Els van Meijel

108 Chapter 6 | Posttraumatic stress in young children negative recollections than parents and children who recovered quickly. In addition, we administered the interviews via telephone. Telephone interviews are considered less valid than face-to-face interviews, because people would be less likely to disclose during telephone interviews due to the lack of face-to-face interaction (Aziz & Kenford, 2004). This might have lead to an underreport of PTSS in our sample. On the contrary, studies in which telephone interviews are compared to face-to-face interviews showed that telephone interviews lead to similar results as face-to-face interviews. Both are valid methods to measure several psychiatric disorders, including PTSD (Aziz & Kenford, 2004; Rohde, Lewinsohn, & Seeley, 1997). ADIS-C/P and DIPA questions were administered if parents reported one or more PTS symptoms on the initial questions of the semi-structured interview. Due to this method, it is possible that some children may have suffered from substantial PTSS but their parents failed to mention symptoms. As a consequence, the ADIS-C/P and DIPA questions would not have been administered in these parents. Nevertheless, this does not seem likely because the initial questions contained examples of PTS symptoms from all PTSD clusters. We expected parents of children with substantial PTSS to recognize a number of these examples. The validation study of the DIPA has not yet been finished in the Netherlands. Hence, apart from the pilot study, the Dutch DIPA-questions have not been extensively validated. Besides, the study was conducted before the release of the DSM-5. For this reason the ADIS-C/P and the DIPA were not yet adjusted to the DSM-5 changes. Our sample size and the number of children who qualify for a PTSD diagnosis are limited. As a consequence, a relatively small difference exists between the number of children who qualify for a DSM-IV diagnosis and the number of children who qualify for a diagnosis with the PTSD-AA algorithm and the DSM-5 subtype for children 6 years and younger. Nevertheless, especially from a clinical point of view, we believe that this difference is important, because all of the children who qualify for a diagnosis are impaired and might need treatment. Furthermore, because our sample consists of young children exposed to accidental trauma, caution should be taken in generalizing the results to children involved in other types of traumatic events. Our study should be replicated with a larger sample size and with children exposed to various types of traumatic events.