Scheeringa Michael S
Institute of Infant and Early Childhood Mental Health, Department of Psychiatry and Neurology, Tulane University School of Medicine,
J Child Adolesc Trauma. 2011 Sep;41(3):181-197. doi: 10.1080/19361521.2011.597079. Epub 2014 Jan 11.
Assessment of posttraumatic stress disorder (PTSD) is more difficult compared to other disorders for multiple reasons that are listed and explained. Multiple causes of low sensitivity for making the PTSD diagnosis in children are discussed. Diagnostic validity and comorbidity issues in particular are highlighted. For the diagnostic criteria, wording changes to five of the items have been proposed, but the most substantial proposed change is lowering the criterion C requirement from three to one symptom. Early studies suggest the course is more chronic. Parenting effects are reviewed and caution is urged before drawing premature conclusions about the directionality of effects. Advice for interviewing respondents is organized into seven practical suggestions. Treatment implications from the above are discussed.
与其他疾病相比，创伤后应激障碍（PTSD）的评估更为困难，原因如下并已作出解释。文中讨论了儿童PTSD诊断敏感性较低的多种原因。特别强调了诊断有效性和共病问题。对于诊断标准，已提议对其中五项内容进行措辞修改，但最重大的提议修改是将C标准的要求从三项症状降至一项症状。早期研究表明病程更具慢性特征。文中回顾了养育方式的影响，并敦促在对影响的方向性得出过早结论之前要谨慎。针对受访者访谈的建议整理为七条实用建议。文中讨论了上述内容对治疗的启示。
