2 APPROACHES TO THE DIAGNOSIS OF POSTTRAUMATIC-STRESS-DISORDER IN INFANCY AND EARLY-CHILDHOOD

Objective: The reliability and validity of DSM-IV criteria and an alte rnative set of criteria for posttraumatic stress disorder (PTSD) are a ssessed in infants and young children (younger than 4 years of age). M ethod: This study was conducted in three phases. Phase 1 applied DSM-I V criteria for PTSD to 20 case reports of severely traumatized infants from the literature. Phase 2 used an expanded checklist of symptoms t hat were developmentally sensitive and behaviorally anchored to create an alternative set of criteria for PTSD in infants. Phase 3 compared the DSM-IV criteria to the alternative criteria on 12 new cases of tra umatized infants. Results: Infants and young children who have experie nced severe traumas show many symptoms of impairment, similar to postt raumatic symptoms in older children and adults. The alternative criter ia were more reliable and more valid for diagnosing PTSD in infancy th an DSM-IV criteria. Conclusions: Clinicians ought to be aware that inf ants and young children can develop posttraumatic disorders after trau matic events. Criteria for diagnosing these disorders in standard noso logies may need revision for use with children younger than 48 months of age.