or turn off the “fight-or-flight” instinct activated by trauma exposure
When diagnosing PTSD in children under the age of seven, doctors must follow a more specific checklist. Some of the main items on this list include:
- Memories of a traumatic event that may surface as a form of play instead of causing clear personal distress
- Repeated, frightening dreams that may or may not seem connected to the source of trauma
- Repeated reactions to a traumatic event that may seem like normal play or take a more obvious serious form (up to and including a loss of any active response to current surroundings)
- Extreme or extended mental/emotional distress when exposed to a trauma reminder, and
- Clear physical reactions to a trauma reminder
At least one of these problems must be present for a PTSD diagnosis. A young child must also have at least two symptoms of an overactive fight-or-flight response (e.g., sleeping difficulties, jumpiness or angry/aggressive outbursts). In addition, when diagnosing PTSD in this age group, doctors look for dysfunctional changes in children’s normal relationships with their parents, siblings, friends, classmates or teachers.
U.S. Department of Veterans Affairs – National Center for PTSD: PTSD in Children and Adolescents
Anxiety and Depression Association of America: PTSD Symptoms in Children Age Six and Younger
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