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Rates of post-traumatic stress disorder in trauma-exposed children and adolescents: meta-analysis

  • Eva Alisic (a1), Alyson K. Zalta (a2), Floryt van Wesel (a3), Sadie E. Larsen (a4), Gertrud S. Hafstad (a5), Katayun Hassanpour (a6) and Geert E. Smid (a7)...
Abstract
Background

It is unclear how many children and adolescents develop post-traumatic stress disorder (PTSD) after trauma.

Aims

To determine the incidence of PTSD in trauma-exposed children and adolescents as assessed with well-established diagnostic interviews and to examine potential moderators of the estimate.

Method

A systematic literature search identified 72 peer-reviewed articles on 43 independent samples (n = 3563). Samples consisting only of participants seeking or receiving mental health treatment were excluded. Main analyses involved pooled incidence estimates and meta-analyses of variance.

Results

The overall rate of PTSD was 15.9% (95% CI 11.5–21.5), which varied according to the type of trauma and gender. Least at risk were boys exposed to non-interpersonal trauma (8.4%, 95% CI 4.7–14.5), whereas girls exposed to interpersonal trauma showed the highest rate (32.9%, 95% CI 19.8–49.3). No significant difference was found for the choice of assessment interview or the informant of the assessment.

Conclusions

Research conducted with the best available assessment instruments shows that a significant minority of children and adolescents develop PTSD after trauma exposure, with those exposed to interpersonal trauma and girls at particular risk. The estimates provide a benchmark for DSM-5 and ICD-11.

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Copyright
Corresponding author
Dr Eva Alisic, Monash Injury Research Institute, Building 70, Monash University, VIC 3800, Australia. Email: eva.alisic@monash.edu
Footnotes
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Declaration of interest

None.

