Rates of post-traumatic stress disorder in trauma-exposed children and adolescents: Meta-analysis

Alisic, E., Zalta, A., van Wesel, F., Larsen, S., Hafstad, G. S., Hassanpour, K., & Smid, G. (2014). Rates of post-traumatic stress disorder in trauma-exposed children and adolescents: Meta-analysis. British Journal of Psychiatry, 204(5), 335-340. doi:10.1192/bjp.bp.113.131227

BACKGROUND: It is unclear how many children and adolescents develop post-traumatic stress disorder (PTSD) after trauma.

AIMS:

To determine the incidence of PTSD in trauma-exposed children and adolescents as assessed with well-established diagnostic interviews and to examine potential moderators of the estimate.

METHOD:

A systematic literature search identified 72 peer-reviewed articles on 43 independent samples (n = 3563). Samples consisting only of participants seeking or receiving mental health treatment were excluded. Main analyses involved pooled incidence estimates and meta-analyses of variance.

RESULTS:

The overall rate of PTSD was 15.9% (95% CI 11.5-21.5), which varied according to the type of trauma and gender. Least at risk were boys exposed to non-interpersonal trauma (8.4%, 95% CI 4.7-14.5), whereas girls exposed to interpersonal trauma showed the highest rate (32.9%, 95% CI 19.8-49.3). No significant difference was found for the choice of assessment interview or the informant of the assessment.

CONCLUSIONS:

Research conducted with the best available assessment instruments shows that a significant minority of children and adolescents develop PTSD after trauma exposure, with those exposed to interpersonal trauma and girls at particular risk. The estimates provide a benchmark for DSM-5 and ICD-11.