Symptoms of posttraumatic stress disorder in adolescents with conduct disorder: Sex differences and onset patterns

Objective: To examine sex differences in the rate and symptoms of posttraum atic stress disorder (PTSD), trauma exposure, and onset patterns in youth w ith conduct disorder (CD). Method: Youth admitted to a clinical facility for severe behaviour problems completed the Diagnostic Interview for Children and Adolescents - Revised (DICA-R) to assess the presence of CD and PTSD. Results: Over one-half of CD youth reported exposure to trauma, yet only 17 % met criteria for PTSD. PTSD was more frequent in CD girls (28%) than in b oys (10%), and girls experienced greater symptom intensity and anhedonia, d ifficulty feeling love or affection, and disturbance of sleep and concentra tion. Girls more frequently reported sexual assault, while boys were more l ikely to report accidents, physical assaults, and witnessing the death of a loved one. Retrospective reports indicated that PTSD tended develop subseq uent to CD. Conclusions: Exposure to trauma is common among CD youth; however, diagnost ic procedures should be adapted for increased sensitivity to PTSD. The deve lopment of CD may increase the risk for PTSD, particularly in girls, by exp osing youth to situations in which they are traumatized. The role of trauma in CD should be routinely examined by clinicians and warrants further rese arch.