Posttraumatic Stress Disorder in Children: A Narrative Review

Abstract

Method: This narrative review summarizes research from the years 2019-2024 on posttraumatic stress disorder (PTSD) and posttraumatic stress symptoms (PTSS) in children. Results: This research suggests that prevalence rates have been highly variable as a function of the stress experienced, for example, post-surgery (15%), following exposure to war (28%) and following head injury (34%). The negative effects have included cognitive dysfunction, aggression and other behavioral difficulties and the comorbidities include sleep disorders, somatic symptoms and depression. Predictors/risk factors have been the primary focus in this literature and have included parent risk factors including exposure to intimate partner violence, sexual and emotional abuse. Sensory modulation and cognitive processes have been implicated as, for example, negative attention bias and subjective threat. Injuries and hospitalizations have been predictors as has been exposure to explosions and earthquakes. The most frequently studied intervention has been cognitive behavioral therapy which has consistently reduced the symptoms of PTSD. Potential underlying biological mechanisms have included parent PTSD, pregnancy inflammation, and autonomic dysregulation including low cortisol and heartrate, although reduced cortical thickness (volume) in several areas of the brain has been the most frequently studied potential mechanism. Discussion: The studies in this review highlight the prevalence and severity of posttraumatic stress disorder in children. However, they have been primarily based on mixed-age child and adolescent samples and the results have varied by the type of stress experienced and the severity of the stress.