Posttraumatic Stress Disorder in Children in the Context of the COVID-19 Pandemic

With its global spread and protracted threat, mounting morbidity and mortality, pervasive social and economic ramifications, vital public health measures, and often compromised risk communication, the COVID-19 pandemic has increased the risk to children’s emotional health relative to more common biological, natural, and man-made events. Posttraumatic stress disorder (PTSD) and PTSD symptoms have been the primary focus of child disaster mental health research. The adult literature has questioned the appropriateness of focusing on PTSD in the context of the COVID-19 pandemic, because most of the extensive adult research on PTSD has not appropriately assessed all diagnostic criteria for the disorder.(1) The pandemic experiences of participants in most studies examined in a recent review did not meet the PTSD exposure criterion,(1) which requires that exposure be “directly” experienced, witnessed in person, secondary to the involvement of a close family member or friend, or “repeated or extreme” contact with “aversive details” of the event.(2) Instead, participants’ experiences were primarily indirect (eg, media contact) and constituted fear related to contracting the disease.(1) This concern extends to the relatively few empirical COVID-19 studies of PTSD in children and exemplifies a problem in many child disaster mental health studies, especially those assessing general population samples that primarily comprise children who do not meet the PTSD exposure criterion.