Post-Traumatic Syndromes in Childhood and Adolescence: A Handbook of Research and Practice

By Vittoria Ardino | Go to book overview

Chapter One
Evaluation and Diagnosis of PTSD in
Children and Adolescents

Kathleen Nader


Introduction

While a more intensely focused attention on youths’ traumatic reactions began in the 1970s, debate continues about the exact nature of youths’ traumatic stress disorders (Nader, 2008a). Although the literature supports commonalities between disturbances in youths and in adults following traumatic events (House, 2002), reactions vary at different ages and in response to additional factors, such as aspects of the child, the nature and duration of the event, and pre- and post-trauma environments. Nevertheless, many of the scales that assess trauma in youths are based on adult diagnostic criteria and do not include the range of possible effects of trauma. Ideally, research and clinical assessments assist diagnosis and the production of treatment plans that are tailored to the needs of a youth (Cook et al., 2005; Kinniburgh & Spinazzola, 2005; Nader, 2008a). In order to engage in appropriate individualized treatment planning and an accurate understanding of trauma in youth, a greater range of variables must be examined.

Children appear to exhibit a wider range of associated symptoms than adults in their traumatic reactions (House, 2002). Studies have found children with subsyndromal but clinically significant Post-Traumatic Stress Disorder (PTSD) (Carrion et al., 2002; Daviss et al., 2000; Nader, 2008a; Olfson et al., 2001; Vila, Porsche, & Mouren-Simeoni, 1999). Additionally, for children, symptoms may have a number of developmental impacts. Traumatic events may disrupt a youth’s brain development, developmental skills, emerging personality traits, and budding skills (Nader, 2008b). For youths, diagnosing traumatic reactions

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