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

Published online by Cambridge University Press:  02 January 2018

Eva Alisic*
Monash Injury Research Institute, Monash University, Monash, Australia, and University Medical Centre, Utrecht, The Netherlands
Alyson K. Zalta
Departments of Psychiatry and Behavioral Sciences, Rush University Medical Center, Chicago, Illinois, USA
Floryt van Wesel
Department of Educational Neuroscience, VU University, Amsterdam, The Netherlands
Sadie E. Larsen
Clement J. Zablocki VA Medical Center, Department of Psychiatry, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
Gertrud S. Hafstad
Norwegian Centre for Violence and Traumatic Stress Studies, Oslo, Norway
Katayun Hassanpour
Department of Psychiatry and Psychotherapy, University Hospital, Zürich, Switzerland
Geert E. Smid
Foundation Centrum ‘45, Arq Research Program, Diemen, The Netherlands
Dr Eva Alisic, Monash Injury Research Institute, Building 70, Monash University, VIC 3800, Australia. Email:
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It is unclear how many children and adolescents develop post-traumatic stress disorder (PTSD) after trauma.


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.


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.


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.


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.

Review Article
Copyright © Royal College of Psychiatrists, 2014 


Declaration of interest



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