Age-related similarities and differences in networks of acute trauma-related stress symptoms in younger and older preschool children

Background: Prior research on trauma-exposed preschool children has found various levels of trauma-related stress symptoms depending on age, which might be explained by developmental factors. Objective: This study uses network analysis to extend prior research and compare symptom presentation in younger and older preschoolers in the acute phase (first 4 weeks) following a potentially traumatic event. Method: Parent-reported trauma-related acute stress symptoms were assessed using the Pediatric Emotional Distress Scale – Early Screener via www.kidtrauma.com. First, the overall symptom severity and symptom levels were compared between younger (1–3 years) and older (4–6 years) preschoolers. Further, two Gaussian graphical models of stress symptoms in younger (n = 242; M(age) = 2.3 years; SD(age) = 0.6 years) and older preschoolers (n = 299; M(age) = 4.8 years; SD(age) = 0.7 years) were modelled and compared. Results: Overall symptom severity did not differ between the groups. Symptom levels for developmental regression and avoidance of talking about the event were higher in older preschoolers. The network structures of the younger and the older preschoolers were largely similar. Highly central symptoms in both networks were trauma-unrelated fear and anger. The connections between fear of reminders and clinginess and trauma-unrelated fear and clinginess were stronger in the older preschoolers’ network. The connections between worry and sadness and withdrawal; fear of reminders and creation of games, stories, and pictures; and whininess and clinginess were all stronger in the younger preschoolers’ network. Conclusions: Trauma-related stress symptomatology of younger and older preschoolers may not differ greatly in the acute phase. Trauma-unrelated fear and anger seem to be central symptoms in both groups. However, examining symptom-level associations across age groups revealed differential connections that might arise from developmental differences. If replicated in longitudinal and within-subject studies, these findings could help tailor interventions for trauma-exposed preschoolers in the acute phase.