Early childhood PTSD and its correlates: a population-based study from Brazil

Post-traumatic stress disorder (PTSD) in preschoolers is increasingly recognized, yet population-based studies remain scarce, especially in contexts of high urban violence and social vulnerability. We conducted the Brazilian Preschool Mental Health Study in Embu das Artes, a high-risk urban area, enrolling 1,292 children from public preschools and their caregivers. Standardized face-to-face interviews assessed PTSD symptoms (YCPS for children, PCL-C for parents), socioemotional development (ASQ: SE-2), and sociodemographic variables. Associations were examined using logistic regression models. The prevalence of PTSD symptomatology was 3.8% in children and 3.1% in caregivers. Preschoolers' PTSD symptomatology was strongly associated with parental PTSD symptomatology (aOR = 12.20; 95% CI: 8.50-17.52), impaired socioemotional development (aOR = 2.30; 95% CI: 1.62-3.26), and higher socioeconomic status (aOR = 1.84; 95% CI: 1.35-2.51). Affiliation with Protestant religion showed a protective effect (aOR = 0.75; 95% CI: 0.60-0.94). PTSD symptomatology is a significant mental health concern in preschoolers exposed to chronic violence. Its strong association with parental PTSD symptomatology supports intergenerational trauma hypotheses. Findings underscore the urgent need for early identification and intervention strategies targeting both preschoolers and caregiver mental health in vulnerable settings.