Rates of post-traumatic stress disorder in trauma-exposed children and adolescents: meta-analysis.
BACKGROUND
It is unclear how many children and adolescents develop post-traumatic stress disorder (PTSD) after trauma.


OBJECTIVE
To determine the incidence of PTSD in trauma-exposed children and adolescents as assessed with well-established diagnostic interviews and to examine potential moderators of the estimate.


METHODS
A systematic literature search identified 72 peer-reviewed articles on 43 independent samples (n = 3563). Samples consisting only of participants seeking or receiving mental health treatment were excluded. Main analyses involved pooled incidence estimates and meta-analyses of variance.


RESULTS
The overall rate of PTSD was 15.9% (95% CI 11.5-21.5), which varied according to the type of trauma and gender. Least at risk were boys exposed to non-interpersonal trauma (8.4%, 95% CI 4.7-14.5), whereas girls exposed to interpersonal trauma showed the highest rate (32.9%, 95% CI 19.8-49.3). No significant difference was found for the choice of assessment interview or the informant of the assessment.


CONCLUSIONS
Research conducted with the best available assessment instruments shows that a significant minority of children and adolescents develop PTSD after trauma exposure, with those exposed to interpersonal trauma and girls at particular risk. The estimates provide a benchmark for DSM-5 and ICD-11.
Eva Alisic, PhD, Monash Injury Research Institute, Monash University, Monash, Australia, and University Medical Centre, Utrecht, The Netherlands; Alyson K. Zalta, PhD, Departments of Psychiatry and Behavioral Sciences, Rush University Medical Center, Chicago, Illinois, USA; Floryt van Wesel, PhD, Department of Educational Neuroscience, VU University, Amsterdam, The Netherlands; Sadie E. Larsen, PhD, Clement J. Zablocki VA Medical Center, Department of Psychiatry, Medical College of Wisconsin, Milwaukee, Wisconsin, USA; Gertrud S. Hafstad, PhD, Norwegian Centre for Violence and Traumatic Stress Studies, Oslo, Norway; Katayun Hassanpour, MD, Department of Psychiatry and Psychotherapy, University Hospital, Zürich, Switzerland; Geert E. Smid, MD, PhD, Foundation Centrum '45, Arq Research Program, Diemen, The Netherlands.
Eva
E
Alisic
Alyson K
AK
Zalta
Floryt
F
van Wesel
Sadie E
SE
Larsen
Gertrud S
GS
Hafstad
Katayun
K
Hassanpour
Geert E
GE
Smid
D000293:Adolescent; D002648:Child; D005260:Female; D006801:Humans; D015994:Incidence; D008016:Life Change Events; D008297:Male; D015995:Prevalence; D013313:Stress Disorders, Post-Traumatic / Q000453:epidemiology*