{
  "abstract": "Children experiencing persistent posttraumatic stress symptoms can receive a diagnosis of post-traumatic stress disorder (PTSD), opening the gate to trauma-focused services. However, many youths are undiagnosed due to complex presentations or because their stressor exposure does not meet Criterion A (“Exposure to actual or threatened death, serious injury, or sexual violence…”; American Psychiatric Association, 2022, p. 302), despite impairing symptoms. The current study applies a novel, three-level framework based on increasingly strict stressor criterion to conceptualize stressor exposures and explore associated symptoms. We employed a convergent parallel, QUAL + quan design to analyze phone-administered baseline assessments of the UCLA PTSD Reaction Index for 438 caregiver-youth dyads seeking treatment as part of a larger randomized controlled trial in U.S. community mental health clinics. Through framework analysis of assessor notes, the following theme developed: Some stressor types do not meet Criterion A but are reported as significant stressors. In the quantitative results, fewer stressors met the increasingly strict severity criteria; yet there were cases of elevated symptoms for non-Criterion A stressors (n = 149). Findings support applying a three-level framework to youth trauma exposures.",
  "abstract_shown": true,
  "affiliations": [
    "Department of Psychology, University of South Carolina, Columbia, United States",
    "Department of Psychology, Harvard University, Cambridge, United States",
    "The Ballmer Institute for Children’s Behavioral Health, University of Oregon, Eugene, United States"
  ],
  "article_type": "research article",
  "arxiv": null,
  "author_total": 6,
  "authors": [
    {
      "affs": [
        0,
        1
      ],
      "name": "Malena A. Nygaard",
      "orcid": "0000-0002-5265-2073"
    },
    {
      "affs": [
        1
      ],
      "name": "Stephanie M. Hernandez"
    },
    {
      "affs": [
        1
      ],
      "name": "Aaron Corn"
    },
    {
      "affs": [
        1
      ],
      "name": "Srividya Mehendale"
    },
    {
      "affs": [
        1
      ],
      "name": "Julie M. Petersen"
    },
    {
      "affs": [
        2
      ],
      "name": "Sarah Kate Bearman"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/b48te15k5a0kb.bib",
  "cited_by": 0,
  "doi": "10.1007/s40653-026-00933-z",
  "fulltext_url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC13737321/",
  "id": "b48te15k5a0kb",
  "issns": [
    "1936-1521",
    "1936-153X"
  ],
  "landing_url": "https://doi.org/10.1007/s40653-026-00933-z",
  "language": "en",
  "licence": "CC-BY-4.0",
  "licence_label": "CC BY 4.0",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "heading",
      "Research"
    ],
    [
      "openalex",
      "3203|Posttraumatic Stress Disorder Research"
    ]
  ],
  "openalex": "W7166738264",
  "pdf_url": "https://link.springer.com/content/pdf/10.1007/s40653-026-00933-z.pdf",
  "pmcid": "PMC13737321",
  "pmid": "42991412",
  "published": "2026-06-30",
  "publisher": "Springer",
  "ris": "https://research.draconitic.com/paper/b48te15k5a0kb.ris",
  "sources": [
    {
      "first_seen": "2026-11-09T12:22:32Z",
      "native_id": "PMC13737321",
      "source": "pmc",
      "url": "https://doi.org/10.1007/s40653-026-00933-z"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "openalex:3203|Posttraumatic Stress Disorder Research",
      "subfield": "psychiatry"
    }
  ],
  "title": "Beyond Criterion A: Employing a Three-Level Framework for Conceptualizing Youth Stressor Severity and Posttraumatic Stress Symptoms",
  "title_text": "Beyond Criterion A: Employing a Three-Level Framework for Conceptualizing Youth Stressor Severity and Posttraumatic Stress Symptoms",
  "type": "peer-reviewed",
  "updated_at": "2026-11-09T12:22:32Z",
  "url": "https://research.draconitic.com/paper/b48te15k5a0kb",
  "venue": "Journal of Child & Adolescent Trauma",
  "versions": []
}