Comparing three diagnostic algorithms of posttraumatic stress in young children exposed to accidental trauma: an exploratory study

Chinese Medicine

Ramón J. L. Lindauer¹  Eva Alisic³  Els P. M. van Meijel¹  Maj R. Gigengack² 

[1] de Bascule, Academic Center for Child and Adolescent Psychiatry, Meibergdreef 5, Amsterdam, 1105 AZ, The Netherlands;Department of Child and Adolescent Psychiatry, Academic Medical Center, University of Amsterdam, Meibergdreef 5, Amsterdam, 1105 AZ, The Netherlands;Monash Injury Research Institute, Monash University, Building 70, 21 Alliance Lane-Monash University, Clayton Campus, Melbourne 3800, VIC, Australia

关键词: DSM-5;    Accident;    Preschool;    Young children;    Posttraumatic stress disorder;   

Others  :  1220367
DOI  :  10.1186/s13034-015-0046-7

 received in 2014-12-19, accepted in 2015-05-06,  发布年份 2015

【 摘 要 】

Background

Both the DSM-5 algorithm for posttraumatic stress disorder (PTSD) in children 6 years and younger and Scheeringa’s alternative PTSD algorithm (PTSD-AA) aim to be more developmentally sensitive for young children than the DSM-IV PTSD algorithm. However, very few studies compared the three algorithms simultaneously. The current study explores diagnostic outcomes of the three algorithms in young child survivors of accidental trauma.

Methods

Parents of 98 young children (0–7 years) involved in an accident between 2006 and 2012 participated in a semi-structured telephone interview. Child posttraumatic stress symptoms (PTSS) were measured with the Anxiety Disorders Interview Schedule for DSM-IV-Child Version (ADIS-C/P), complemented with items from the Diagnostic Infant and Preschool Assessment (DIPA). Descriptive statistics were used to analyze the characteristics of the children, accident related information and PTS symptoms. We compared the three PTSD algorithms in order to explore the diagnostic outcomes.

Results

A total of 9 of the children (9.2 %) showed substantial PTSS. Of these children 2 met the criteria of all three algorithms, 7 met both the DSM-5 subtype for children 6 years and younger and the PTSD-AA algorithm, and 2 did not fully meet any of the algorithms (subsyndromal PTSD).

Conclusions

For young children, the DSM-5 subtype for children 6 years and younger and the PTSD-AA algorithm appear to be better suited than the previous DSM-IV algorithm. It remains important that clinicians pay attention to children with subsyndromal PTSD.

