This docs not indicate that therapy is making them worse, but rather that therapy has begun to address their avoidant strategies to the point that they can start to acknowledge the severity of these symptoms. Conclusion The above discussion highlights challenges and strengths of using the present DSM-IV-TR diagnostic criteria for PTSD in children. Unlike the controversy about pediatric bipolar disorder, there has not been a challenge that too many false-positives of child PTSD are being made. Concern about false-positives (lack of specificity) has been raised in the adult literature, but these concerns and speculations have been forcefully rebutted Inhibitors,research,lifescience,medical with empirical data and do not appear to be widely held.

In contrast, for child PTSD, the concern has been the opposite: that too few traumatized children are diagnosed Inhibitors,research,lifescience,medical whether due to insensitive criteria or due to the need for a novel syndrome. However, again, these are speculations that ignore the data

that PTSD is the most common and underlying syndrome that develops after all types of lifethreatening trauma, and has shown validity across all ages, good predictive validity, and concurrence with Inhibitors,research,lifescience,medical preliminary neurobiologies measures. In summary, PTSD remains a well-validated disorder, and is the most useful construct of child and adolescent post-trauma psychopathology for research and clinical purposes. The current PTSD diagnostic criteria should be revised to reflect current research about developmental manifestations of this disorder. Acknowledgments The authors thank Anthony Mannarino, PhD, Esther Inhibitors,research,lifescience,medical Deblinger, PhD, Robert Steer, EdD, Ann Marie Kotlik, the staff of AGH CTSCA, Charles Zeanah, MD, and all the children and families from whom we have learned. Funding for this project was provided in part by the US Substance Abuse and Mental Health Services Administration (SAMHSA) National Child Traumatic Stress Network, Grant No. SM 54319. Contributor Information Judith A. Cohen, Professor

of Psychiatry, Inhibitors,research,lifescience,medical Drexel University College of Medicine; Medical Director, Center for Traumatic Stress in Children and Adolescents, Allegheny General Hospital, Pittsburgh, Pennsylvania, USA. Michael S. Scheeringa, Associate Professor, Department of Psychiatry and Neurology, Tulane University School of Medicine, New Orleans, Louisiana, USA.
Anorexia nervosa developing in early adolescence was well documented in the case of Princess Margaret of Hungary, who lived and died in the 13th century1 She was the daughter of King Bcla IV, who had her enter a Dominican convent and during her early childhood. Her history comes from a complete copy of depositions by witnesses who gave evidence in the process of her beatification, which began less than 5 years after her death. Her eating behaviors were ABT-378 supplier indistinguishable from those of young anorexia nervosa patients of today. Although there is documentation of fasting female saints in the middle ages,2 the fasting did not appear to occur during childhood.