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Posttraumatic Stress Disorder in Very Young Children: Diagnostic Agreement Between ICD‐11 and DSM‐5
Author(s) -
Vasileva Mira,
Haag AnnChristin,
Landolt Markus A.,
Petermann Franz
Publication year - 2018
Publication title -
journal of traumatic stress
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.259
H-Index - 134
eISSN - 1573-6598
pISSN - 0894-9867
DOI - 10.1002/jts.22314
Subject(s) - mcnemar's test , icd 10 , dsm 5 , psychiatry , nosology , posttraumatic stress , acute stress disorder , poison control , cohen's kappa , medicine , psychology , clinical psychology , pediatrics , medical emergency , statistics , mathematics , machine learning , computer science
Abstract The prevalence of posttraumatic stress disorder (PTSD) in very young children depends on the diagnostic criteria. Thus far, studies have investigated the International Classification of Diseases (11th rev.; ICD‐11 ) criteria for PTSD only in samples of children older than 6 years of age. The aim of this study was to test the diagnostic agreement between the ICD‐11 and the Diagnostic and Statistical Manual of Mental Disorders (5th ed.; DSM‐5 ) criteria for children who are 6 years old and younger. Caregivers of children aged 3–6 years in foster care in Germany ( N = 147) and parents of children aged 1–4 years who had attended a hospital in Switzerland following burn injuries ( N = 149) completed a questionnaire about children's PTSD. Rates of PTSD were calculated according to ICD‐11 (considering a specific and a more general conceptualization of intrusive memories) and DSM‐5 criteria and were compared using McNemar's tests and Cohen's kappa. The proportion of children who met the ICD‐11 criteria was 0.6–25.8% lower than the proportion of PTSD cases according to the DSM‐5 criteria. The diagnostic agreement between each ICD‐11 algorithm and DSM‐5 was moderate, κ = 0.52–0.66. A systematic investigation of adaptions of the ICD‐11 avoidance cluster identified alternative symptom combinations leading to higher agreement with the DSM‐5 requirements. Furthermore, DSM‐5 had higher predictive power for functional impairment than the ICD‐11 algorithms. In conclusion, the findings suggest that the ICD‐11 criteria show less sensitivity in very young children, which can be explained by the more stringent avoidance cluster.