4. Post-Traumatic Stress Disorder in Preschool Children

Post-traumatic stress disorder (PTSD) was first included in the DSM in 1980, and in 1987, the manual referred for the first time to trauma in children. Those working on DSM-5 are looking to emphasize how disorders differ depending on the age of the patient.

Children under age 6 who were exposed to a death or a threatened death, an actual or threatened serious injury or an actual or threatened sexual violation could have this condition, the DSM experts say. A child could have experienced such a trauma themselves or witnessed it occurring to someone else, such as a parent.

The symptoms include intrusive, distressing memories; recurrent distressing dreams and dissociative reactions in which the child feels or acts as if the traumatic events were recurring. Children with this disorder might avoid situations that remind them of the trauma, become socially withdrawn, have problems with concentration or exhibit extreme temper tantrums.

“It is possible that future research will show differences in traumatic stress responses that are due to the maturity level of the brain and nervous system, said Dr. Jeffrey P. Staab, associate professor of psychiatry at the Mayo Clinic, in Rochester, Minn. “For now, we do not want to overlook traumatized children in need of treatment because we lack an age-appropriate definition of their response to horrible events.”