Posttraumatic stress disorder from early childhood to late adolescence: a resilience-oriented approach to prevention, diagnosis, and clinical management.

Posttraumatic stress disorder (PTSD) in children and adolescents remains underrecognized despite its significant developmental, relational, and public health impact. This narrative review synthesizes evidence on the prevention, diagnosis, and management of PTSD from early childhood through late adolescence, emphasizing a resilience-oriented and multisystemic framework. Developmentally informed assessment is essential to capture age-specific symptom patterns and to distinguish PTSD from complex PTSD, increasingly observed after chronic interpersonal trauma. Trauma-focused psychotherapies-particularly trauma-focused cognitive behavioral therapy (TF-CBT)-are the gold standard, with eye movement desensitization and reprocessing (EMDR) and narrative exposure therapy (KidNET) as effective alternatives. In the early post-trauma phase, single-session debriefing is discouraged, whereas selective multisession interventions such as the Child and Family Traumatic Stress Intervention (CFTSI) reduce acute distress and strengthen caregiver support. No pharmacological treatment is approved for pediatric PTSD; psychotherapy remains first-line, with selective serotonin reuptake inhibitors considered only for severe, persistent, or comorbid cases after shared decision-making. Recovery depends not only on symptom reduction but also on restoring safety, attachment, and agency through coordinated interventions involving family, peers, schools, and communities. Integrating resilience-building and social-support strategies across clinical, educational, and policy levels is key to sustainable recovery and long-term developmental health.