Peer-reviewed article
Posttraumatic stress disorder from early childhood to late adolescence: a resilience-oriented approach to prevention, diagnosis, and clinical management.
Kerbage H, Bui E, Revet A, Denis H, Purper-Ouakil D et al. ·
Summary
Written by AI, not yet AICS's view · claude-haiku-4-5-20251001This review synthesizes evidence on preventing, diagnosing, and treating posttraumatic stress disorder (PTSD) in children and adolescents from early childhood through late adolescence. It emphasizes a resilience-oriented approach that recognizes age-specific symptoms and distinguishes PTSD from complex PTSD following chronic trauma. Trauma-focused cognitive behavioral therapy is identified as the gold standard treatment, with EMDR and narrative exposure therapy as effective alternatives, while early multisession interventions involving caregivers are recommended over single-session debriefing. Recovery requires coordinated support across family, peers, schools, and communities to restore safety, attachment, and agency rather than focusing only on symptom reduction.
Key points
- Trauma-focused cognitive behavioral therapy (TF-CBT) is the gold standard treatment for pediatric PTSD, with EMDR and narrative exposure therapy (KidNET) as effective alternatives
- Single-session debriefing in the early post-trauma phase is discouraged; selective multisession interventions like CFTSI reduce acute distress and strengthen caregiver support
- No pharmacological treatment is approved for pediatric PTSD; psychotherapy is first-line treatment, with SSRIs considered only for severe, persistent, or comorbid cases
- Developmentally informed assessment is essential to capture age-specific symptom patterns and distinguish PTSD from complex PTSD after chronic interpersonal trauma
- Recovery depends on restoring safety, attachment, and agency through coordinated interventions involving family, peers, schools, and communities, integrating resilience-building strategies
Limitations
This is a narrative review that synthesizes existing evidence rather than presenting original research or data. It does not provide specific effectiveness rates, sample sizes, or detailed outcomes from individual studies, and does not evaluate the relative effectiveness of different interventions through meta-analysis.
Abstract
Posttraumatic stress disorder (PTSD) in children and adolescents remains underrecognized despite its significant developmental, relational, and public health impact. This narrative review synthesizes evidence on the prevention, diagnosis, and management of PTSD from early childhood through late adolescence, emphasizing a resilience-oriented and multisystemic framework. Developmentally informed assessment is essential to capture age-specific symptom patterns and to distinguish PTSD from complex PTSD, increasingly observed after chronic interpersonal trauma. Trauma-focused psychotherapies-particularly trauma-focused cognitive behavioral therapy (TF-CBT)-are the gold standard, with eye movement desensitization and reprocessing (EMDR) and narrative exposure therapy (KidNET) as effective alternatives. In the early post-trauma phase, single-session debriefing is discouraged, whereas selective multisession interventions such as the Child and Family Traumatic Stress Intervention (CFTSI) reduce acute distress and strengthen caregiver support. No pharmacological treatment is approved for pediatric PTSD; psychotherapy remains first-line, with selective serotonin reuptake inhibitors considered only for severe, persistent, or comorbid cases after shared decision-making. Recovery depends not only on symptom reduction but also on restoring safety, attachment, and agency through coordinated interventions involving family, peers, schools, and communities. Integrating resilience-building and social-support strategies across clinical, educational, and policy levels is key to sustainable recovery and long-term developmental health.