Background: Posttraumatic stress disorder (PTSD) is a debilitating mental health condition that can develop after experiencing or witnessing a traumatic event. While considerable research has investigated PTSD in adults, little is known about the biological, psychological, and social factors that contribute to its onset, development, and persistence in youth.Methods: This systematic review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines to identify longitudinal studies examining factors associated with PTSD status and symptom severity in children and adolescents. Literature searches were conducted in PubMed, Scopus, and Web of Science, yielding 24 eligible studies after screening.Results: The included studies identified various biological factors associated with paediatric PTSD, including dysregulation of the hypothalamic-pituitary-adrenal axis, brain structural alterations, and physiological markers such as heart rate. Psychological factors, including depression, trauma appraisals, coping styles, and cognitive deficits predicted PTSD symptom development. Social factors included parental PTSD, family environment, and cultural influences. Many studies highlighted the importance of the interplay between these biological, psychological, and social factors in the manifestation of PTSD in youth.Conclusion: This review synthesises evidence that PTSD development in youth is influenced by a complex array of neurobiological vulnerabilities, psychological processes, and environmental factors. Longitudinal, multi-dimensional studies are needed to further elucidate personalised risk profiles and trajectories, which can inform targeted prevention and intervention strategies for PTSD in youth.
Antecedentes: El trastorno de estrés postraumático (TEPT) es una condición mental debilitante que puede desarrollarse tras experimentar o presenciar un acontecimiento traumático. Aunque se han realizado numerosas investigaciones sobre el TEPT en adultos, se sabe poco sobre los factores biológicos, psicológicos y sociales que contribuyen a su aparición, desarrollo y persistencia en los jóvenes.
Métodos: Esta revisión sistemática siguió las directrices de los Elementos de Reporte Preferidos para Revisiones Sistemáticas y Metaanálisis (PRISMA por sus siglas en inglés) para identificar estudios longitudinales que examinaran los factores asociados con el estado del TEPT y la gravedad de los síntomas en niños y adolescentes. Se realizaron búsquedas bibliográficas en PubMed, Scopus y Web of Science, y tras el cribado se obtuvieron 24 estudios elegibles.
Resultados: Los estudios incluidos identificaron diversos factores biológicos asociados con el TEPT pediátrico, incluida la desregulación del eje hipotálamo-hipófisis-suprarrenal, alteraciones estructurales cerebrales y marcadores fisiológicos como la frecuencia cardiaca. Los factores psicológicos, como la depresión, las evaluaciones del trauma, los estilos de afrontamiento y los déficits cognitivos predijeron el desarrollo de síntomas de TEPT. Los factores sociales incluían el TEPT de los padres, el entorno familiar y las influencias culturales. Muchos estudios destacaron la importancia de la interacción entre estos factores biológicos, psicológicos y sociales en la manifestación del TEPT en los jóvenes.
Conclusiones: Esta revisión sintetiza la evidencia de que el desarrollo del TEPT en los jóvenes está influido por un complejo conjunto de vulnerabilidades neurobiológicas, procesos psicológicos y factores ambientales. Se necesitan estudios longitudinales y multidimensionales para dilucidar mejor los perfiles y trayectorias de riesgo personalizados, que pueden servir de base para estrategias de prevención e intervención específicas para el TEPT en jóvenes.
Keywords: PTSD; TEPT; adolescentes; adolescents; biological factors; children; factores biológicos; factores psicológicos; factores sociales; niños; psychological factors; social factors.
An integrative biopsychosocial approach to understanding PTSD risk in children and adolescents is needed. Stress response dysregulation, autonomic nervous system activity, and brain structure and function were the most widely studied biological factors but showed inconsistent findings that may reflect differences in demographic factors, study design and the nature and duration of the trauma exposure.Psychosocial factors were less well studied but identified trauma appraisals, cognitive function profiles and coping styles as individual-level risk factors. Parental psychopathology was associated with higher PTSD risk.Differences in the range of factors investigated in studies of youth and adults highlight the need for research focussed on younger populations. Future studies should employ multidimensional approaches, include diverse populations, have increased representation of low- and middle-income countries, and consider risk factors according to different developmental stages.