CENTER’S PIECE: Diagnostic criteria for post-traumatic stress disorder in children outlined

It is felt that the public does not know or understand that Post-Traumatic Stress Disorder (PTSD) can occur in the lives of children. These children usually have been physically, emotionally, and/or sexually abused, neglected, abandoned, starved, not been cuddled or loved, a survivor of fire, famine or flood, a death of a parent, sibling or family member. The list can go and on. Thank goodness that modern medicine and science have made strides into understanding what PTSD is and how to treat it in our children.

The Clinical Team at Centers felt it was important to share the following information in the hope that it will shed some light on what trauma/PTSD guidelines actually are.

The 5th edition of the Diagnostic and Statistical Manual of Mental Disorders now includes specific guidelines for diagnosing PTSD in children under the age of 6 years. Listed below are the criteria for PTSD in children.

A. Children under 6 have been exposed to an event involving real or threatened death, serious injury or sexual violence in at least one of the following ways:

1. The child directly experienced the event.

2. The child personally witnessed the event;

3. The child learned about a traumatic event that happened to a sibling or friend.

B. The presence of at least one of the following intrusive symptoms that are associated with the trauma and became evident after the event occurred.

1. Recurring, spontaneous and intrusive memories.  

2. Dreams of the event.

3. Flashbacks or some dissociate response where the child seems to be acting out the event as if it was happening again.

4. Strong and long-lasting emotional distress after being reminded of the event or after seeing trauma-related cues.

5. Strong physical reactions, like increased heart rate or profuse sweating to trauma-related reminders.

C. The child exhibits at least one of the following avoidance symptoms or        changes in his or her thoughts and mood. These symptoms must begin or worsen after the experience of the traumatic event. Avoidance of or the attempted avoidance of activities, places or reminders that bring back thoughts about the traumatic event.

1. Avoidance of or the attempted avoidance of people, conversations or interpersonal situations that serve as reminders of the traumatic event.

2. More frequent negative emotional states such as fear, shame or sadness.

Increased lack of interest in activities that used to be meaningful.

4. Social withdrawal.

5. Long-standing reduction in the expression of positive emotions.

D. The child experiences at least one of the below changes in his or her arousal  or reactivity and these changes began or have worsened after the traumatic event:

1. Increased irritable behavior or angry outbursts.

2. Hypervigilance which consists of being on guard all the time and unable to relax.

3. Exaggerated startle response.

4. Difficulties concentrating.

5. Problems with sleeping.

In addition to the above criteria, these symptoms need to have lasted at least one month and result in considerable distress or difficulties in relationships or with school behaviors. The symptoms also cannot be better attributed to ingestion of a substance or to some other medical condition.

The new criteria for PTSD in young children can help improve our understanding of the post trauma responses in children, thus, paving the way for new treatments for young children who have been exposed to a traumatic event.

If your child has experienced any type of trauma, contact Centers at 432-570-1084 in Midland or 432-580-7006 in Odessa. Centers therapists have received extensive trainings/certifications in multiple modalities that have proven effective and reliable in helping in the healing process.