Underdiagnosis of posttraumatic stress disorder in at risk youth


  • This article was edited by the journal's Editor-Elect, Daniel S. Weiss.

  • We would like to thank the late Robert Leonhardt and David Doty, PhD, at Friendship House, Scranton, PA, and Christina Ouellette, CEO of Children's Behavioral Health Services, Inc., Edwardsville, PA, for their support of this research.


Three studies examined the diagnosis of posttraumatic stress disorder (PTSD) in agencies treating at risk youth. Studies 1 and 2 (1999) found that baseline PTSD diagnosis was rare in a residential and an outpatient agency (2.3% and 5.4%, respectively) whereas trauma-focused interviews identified PTSD in 47.7% and 44.6% of these clients. Subsequent training efforts increased awareness of PTSD and recognition of unique issues in assessing at risk youth. Study 3 (2009) reexamined PTSD diagnosis rates in these agencies 10 years later and found that the residential agency had an increased rate of PTSD diagnosis (10.8%), whereas PTSD diagnosis remained rare in the outpatient agency (4.0%). Suggestions are offered for increased accuracy in the diagnosis of PTSD and complex PTSD with at risk youth.

Traditional and Simplified Chinese Abstracts by AsianSTSS

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