Some manifestations of PTSD unique to children would include the loss of recently acquired developmental skills (regression), onset of new fears or re-activation of old ones, separation anxiety, and increases in agitation, impulsive behavior and hyperactivity that may easily be confused with ADHD. Kids presenting with suspected PTSD frequently exhibit symptoms that weren’t captured in the previous diagnostic criteria.Most preschool-age children lack the language skills to accurately describe their internal experiences. Nearly half of the diagnostic criteria in the DSM-IV required a verbal description of the patient’s internal states and experiences.Two large concerns led to the establishment of a unique set of criteria for younger children… Structured diagnostic interviews include measures to detect PTSD in children, but such interviews are rarely administered outside academic medical centers. While the fear some conditions were being diagnosed too frequently in children (see our discussions of bipolar disorder and disruptive mood dysregulation disorder), many leading clinicians in the field raised concerns that in addition to the potential for overdiagnosis, PTSD may be underdiagnosed, or misdiagnosed as some other condition. Most importantly for the sake of our discussion, the symptom thresholds for establishing a diagnosis in children and teens have been changed to take into account differences in the ways that trauma is manifested in kids, and a unique set of diagnostic criteria have been established for identification of PTSD in kids ages six and under. Four symptom clusters for PTSD are now identified as opposed to three…intrusion symptoms (nightmares, flashbacks), avoidance, persistent negative alterations in cognitions and mood and alterations in arousal and reactivity.The types of exposures leading to PTSD were better delineated…direct experience of the event, witnessing (in person) the event as it occurred to others, learning that the traumatic event(s) occurred to a close family member or friend, and experience of repeated or extreme exposure to aversive detail(s) of the traumatic event(s)-this applies to first responders as opposed to those experiencing the event through media exposure.Sexual violence was identified as a specific threat under experiences that qualify as “traumatic” in addition to actual or threatened death and serious injury.In today’s installment of our blog series… Dissecting the DSM-5…What it Means for Kids and Families, we’ll explore the changes made in diagnostic criteria for Posttraumatic Stress Disorder (PTSD) and review how the changes are intended to provide clinicians with developmentally-sensitive tools to better identify the signs of trauma in children and teens.Īs past of the DSM-5 review process, the diagnostic criteria for Posttraumatic Stress Disorder underwent significant revisions…
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