Translational pathways of oxytocin therapy in schizophrenia: bridging negative symptom domains and neural mechanisms.

Posttraumatic stress disorder (PTSD) in children and adolescents remains frequently underdiagnosed despite its substantial developmental, relational, and public health impact [, ]. Lifetime PTSD prevalence among adolescents ranges from 4 to 8% in community samples [–] and is markedly higher among refugees, war-exposed youth, and survivors of sexual abuse [, ]. Early trauma exposure increases vulnerability to a wide range of psychiatric and physical outcomes—depression, suicidal behaviours, substance use, and cardiovascular disease [–]. Yet recognition in pediatric practice remains low, and many affected youth do not receive evidence-based trauma-focused interventions []. Current diagnostic frameworks—largely derived from adult criteria—may overlook developmental variations in symptom expression. Overlap with depression, ADHD, anxiety disorders, and autism spectrum disorder complicates detection, and cultural factors shape how children express distress. Interpersonal trauma in childhood (abuse, neglect, exposure to violence) disrupts emotion regulation, stress reactivity, and neurodevelopment, producing a symptom spectrum that may exceed the classic PTSD clusters of re-experiencing, avoidance, negative cognitions/affect, and hyperarousal []. ICD-11’s distinction between PTSD and Complex PTSD (CPTSD) may better capture the presentations of youth exposed to chronic interpersonal trauma [], while proposals such as Developmental Trauma Disorder highlight attachment dysregulation and developmental impairments not fully represented in DSM-5 [, ]. Recent global events—including the COVID-19 pandemic, armed conflicts, migration crises, and increased attention to early adversity—have heightened awareness of trauma-related needs among young people. There is growing consensus that prevention and treatment must extend beyond symptom reduction to strengthen protective factors such as supportive relationships, adaptive coping skills, and community resources []. A resilience-oriented framework acknowledges heterogeneous trajectories and the potential for adaptive functioning even after severe adversity.