Footnotes
References
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1 Yule, W. Posttraumatic stress disorder in the general population and in children. J Clin Psychiatry 2001; 17: 23–8.
2 Fletcher, KE. Childhood posttraumatic stress disorder. In Child Psychopathology (eds Mash, EJ, Barkley, RA): 330–71. Guilford, 2003.
3 Copeland, WE, Keeler, G, Angold, A, Costello, EJ. Traumatic events and posttraumatic stress in childhood. Arch Gen Psychiatry 2007; 64: 577–84.
4 Nooner, KB, Linares, LO, Batinjane, J, Kramer, RA, Silva, R, Cloitre, M. Factors related to posttraumatic stress disorder in adolescence. Trauma Violence Abuse 2012; 13: 153–66.
5 Dyregrov, A, Yule, W. A review of PTSD in children. Child Adolesc Ment Health 2006; 11: 176–84.
6 Tolin, DF, Foa, EB. Sex differences in trauma and posttraumatic stress disorder: a quantitative review of 25 years of research. Psychol Bull 2006; 132: 959–92.
7 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: 1326–37.
8 Dyb, G, Holen, A, Braenne, K, Indredavik, MS, Aarseth, J. Parent-child discrepancy in reporting children's post-traumatic stress reactions after a traffic accident. Nord J Psychiatry 2003; 57: 339–44.
9 Richardson, LK, Frueh, BC, Acierno, R. Prevalence estimates of combat-related post-traumatic stress disorder: critical review. Aust NZ J Psychiatry 2010; 44: 419.
10 Ohan, JL, Myers, K, Collett, BR. Ten-year review of rating scales. IV: Scales assessing trauma and its effects. J Am Acad Child Adolesc Psychiatry 2002; 41: 1401–22.
11 Hawkins, SS, Radcliffe, J. Current measures of PTSD for children and adolescents. J Pediatr Psychol 2006; 31: 420–30.
12 Nader, K, Kriegler, JA, Blake, DD, Pynoos, RS, Newman, E, Weather, FW. Clinician Administered PTSD Scale, Child and Adolescent Version. National Center for PTSD, 1996.
13 Silverman, WK, Albano, AM. ADIS: Anxiety Disorders Interview Schedule for DSM-IV: Child version. Psychological Corporation, 1996.
14 Reich, W, Leacock, N, Shanfield, C. Diagnostic Interview for Children and Adolescents – Revised (DICA-R). Washington University, 1994.
15 Kaufman, J, Birmaher, B, Brent, D, Rao, U, Flynn, C, Moreci, P, et al. Schedule for Affective Disorder and Schizophrenia for School-Age Children – Present and Lifetime Version (K-SADS-PL): initial reliability and validity data. J Am Acad Child Adolesc Psychiatry 1997; 36: 980–8.
16 Saigh, PA, Yasik, AE, Oberfield, RA, Green, BL, Halamandaris, PV, Rubenstein, H, et al. The Children's PTSD Inventory: development and reliability. J Trauma Stress 2000; 13: 369–80.
17 Alisic, E, Jongmans, MJ, van Wesel, F, Kleber, RJ. Building child trauma theory from longitudinal studies: a meta-analysis. Clin Psychol Rev 2011; 31: 736–47.
18 Brosbe, MS, Hoefling, K, Faust, J. Predicting posttraumatic stress following pediatric injury: a systematic review. J Pediatr Psychol 2011; 36: 718–29.
19 Cox, CM, Kenardy, JA, Hendrikz, JK. A meta-analysis of risk factors that predict psychopathology following accidental trauma. J Spec Pediatr Nurs 2008; 13: 98110.
20 Furr, JM, Comer, JS, Edmunds, JM, Kendall, PC. Disasters and youth: a meta-analytic examination of posttraumatic stress. J Consult Clin Psychol 2010; 78: 765–80.
21 Kahana, SY, Feeny, NC, Youngstrom, EA, Drotar, D. Posttraumatic stress in youth experiencing illnesses and injuries: an exploratory meta-analysis. Traumatology 2006; 12: 148–61.
22 Trickey, D, Siddaway, AP, Meiser-Stedman, R, Serpell, L, Field, AP. A meta-analysis of risk factors for post-traumatic stress disorder in children and adolescents. Clin Psychol Rev 2012; 32: 122–38.
23 Wilson, DB. Meta-analysis Macros for SAS, SPSS, and Stata 2006. http://mason.gmu.edu/~dwilsonb/ma.html.
24 Lipsey, MW, Wilson, DB. Practical Meta-analysis. Sage, 2001.
25 Wechsler-Zimring, A, Kearney, CA. Posttraumatic stress and related symptoms among neglected and physically and sexually maltreated adolescents. J Trauma Stress 2011; 24: 601–4.
26 Hoven, CW, Duarte, CS, Lucas, CP, Wu, P, Mandell, DJ, Goodwin, RD, et al. Psychopathology among New York City public school children 6 months after September 11. Arch Gen Psychiatry 2005; 62: 545–52.
27 Olff, M, Langeland, W, Draijer, N, Gersons, BP. Gender differences in posttraumatic stress disorder. Psychol Bull 2007; 133: 183204.
28 Santiago, PN, Ursano, RJ, Gray, CL, Pynoos, RS, Spiegel, D, Lewis-Fernandez, R, et al. A systematic review of PTSD prevalence and trajectories in DSM-5 defined trauma exposed populations: intentional and non-intentional traumatic events. PLoS One 2013; 8: e59236.
29 Freyd, JJ. Betrayal Trauma. The Logic of Forgetting Childhood Abuse. Harvard University Press, 1996.
30 Janoff-Bulman, R. Shattered Assumptions: Towards a New Psychology of Trauma. Free Press, 1992.
31 Kessler, RC. Posttraumatic stress disorder: the burden to the individual and to society. J Clin Psychiatry 2000; 5: 412.
32 Saigh, PA, Mroueh, M, Bremner, JD. Scholastic impairments among traumatized adolescents. Behav Res Ther 1997; 35: 429–36.
33 Seng, JS, Graham-Bermann, SA, Clark, MK, McCarthy, AM, Ronis, DL. Posttraumatic stress disorder and physical comorbidity among female children and adolescents: results from service-use data. Pediatrics 2005; 116: e76776.
34 Hankin, BL, Abramson, LY, Moffitt, TE, Silva, PA, McGee, R, Angell, KE. Development of depression from preadolescence to young adulthood: emerging gender differences in a 10-year longitudinal study. J Abnorm Psychol 1998; 107: 128–40.
35 Wittchen, HU, Schonfeld, S, Thurau, C, Trautmann, S, Galle, M, Mark, K, et al. Prevalence, incidence and determinants of PTSD and other mental disorders: design and methods of the PID-PTSD+3 study. Int J Methods Psychiatr Res 2012; 21: 98116.
36 Rosner, R, Arnold, J, Groh, EM, Hagl, M. Predicting PTSD from the Child Behavior Checklist: data from a field study with children and adolescents in foster care. Child Youth Serv Rev 2012; 34: 1689–94.
37 Lemos-Miller, A, Kearney, CA. Depression and ethnicity as intermediary variables among dissociation, trauma-related cognitions, and PTSD symptomatology in youths. J Nerv Ment Dis 2006; 194: 584–90.
38 Suliman, S, Kaminer, D, Seedat, S, Stein, D. Assessing post-traumatic stress disorder in South African adolescents: using the child and adolescent trauma survey (CATS) as a screening tool. Ann Gen Psychiatry 2005; 4: 2.
39 Thompson, SG, Higgins, JP. How should meta-regression analyses be undertaken and interpreted? Stat Med 2002; 21: 1559–73.
40 Finkelhor, D, Ormrod, RK, Turner, HA. Lifetime assessment of poly-victimization in a national sample of children and youth. Child Abuse Negl 2009; 33: 403–11.
41 Merikangas, KR, Swanson, SA. Comorbidity in anxiety disorders. Curr Top Behav Neurosci 2010; 2: 3759.
42 Elhai, JD, Miller, ME, Ford, JD, Biehn, TL, Palmieri, PA, Frueh, BC. Posttraumatic stress disorder in DSM-5: estimates of prevalence and symptom structure in a nonclinical sample of college students. J Anxiety Disord 2012; 26: 5864.
43 Scheeringa, MS. Developmental considerations for diagnosing PTSD and acute stress disorder in preschool and school-age children. Am J Psychiatry 2008; 165: 1237–9.
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Rates of post-traumatic stress disorder in trauma-exposed children and adolescents: meta-analysis

  • Eva Alisic (a1), Alyson K. Zalta (a2), Floryt van Wesel (a3), Sadie E. Larsen (a4), Gertrud S. Hafstad (a5), Katayun Hassanpour (a6) and Geert E. Smid (a7)...
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