TABLE 2

Potential for Diagnostic Overlap With Trauma- and Non–Trauma-Specific Symptoms

Traumatic stress and depression
PTSD symptom clusters may mimic symptoms commonly considered indications of depression Negative cognition and mood sypmtoms of PTSD include depressive similar symptoms: negative belief toward self, self-blame, negative emotional state, loss of interest, detachmentHyperarousal and increased reactivity in PTSD include depressive similar symptomsa: irritable and angry, reckless and self-destructive behavior, poor concentration, sleep disturbances  
Traumatic stress and anxiety
Panic attacks may not indicate panic disorder if attacks are triggered by trauma reminders, better explained as intrusive and hyperarousal symptoms of PTSDSeparation challenges may be similar to separation anxiety but could be trauma specific depending on context of traumatic experience(s) and association with trauma remindersGeneralized and social anxiety are often independent of trauma-specific context and reminders; however, still important to consider symptoms in context of traumatic experiences
Traumatic stress and ADHD
Many overlapping symptoms make differentiating trauma and ADHD symptoms in the presence of traumatic stress nearly impossible, especially in younger childrenCollateral information from multiple settings may help clarify if symptoms are specific/exacerbated by certain relationships/settings or are more universalReevaluation after treatment for traumatic stress and reduction of trauma symptoms for possible ADHD may be needed to make diagnosis
  • a Suicidal ideation is a well-recognized symptom of major depressive disorder. However, suicidal ideation and nonsuicidal self-injurious behavior can be observed in a number of conditions in addition to depression that disproportionally affect maltreated children, including, but not limited to, PTSD, anxiety, substance use disorder, and personality, mood, and psychotic disorders.