eMedicine Specialties > Pediatrics: Developmental and Behavioral > Medical Topics

Child Abuse & Neglect, Posttraumatic Stress Disorder: Differential Diagnoses & Workup

Author: Angelo P Giardino, MD, PhD, Clinical Associate Professor, Department of Pediatrics, Baylor College of Medicine; Medical Director, Texas Children's Health Plan, Inc
Coauthor(s): Toi Blakley Harris, MD,, Assistant Professor and Director of Diversity and Education, Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine; Founder and Director, Texas Regional Psychiatry Minority Mentor Network; Eileen R Giardino, PhD, RN, MSN, FNP-BC, ANP-BC, Associate Professor of Nursing, Department of Acute and Continuing Care, University of Texas Health Sciences Center Houston School of Nursing
Contributor Information and Disclosures

Updated: Jul 28, 2009

Differential Diagnoses

Anxiety Disorder: Generalized Anxiety
Child Abuse & Neglect: Psychosocial Dwarfism
Anxiety Disorder: Panic Disorder
Child Abuse & Neglect: Reactive Attachment Disorder
Anxiety Disorder: Separation Anxiety and School Refusal
Child Abuse & Neglect: Sexual Abuse
Anxiety Disorder: Social Phobia and Selective Mutism
Learning Disorder: Mathematics
Anxiety Disorder: Specific Phobia
Learning Disorder: Reading
Child Abuse & Neglect: Dissociative Identity Disorder
Learning Disorder: Written Expression
Child Abuse & Neglect: Failure to Thrive
Mood Disorder: Depression
Child Abuse & Neglect: Physical Abuse
Mood Disorder: Dysthymic Disorder

Other Problems to Be Considered

Autism
Attention deficit/hyperactivity disorder (ADHD)  

Workup

Laboratory Studies

  • No specific laboratory studies exist to make the diagnosis of posttraumatic stress disorder (PTSD). While this observation is not used clinically for diagnosis, research demonstrates exaggerated hypothalamic-pituitary-adrenal axis activity and increased overall adrenergic activity in acute PTSD.

Imaging Studies

Other Tests

  • Several psychometric measures, such as semi-structured interviews or self-report measures, are used to evaluate PTSD in children. Semi-structured measures include the Child and Adolescent Psychiatric Assessment: Life Events Section and PTSD Module (CAPA-PTSD) and the Children’s PTSD Inventory (CPTSDI). Self-report measures include the abbreviated UCLA PTSD Reaction Index, the Trauma Symptom Checklist for Children (TSCC), the Impact of Events Scale, and the Screen for Child Anxiety Related Disorders (SCARED).
  • Researchers have cautioned that children with PTSD symptoms who do not cross the traditional threshold for PTSD diagnosis may still suffer significant functional impairment.
  • Some research suggests that more functional impairment is observed in children who report intense (although not necessarily frequent) avoidance symptoms and distress in response to triggers.

More on Child Abuse & Neglect, Posttraumatic Stress Disorder

Overview: Child Abuse & Neglect, Posttraumatic Stress Disorder
Differential Diagnoses & Workup: Child Abuse & Neglect, Posttraumatic Stress Disorder
Treatment & Medication: Child Abuse & Neglect, Posttraumatic Stress Disorder
Follow-up: Child Abuse & Neglect, Posttraumatic Stress Disorder
References
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Further Reading

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Keywords

posttraumatic stress disorder, post-traumatic stress disorder, traumatic stress disorder, child abuse, child neglect, child maltreatment, acute traumatic reaction, chronic or delayed traumatic disorder, PTSD, psychological trauma, physical trauma, acute stress reaction

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Contributor Information and Disclosures

Author

Angelo P Giardino, MD, PhD, Clinical Associate Professor, Department of Pediatrics, Baylor College of Medicine; Medical Director, Texas Children's Health Plan, Inc
Angelo P Giardino, MD, PhD is a member of the following medical societies: Academic Pediatric Association, American Academy of Pediatrics, American Professional Society on the Abuse of Children, Harris County Medical Society, Helfer Society, and International Society for Prevention of Child Abuse and Neglect
Disclosure: Nothing to disclose.

Coauthor(s)

Toi Blakley Harris, MD,, Assistant Professor and Director of Diversity and Education, Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine; Founder and Director, Texas Regional Psychiatry Minority Mentor Network
Toi Blakley Harris, MD, is a member of the following medical societies: American Academy of Child and Adolescent Psychiatry, American Psychiatric Association, and Association for Academic Psychiatry
Disclosure: Nothing to disclose.

Eileen R Giardino, PhD, RN, MSN, FNP-BC, ANP-BC, Associate Professor of Nursing, Department of Acute and Continuing Care, University of Texas Health Sciences Center Houston School of Nursing
Eileen R Giardino, PhD, RN, MSN, FNP-BC, ANP-BC is a member of the following medical societies: American Academy of Nurse Practitioners, American College Health Association, American Nurses Association, American Professional Society on the Abuse of Children, and International Society for Prevention of Child Abuse and Neglect
Disclosure: Nothing to disclose.

Medical Editor

Carol Diane Berkowitz, MD, Executive Vice Chair, Department of Pediatrics, Professor, Harbor-University of California at Los Angeles Medical Center
Carol Diane Berkowitz, MD is a member of the following medical societies: Alpha Omega Alpha, Ambulatory Pediatric Association, American Academy of Pediatrics, American College of Emergency Physicians, American Medical Association, American Pediatric Society, and North American Society for Pediatric and Adolescent Gynecology
Disclosure: Nothing to disclose.

Pharmacy Editor

Mary L Windle, PharmD, Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy, Pharmacy Editor, eMedicine
Disclosure: Pfizer Inc Stock Investment from financial planner; Avanir Pharma Stock Investment from financial planner ; WebMD Salary and stock Employment and investment from financial planner

CME Editor

Carrie Sylvester, MD, MPH, Director of Education in Child and Adolescent Psychiatry, Professor, Departments of Psychiatry and Pediatrics, Northwestern University Medical School
Carrie Sylvester, MD, MPH is a member of the following medical societies: American Academy of Child and Adolescent Psychiatry, American Academy of Pediatrics, American Medical Women's Association, American Psychiatric Association, and American Society for Adolescent Psychiatry
Disclosure: Nothing to disclose.

Chief Editor

Caroly Pataki, MD, Professor of Clinical Psychiatry and Behavioral Sciences, Department of Psychiatry, Division Chair, Child and Adolescent Psychiatry, Director of Training, Child and Adolescent Psychiatry Residency Program, University of Southern California Keck School of Medicine
Caroly Pataki, MD is a member of the following medical societies: American Academy of Child and Adolescent Psychiatry, New York Academy of Sciences, and Physicians for Social Responsibility
Disclosure: Nothing to disclose.

 
 
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