Els van Meijel

98 Chapter 6 | Posttraumatic stress in young children the PTSD-AA algorithm, criterion A2 was left out from the DSM-5. This criterion was considered redundant for the development of PTSD, because research showed that this criterion is common after experiencing a traumatic event and has little influence on the number of people who qualify for PTSD following a traumatic event (Breslau & Kessler, 2001). In addition, other studies showed that people can develop PTSD without meeting criterion A2. For example, many professionals like military personnel or police officers do not have an emotional response to a traumatic event because of their professional training, but can still develop PTSD (Friedman, Resick, Bryant, & Brewin, 2011). Table 6.1 presents an overview of the PTS symptoms and criteria of the DSM-IV, PTSD-AA algorithm and DSM-5 subtype for children 6 years and younger. It is important to compare the three algorithms and to explore the diagnostic outcomes of the algorithms among young children (Alisic et al., 2011). However, research in this area is scarce. A study on PTSD in young children with burn injuries demonstrated a prevalence rate of 4.6% with DSM-IV, 25.4% with DSM-5 and 24.6% with PTSD-AA at 1 month after the injury (De Young, Kenardy, & Cobham, 2011a). Meiser-Stedman and colleagues found a PTSD prevalence rate of 1.7%with the DSM-IV algorithm and 10% with the PTSD-AA algorithm in young children who were involved in a motor vehicle accident (Meiser-Stedman, Smith, Glucksman, Yule, & Dalgleish, 2008). Scheeringa and colleagues compared PTSD diagnoses according to the DSM-IV, PTSD-AA, DSM-5 and DSM-5-under consideration (DSM-5-UC) algorithm in children aged 3 to 6 years exposed to diverse types of trauma (Scheeringa et al., 2012). They found that the percentage of children who qualified for a PTSD diagnosis was significantly lower when using the DSM-IV algorithm (13%) compared to the PTSD-AA algorithm (45%), DSM-5 algorithm (44%) or DSM-5-UC algorithm (49%). In order to understand PTSD in young children and prevent underdiagnosis, a broad research base is needed, including research in various countries and after various types of trauma exposure. In the present study we compared the three main PTSD algorithms for young children age 0 to 7 years in an accidental injury sample involving various types of exposure (e.g., road traffic accidents, near drowning, falls).