New findings on alternative criteria for PTSD in preschool children.
OBJECTIVE
An alternative set of criteria for posttraumatic stress disorder (PTSD) for preschool children was analyzed for validity.


METHODS
Sixty-two traumatized children and 63 healthy controls, aged 20 months through 6 years, were assessed. The traumatic experiences included motor vehicle collisions, accidental injuries, abuse, and witnessing violence. The number of symptoms required for clusters C and D and the utility of proposed symptoms were systematically analyzed.


RESULTS
No cases met the DSM-IV algorithm for PTSD. Cluster B was endorsed 67.9% of the time. The proportion of cases meeting the cluster C threshold was 2% when three symptoms were required, 11% when two symptoms were required, and 39% when one symptom was required. The rate of cluster D was 45% when two symptoms were required and 73% when one symptom was required. Four novel symptoms did not substantially add to the diagnostic validity of the criteria. The optimal algorithm (one cluster B symptom, one cluster C symptom, and two cluster D symptoms) diagnosed PTSD at a rate of 26%. Measures of comorbid symptoms concurrently provided convergent validation to support this revised algorithm.


CONCLUSIONS
Revisions to the DSM-IV PTSD criteria continue to be supported so that highly symptomatic young children can be diagnosed.
Scheeringa
Michael S
MS
Departments of Psychiatry and Neurology, Tulane University Health Sciences Center, 1440 Canal Street, TB52, New Orleans, LA 70112, USA. mscheer@tulane.edu
Zeanah
Charles H
CH
Myers
Leann
L
Putnam
Frank W
FW
D000465:Algorithms; D002648:Child; D002675:Child, Preschool; D016000:Cluster Analysis; D039721:Diagnostic and Statistical Manual of Mental Disorders; D005260:Female; D006801:Humans; D007223:Infant; D008016:Life Change Events; D008297:Male; D011569:Psychiatric Status Rating Scales; D015203:Reproducibility of Results; D013313:Stress Disorders, Post-Traumatic / Q000175:diagnosis*