Background: There is virtually no debate that the COVID-19 pandemic had effects on children and youth, from vast changes in their learning environment and daily routines (i.e., virtual school) to their mental health. However, it is not clear whether the pandemic qualifies as a traumatic event on Criterion A for PTSD. The debate surrounds whether this Criterion should be modified to include this pandemic (Wathelet et al., 2021), or if the observed stress should be categorized as another existing diagnosis (Van Overmeire, 2020). Previous research did not specify the circumstances surrounding reported stress, so it’s difficult to denote whether or not COVID-19 had a direct impact on youth’s PTSD rates (Pfefferbaum, 2022). However, research points to a complex relationship between the COVID-19 pandemic, PTSD symptoms, and trauma exposure. The current study examines whether youth who were receiving trauma therapy had exposure to meet Criterion A for PTSD and if they were more likely to have higher pandemic-related trauma exposure if they also had higher traumatic stress scores from pre-pandemic trauma exposure.

Method: 130 youth (7-19 years old) in child trauma treatment clinics in an academic medical setting were administered the following measures to assess COVID-19 trauma exposure and stress: 1) UCLA Brief COVID-19 Screen for Child/Adolescent PTSD, 2) UCLA PTSD Reaction Index DSM-5 semi-structured interview, 3) Social support questions from the Substance Abuse and Mental Health Services Administration and the Center for Mental Health Services National Outcomes Measures Services Tool, and 4) a nine question interview assessing the family’s experience during the pandemic.

Results and Conclusions: The COVID-19 Screen for PTSD demonstrated that only 9.2% of the sample had a score to suggest PTSD, though much of the sample endorsed exposures that would meet Criterion A for PTSD. The majority of participants did not endorse a significant level of pandemic-related PTS. Participants who reported a significant level of pandemic-related PTS also described feeling distressed about their perception of safety in the interview. The only significant difference between participants who did and did not significantly endorsed symptoms for pandemic-related PTS was those who endorsed symptoms did not have a strong friend/familial support system to lean on when in crisis.

Although there was evidence for COVID-19 qualifying as a Criterion A event and this translated to PTSD symptoms for some participants, overall, there was less of a traumatic effect of COVID-19 on this sample than expected. Analysis confirmed that Criterion A for pandemic-related PTSD significantly predicted pandemic-related PTS and baseline PTS symptoms. It was surprising that baseline PTS symptoms did not significantly predict pandemic-related PTS, thus demonstrating no mediation. Prior research suggests that previous traumatic experiences typically put an individual at risk for future PTS (Megalakaki et al., 2021). It is posited from the interviews that due to the nature of the participants (i.e., current stage of development, recency of past traumas), they did not consider or fully understand the implications of the pandemic. Interestingly, participants noted positive items from the pandemic, such as more family time and less school stress.