【 授权许可】

   
2015 Gigengack et al.; licensee BioMed Central.

【 参考文献 】

• [1]Diagnostic and statistical manual of mental disorders (5th ed.). Author, Arlington, VA; 2013.
• [2]Postert C, Averbeck-Holocher M, Beyer T, Muller J, Furniss T. Five systems of psychiatric classification for preschool children: do differences in validity, usefulness and reliability make for competitive or complimentary constellations? Child Psychiatry Hum Dev. 2009; 40(1):25-41.
• [3]De Young AC, Kenardy JA, Cobham VE. Trauma in early childhood: a neglected population. Clin Child Fam Psychol Rev. 2011; 14(3):231-250.
• [4]Scheeringa MS, Zeanah CH, Drell MJ, Larrieu JA. Two approaches to the diagnosis of posttraumatic stress disorder in infancy and early childhood. J Am Acad Child Adolesc Psychiatry. 1995; 34(2):191-200.
• [5]Diagnostic and statistical manual of mental disorders (4th ed., text rev.). Author, Washington, DC; 2000.
• [6]Scheeringa MS, Myers L, Putnam FW, Zeanah CH. Diagnosing PTSD in early childhood: An empirical assessment of four approaches. J Trauma Stress. 2012; 25(4):359-367.
• [7]Scheeringa MS, Zeanah CH, Myers L, Putnam FW. New findings on alternative criteria for PTSD in preschool children. J Am Acad Child Adolesc Psychiatry. 2003; 42(5):561-570.
• [8]Scheeringa MS, Zeanah CH, Myers L, Putnam FW. Predictive validity in a prospective follow-up of PTSD in preschool children. J Am Acad Child Adolesc Psychiatry. 2005; 44(9):899-906.
• [9]Friedman MJ. Finalizing PTSD in DSM-5: getting here from there and where to go next. J Trauma Stress. 2013; 26(5):548-556.
• [10]Breslau N, Kessler RC. The stressor criterion in DSM-IV posttraumatic stress disorder: an empirical investigation. Biol Psychiatry. 2001; 50(9):699-704.
• [11]Friedman MJ, Resick PA, Bryant RA, Brewin CR. Considering PTSD for DSM-5. Depress Anxiety. 2011; 28(9):750-769.
• [12]Alisic E, Jongmans MJ, van Wesel F, Kleber RJ. Building child trauma theory from longitudinal studies: a meta-analysis. Clin Psychol Rev. 2011; 31(5):736-747.
• [13]De Young AC, Kenardy JA, Cobham VE. Diagnosis of posttraumatic stress disorder in preschool children. J Clin Child Adolesc Psychol. 2011; 40(3):375-384.
• [14]Meiser-Stedman R, Smith P, Glucksman E, Yule W, Dalgleish T. The posttraumatic stress disorder diagnosis in preschool- and elementary school-age children exposed to motor vehicle accidents. Am J Psychiatry. 2008; 165(10):1326-1337.
• [15]Beer R, Verlinden E, Boer F, Lindauer R: Protocol: Classificatie, screening en diagnostiek van kinderen en adolescenten met traumagerelateerde problematiek. Kenniscentrum kinder- en jeugdpsychiatrie [http://www.kenniscentrum-kjp.nl/app/webroot/files/tmpwebsite/Downloadables_trauma_en_kindermishandeling_bijlagen/diagnostiekprotocol_versie_2011_3.pdf].
• [16]Siebelink BM, Treffers PDA. Nederlandse bewerking van het Anxiety Disorder Interview Schedule for DSM-IV: Child version (Parent interview schedule). Swets & Zeitlinger, Lisse/Amsterdam; 2001.
• [17]Silverman WK, Albano AM. Anxiety Disorders Interview Schedule for DSM-IV Child Version. The Psychological Corporation, San Antonio; 1996.
• [18]Silverman WK, Saavedra LM, Pina AA. Test-retest reliability of anxiety symptoms and diagnoses with the Anxiety Disorders Interview Schedule for DSM-IV: child and parent versions. J Am Acad Child Adolesc Psychiatry. 2001; 40(8):937-944.
• [19]Lyneham HJ, Abbott MJ, Rapee RM. Interrater reliability of the Anxiety Disorders Interview Schedule for DSM-IV: child and parent version. J Am Acad Child Adolesc Psychiatry. 2007; 46(6):731-736.
• [20]Scheeringa MS, Haslett N. The reliability and criterion validity of the Diagnostic Infant and Preschool Assessment: a new diagnostic instrument for young children. Child Psychiatry Hum Dev. 2010; 41(3):299-312.
• [21]McLaughlin KA, Koenen KC, Friedman MJ, Ruscio AM, Karam EG, Shahly V et al.. Subthreshold posttraumatic stress disorder in the world health organization world mental health surveys. Biol Psychiatry. 2015; 77(4):375-384.
• [22]Scheeringa MS, Wright MJ, Hunt JP, Zeanah CH. Factors affecting the diagnosis and prediction of PTSD symptomatology in children and adolescents. Am J Psychiatry. 2006; 163(4):644-651.
• [23]Angold A, Costello EJ, Farmer EM, Burns BJ, Erkanli A. Impaired but undiagnosed. J Am Acad Child Adolesc Psychiatry. 1999; 38(2):129-137.
• [24]Aziz MA, Kenford S. Comparability of telephone and face-to-face interviews in assessing patients with posttraumatic stress disorder. J Psychiatr Pract. 2004; 10(5):307-313.
• [25]Rohde P, Lewinsohn PM, Seeley JR. Comparability of telephone and face-to-face interviews in assessing axis I and II disorders. Am J Psychiatry. 1997; 154(11):1593-1598.