Post-traumatic Stress Disorder (PTSD) in Children and Adolescents


ICD-10 Code: F43.10

Posttraumatic stress disorder (PTSD) is part of a cluster of diagnoses called the trauma and stressor-related disorders.  Trauma and stressor-related disorders are a group of psychiatric conditions that include:

  • Posttraumatic stress disorder
  • Acute stress disorder
  • Reactive attachment disorder

These disorders are characterized by an adverse reaction to one or more traumatic or unusually stressful experiences.  

 

The Diagnostic and Statistical Manual of Mental Disorders-5th Edition defines traumatic events as situations in which the individual experiences, is threatened with, or witnesses serious injury, death, or sexual violence.  Repeated exposure to extreme details of traumatic events as part of an individual’s employment (e.g., a police officer or social worker who regularly encounters details of child abuse) also qualifies as a traumatic event.   

PTSD and acute stress disorder are both characterized by a set of adverse cognitive, behavioral, and emotional changes that occur after experience of one or more traumatic events. Both disorders are characterized by intrusive and upsetting memories of the traumatic event(s), adverse cognitive and emotional changes (e.g., very negative beliefs about the world; persistent dysphoria or anger), avoidance behaviors (including avoiding thinking about the event), and increased autonomic reactivity.   Acute stress disorder is diagnosed when the symptoms occur in the month following the traumatic event.  PTSD is diagnosed when the symptoms persist for one month or longer following the traumatic event.

Reactive attachment disorder (RAD) is diagnosed only in children and is characterized by inhibited and emotionally withdrawn behaviors toward the child’s caregiver(s), along with other social and emotional disturbances.  RAD is an adverse reaction to neglect, repeated changes in caregivers (e.g., frequent changes in foster care), or rearing in adverse circumstances (e.g., institutions with inadequate availability of caregivers).

What is Post-traumatic Stress Disorder?

PTSD is a psychiatric disorder that affects approximately 1 - 9% of children and adolescents, depending on the population sampled.  The prevalence of traumatic events is significantly higher, affecting up to 39% of high-risk children and adolescents, and many children do not develop PTSD as a result of these experiences.

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Understanding Post-traumatic Stress Disorder

PTSD severity can range from mild to debilitating.  In severe cases, PTSD can lead to inability to go to school, or form or maintain satisfying relationships with peers or adults.  Many children with PTSD also have or go on to develop other psychiatric conditions, most commonly depressive disorders, substance use disorders, anxiety disorders, and externalizing disorders such as attention deficit/hyperactivity disorder and oppositional defiant disorder.

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How Is Post-traumatic Stress Disorder Treated?

PTSD is treatable.  Published treatment guidelines for PTSD include those from the Society of Clinical Child and Adolescent Psychology, the American Academy of Child and Adolescent Psychiatry, and the National Institute for Clinical Excellence.

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