The wording of two symptoms was modified to enhance face validity and symptom detection. The symptoms of "sense of a foreshortened future" and "inability to recall an important aspect of the event" were deleted because of the developmental challenges in manifesting and/or detecting them. The symptoms of "loss of interests," "restricted range of affect," "detachment from loved ones," and "avoidance of thoughts or feelings related to the trauma" manifest in young children but are consistently ranked as some of the least frequent among the PTSD symptoms (15). The number of these symptoms that are possible to detect is simply fewer compared to adults. The major change was to require only one symptom in either the avoidance symptoms or negative alterations in cognitions and mood, instead of the DSM-IV threshold of three symptoms. Furthermore, there were no differences in PTSD severity for those with overtly distressing recollections compared to those who showed other emotions with their recollections.Īvoidance symptoms and negative alterations in cognitions and moodīecause many of the avoidance and negative cognition symptoms are highly internalized phenomena, the most significant changes in the criteria for preschool children are in this section While distressed reactions are common, parents also commonly reported no affect or what appeared to be excitement (6). Some children were neutral or "over bright" (2,13). Research showed empirically that preschool children do not always manifest overt distress with their intrusive, unwanted thoughts. " required three conditions: (1) recurrent, (2) intrusive, and (3) distressing. The old symptom of "recurrent and intrusive distressing recollections of the event. The change to the re-experiencing symptoms is a relatively minor change in wording to increase face validity and, thereby, lower the symptom detection threshold. This criterion, which has been shown to lack predictive validity for both adult (14) and preschool populations (6), has also been deleted for the regular PTSD criteria in DSM-5. If children were too young to verbalize their acute reactions to traumatic experiences, and there were no adults present to witness their reactions, there was no feasible way to know about these reactions. Immediate reaction to traumatic event criterionThe criterion that the children's reactions at the time of the traumatic events showed extreme distress has been deleted. How is the diagnosis different in preschool PTSD?īecause young children have emerging abstract cognitive and verbal expression capacities, research has shown that the criteria need to be more behaviorally anchored and developmentally sensitive to detect PTSD in preschool children (2,13). Young children are exposed to many types of traumatic experiences, placing them at risk for PTSD. What types of trauma do young children experience?
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