Posttraumatic Stress Disorder in Young Children 3 Years Posttrauma: Prevalence and Longitudinal Predictors.
OBJECTIVE
Age-appropriate criteria for posttraumatic stress disorder (PTSD) in young children have been established. The present study investigated the long-term course of such PTSD and its predictors in young children.


METHODS
Young children (aged 2-10 years) and parents/caregivers who had attended emergency departments after motor vehicle collisions (MVCs) between May 2004 and November 2005 were assessed at 2 to 4 weeks and 6 months post-MVC; 71 families were re-interviewed 3 years post-MVC. Participants were assessed according to standard DSM-IV criteria for PTSD and a well-validated alternative algorithm for diagnosing PTSD in young children (PTSD-AA). Demographic, trauma-related, and parental mental health variables and intellectual ability were also assessed at baseline.


RESULTS
Using an "optimal-report" procedure (a positive diagnosis according to parent or child for older children, or just parent for younger children), 7.0% met criteria for DSM-IV PTSD and 16.9% for PTSD-AA at 3 years. Using parent report alone, these rates were 1.4% and 2.8%, respectively. Parent-child agreement for PTSD and PTSD-AA was no better than chance (Cohen κ = -0.03 and -0.04, respectively). Baseline parent posttraumatic stress relating to the child's trauma, and not trauma severity, was correlated with optimal-report child PTSD-AA at each assessment (r values = 0.29-0.31) and accounted for unique variance in logistic regression models of this outcome at each assessment.


CONCLUSIONS
PTSD-AA in young children can persist for years but is underrecognized by parents despite its being shaped to a large extent by parents' own acute traumatic stress in response to the child's trauma.
Department of Clinical Psychology, University of East Anglia, Norwich, NR4 7TJ, United Kingdom. r.meiser-stedman@uea.ac.uk.|Department of Clinical Psychology, University of East Anglia, Norwich, United Kingdom.
Richard
R
Meiser-Stedman
Institute of Psychiatry, Psychology and Neuroscience, King's College, London, United Kingdom.
Patrick
P
Smith
Institute of Psychiatry, Psychology and Neuroscience, King's College, London, United Kingdom.
William
W
Yule
Emergency Department, King's College Hospital, London, United Kingdom.
Edward
E
Glucksman
Medical Research Council Cognition & Brain Sciences Unit and Cambridgeshire and Peterborough NHS Foundation Trust, Cambridge, United Kingdom.
Tim
T
Dalgleish
D000063:Accidents, Traffic / Q000523:psychology*; D000465:Algorithms; D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D007406:Interview, Psychological; D008016:Life Change Events; D008137:Longitudinal Studies; D008297:Male; D011379:Prognosis; D057566:Self Report; D013313:Stress Disorders, Post-Traumatic / Q000175:diagnosis* / Q000453:epidemiology* / Q000523:psychology