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Abstract: Empirical data have challenged chronic posttraumatic stress disorder (PTSD) consisting of three dimensions. In the present study we aimed to determine the factor structure of acute posttraumatic symptoms in two recently traumatized samples. In sample 1, 203 civilian trauma survivors were administered the Davidson Trauma Scale (DTS) approximately 1 week posttrauma. In sample 2, 182 civilian treatment seeking trauma survivors completed the DTS at an average of 41.4 days posttrauma. Our confirmatory factor analyses indicated that a 4-factor intercorrelated model provided the best representation of the data in both samples. The four factors are best described as reexperiencing, active avoidance, dysphoria, and hyperarousal. For acute posttraumatic symptoms, the empirical data suggest to split the avoidance cluster into ‘Active avoidance’ and ‘Dysphoria’—confirming findings in studies on chronic PTSD. In future revisions of the DSM, the diagnostic criteria for PTSD may need to be adapted to fit the research findings. [Copyright &y& Elsevier]

The impact of providing early interventions to acutely traumatized children is not yet known. No research has examined the potential benefits or harm of providing brief psychosocial interventions to children in the immediate aftermath of trauma exposure. Three studies have documented the efficacy of providing trauma-focused, cognitive–behavioral therapy (TF-CBT) to symptomatic children within 1–6 months of experiencing sexual abuse. Several controlled and open studies of traumatized children with chronic posttraumatic stress disorder have provided additional support for TF-CBT interventions; however, the optimal dosage and critical components of TF-CBT for traumatized children have not been determined. Only one randomized controlled pharmacologic trial has been conducted for acutely traumatized children; open studies of various pharmacologic treatments are limited by methodologic shortcomings but suggest that there are promising agents for evaluation in future controlled trials. The importance and feasibility of conducting early screening of trauma-exposed children is discussed, and recommendations for research priorities are presented. [Copyright &y& Elsevier]