Background
DSM-IV [5] | PTSD-AA [6] | DSM-5, subtype for children 6 years and younger [1] |
---|---|---|
Criterion A1 | Criterion A1 | Criterion A1 |
Criterion A2: Response to event involves intense fear, helplessness or horror | Criterion A2 not required | Criterion A2 not required |
B. Intrusion (1 required) | B. Intrusion (1 required) | B. Intrusion (1 required) |
1. Recurrent and intrusive distressing recollections | 1. Recurrent and intrusive recollections, not required to be distressing | 1. Recurrent and intrusive recollections, not required to be distressing |
2. Recurrent distressing dreams of the event | 2. Recurrent distressing dreams of the event | 2. Recurrent distressing dreams of the event |
3. Dissociation (e.g., flashbacks) | 3. Dissociation (e.g., flashbacks) | 3. Dissociation (e.g., flashbacks) |
4. Intense psychological distress at reminders | 4. Intense psychological distress at reminders | 4. Intense psychological distress at reminders |
5. Physiological reactivity at reminders | 5. Physiological reactivity at reminders | 5. Physiological reactivity at reminders |
C. Avoidance/numbing (3 required) | C. Avoidance/numbing (1 required) | C. Avoidance/negative alterations in cognitions and mood (1 required) |
1. Efforts to avoid thoughts, feelings or conversations | 1. Efforts to avoid thoughts, feelings or conversations | 1. Efforts to avoid activities, places or physical reminders |
2. Efforts to avoid activities, places or people | 2. Efforts to avoid activities, places or people | 2. Efforts to avoid people, conversations or interpersonal situations |
3. Inability to recall an important aspect of the trauma | 3. Inability to recall an important aspect of the trauma | 3. Increased frequency of negative emotional states |
4. Diminished interests in significant activities | 4. Diminished interests, emphasize play constriction | 4. Diminished interests, including play constriction |
5. Feelings of detachment from others | 5. Socially withdrawn behavior | 5. Socially withdrawn behavior |
6. Restricted range of affect | 6. Restricted range of affect | 6. Reduction in expression of positive emotions |
7. Sense of foreshortened future | 7. Sense of foreshortened future | |
D. Hyperarousal (2 required) | D. Hyperarousal (2 required) | D. Hyperarousal (2 required) |
1. Difficulty falling or staying asleep | 1. Difficulty falling or staying asleep | 1. Difficulty falling or staying asleep |
2. Irritability, angry outbursts | 2. Irritability, includes excessive temper | 2. Irritability, angry outbursts, includes extreme temper tantrums |
3. Difficulty concentrating | 3. Difficulty concentrating | 3. Difficulty concentrating |
4. Hypervigilance | 4. Hypervigilance | 4. Hypervigilance |
5. Exaggerated startle response | 5. Exaggerated startle response | 5. Exaggerated startle response |
Method
Participants and procedure
Measures
Data analysis
Results
Sample characteristics
N (%) | Median | Mean (SD) | Min-Max | |
---|---|---|---|---|
Gender | ||||
Male | 67 (68.4) | -- | -- | -- |
Female | 31 (31.6) | -- | -- | -- |
Child age during accident | -- | 3 | 3.1 (2.2) | 0–7 |
Child age during interview | -- | 6 | 6.2 (2.7) | 1–13 |
Time between accident and interview (in months) | -- | 35 | 36.3 (20.6) | 4–69 |
Trauma type | ||||
Road traffic accident | 28 (28.6) | -- | -- | -- |
Fall | 49 (50.0) | -- | -- | -- |
Other, including burns and near drowning | 21 (21.4) | -- | -- | -- |
Total days in hospital including (P)ICUa
| 81 (81.0) | 1 | 4.7 (9.5) | 1–57 |
Total days on (P)ICUa
| 27 (27.0) | 1 | 3.6 (4.3) | 1–14 |
Posttraumatic stress symptoms
PTSD criterion or diagnosis | N (n = 9) | % (n = 9) | Prevalence rate % (n = 98) |
---|---|---|---|
Intrusion | 8 | 88 | -- |
Avoidance/numbing (DSM-IV; 3 symptoms) | 2 | 22 | -- |
Avoidance/numbing (PTSD-AA; 1 symptom) | 9 | 100 | -- |
Avoidance/negative alterations cognitions and mood (DSM-5; 1 symptom) | 9 | 100 | -- |
Hyperarousal | 8 | 88 | -- |
DSM-IV diagnosis | 2 | 22 | 2.0 |
PTSD-AA diagnosis | 7 | 77 | 7.1 |
DSM-5 diagnosis | 7 | 77 | 7.1 |
Substantial symptoms but no diagnosisa
| 2 | 22 | 2.0 |