Exploring Dimensions of Posttraumatic Stress in Young Children

The latent structure of posttraumatic stress symptoms (PTSS) in early childhood remains poorly understood. This study aimed to assess PTSS in young children, identify underlying latent constructs, and evaluate their construct validity. Participants included 190 children (M_age = 5.4 years, 53.7% female) and their mothers (M_age = 35.4 years), recruited from local communities and domestic violence shelters in an urban-suburban region of the U.S. Northeast. All children had experienced at least one potentially traumatic event (25.3% violence exposed). Mothers completed a semi-structured clinical interview and questionnaires at baseline and six months later. Exploratory structural equation modeling of early childhood PTSS did not support the four-factor structure adopted by the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, nor did it replicate any individual symptom cluster. Instead, findings provided preliminary evidence for two distinct, interrelated latent dimensions: Avoidance/Arousal and Intrusions/Fear. These dimensions included developmentally specific symptoms not currently represented in prevailing diagnostic frameworks. Both factor-derived scales demonstrated strong internal consistency and were significantly associated with various trauma exposure types, convergent symptom measures, and concurrent impairment indicators. Notably, only the Intrusions/Fear factor predicted impairment at follow-up. These results raise questions about the applicability of existing posttraumatic stress disorder symptom clusters for preschool-aged children and highlight the need for developmentally sensitive, dimensional approaches to understanding early childhood posttraumatic stress and related psychopathology.