Els van Meijel

103 Posttraumatic stress in young children | Chapter 6 children did not fulfill the criteria for substantial PTSS. Impairment was measured with DIPA questions about impairment in the following domains: parental relationships, sibling relationships, daycare provider/teacher relationships, relationships with peers, ability to act appropriately outside home or daycare/school and measure of child’s distress (questions 56 to 61). If parents reported child PTSS in the past, they were also asked if the symptoms were still present (results are not presented and are available on request). If parents reported other experienced traumatic events besides the accident, the PTS questions were administered separately for each of the events. Data analysis We used IBM Statistical Product and Service Solutions (SPSS) 19 for all analyses. Descriptive statistics were used to analyze the characteristics of the children, accident related information and PTS symptoms. Differences between participants and non- participants were analyzed using the chi-square test and Mann-Whitney U tests. We compared the DSM-IV PTSD algorithm, the DSM-5 PTSD subtype for children 6 years and younger and the PTSD-AA algorithm in order to explore the diagnostic outcomes of the algorithms. We defined substantial PTSS as 1) the child met the criteria of all PTSD clusters of any of the three algorithms and the parent reported impairment (threshold PTSD) or 2) the child did not fully meet the criteria of all PTSD clusters of any of the three algorithms, but met two of the clusters in any of the three algorithms and the parent reported impairment (subthreshold PTSD). Subthreshold PTSD is clinically significant, because people with subthreshold PTSD can experience impairment and may require treatment (McLaughlin et al., 2015). Our definition of subthreshold PTSD is supported by a study on definitions of subthreshold PTSD according to the DSM-5 PTSD algorithm (McLaughlin et al., 2015). The results of this study show that full symptoms in two or three of the PTSD clusters is the best fit for subthreshold PTSD. The authors recommend that future studies should use this definition of subthreshold PTSD (McLaughlin et al., 2015).