![]() ![]() The text that accompanies the criteria also points out that developmentally inappropriate sexual experiences without the experience of physical violence or injury are represent sufficient trauma to produce symptoms of PTSD. Passive reduction in expression of positive emotions. ![]() Constriction of play as an example of a negative alteration in cognition.Intrusive memories (flashbacks) may not necessarily appear distressing and may be expressed through reenactment in play.Specifically, the new criteria point out that… The new criteria for young children call attention to the differences in how PTSD may manifest in this population. Some manifestations of PTSD unique to children would include the loss of recently acquired developmental skills (regression), onset of new fears or re-activation of old ones, separation anxiety, and increases in agitation, impulsive behavior and hyperactivity that may easily be confused with ADHD. Kids presenting with suspected PTSD frequently exhibit symptoms that weren’t captured in the previous diagnostic criteria.Most preschool-age children lack the language skills to accurately describe their internal experiences. Nearly half of the diagnostic criteria in the DSM-IV required a verbal description of the patient’s internal states and experiences. ![]() Two large concerns led to the establishment of a unique set of criteria for younger children… Structured diagnostic interviews include measures to detect PTSD in children, but such interviews are rarely administered outside academic medical centers. While the fear some conditions were being diagnosed too frequently in children (see our discussions of bipolar disorder and disruptive mood dysregulation disorder), many leading clinicians in the field raised concerns that in addition to the potential for overdiagnosis, PTSD may be underdiagnosed, or misdiagnosed as some other condition. Most importantly for the sake of our discussion, the symptom thresholds for establishing a diagnosis in children and teens have been changed to take into account differences in the ways that trauma is manifested in kids, and a unique set of diagnostic criteria have been established for identification of PTSD in kids ages six and under.
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