At any given time, approximately one in a thousand children develop posttraumatic stress disorder (PTSD) after being exposed to serious adversities. In British Columbia, as many as 700 children may have PTSD at any given time. According to the 5^th edition of the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders, to receive a PTSD diagnosis, children must meet the following criteria:

• Being exposed to actual or threatened death or serious injury or sexual violence — through directly experiencing or witnessing or learning of such events
• Experiencing clinically significant problems related to the trauma that continue for a month or more and that impair the child’s functioning, including:
  • intrusive, recurrent and distressing memories or dreams or flashbacks, or intense
    psychological distress or physiological reactions
  • avoidance of associated situations, such as specific places or people
  • negative thoughts and emotions such as fear, horror, anger, guilt or shame
  • hyper-reactivity, including anger outbursts and sleep difficulties.

There are separate diagnostic criteria for children aged six years and younger — given that symptoms may differ when compared with those of older children (and adults). For example, for young children, intrusive symptoms may involve re-enacting trauma during play. For more information, see Vol. 15, No. 2 of the Children’s Mental Health Research Quarterly.