Childhood Posttraumatic Stress Disorder

Posttraumatic stress disorder (PTSD) is a mental health condition that can develop in children and adolescents following exposure to traumatic events, such as natural disasters, motor vehicle accidents, mass shootings, or sexual violence. Unfortunately, trauma exposure is common: two-thirds of youth are estimated to experience a traumatic event by the time they reach adulthood. Although the majority of youth are resilient and do not develop clinically significant psychological problems after a traumatic event, some youth will develop PTSD following trauma exposure. This chapter provides an overview of PTSD in children and adolescents, including etiology, assessment, diagnosis, and treatment, as well as issues relevant to PTSD in children with disabilities. Specifically, the chapter discusses risk and resilience factors that contribute to the development of PTSD, including individual factors (e.g., gender, race, and genetics) and environmental factors (e.g., social support, family functioning, and life stress). Assessment and diagnosis of PTSD is explained, including an overview of DSM-5 and ICD-11 diagnostic criteria for PTSD. Diagnostic considerations, including challenges with diagnosing youth with intellectual disabilities, are detailed. Particular emphasis is placed on symptom profiles that vary depending on the developmental stage of the youth and the behavioral, emotional, cognitive, and interpersonal symptoms at different ages. An overview of empirically supported treatment approaches for PTSD is provided. Trauma-focused cognitive behavioral therapy is well-established for treating children and adolescents with PTSD; the components of this treatment are described. Other treatment approaches, including eye movement desensitization and reprocessing therapy and prolonged exposure therapy, are also discussed. Understanding how to identify and treat PTSD is an important component of working with youth with disabilities.