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Acute stress disorder symptomatology during hospitalization for pediatric injury
W B Daviss1, R Racusin, A Fleischer
1Dartmouth Medical School, Lebanon, NH 03756-0001, USA. William.B.Daviss@dartmouth.edu
Insights
Children hospitalized for injuries often experience acute stress disorder (ASD) symptoms. Parental distress and prior trauma significantly predict ASDS in pediatric injury patients.
Area of Science:
- Pediatric Psychology
- Trauma Studies
- Child Psychiatry
Background:
- Hospitalization for injuries can be a significant stressor for children.
- Acute Stress Disorder (ASD) and its symptomatology (ASDS) are potential outcomes.
- Identifying predictors is crucial for early intervention.
Purpose of the Study:
- To identify predictors of acute stress disorder (ASD) and ASD symptomatology (ASDS) in children hospitalized for injuries.
- To understand the factors contributing to post-injury psychological distress in pediatric patients.
Main Methods:
- Fifty-four pediatric patients hospitalized for injuries were assessed.
- Data collected included child and parent reports, injury severity, prior trauma, and family impact.
- Parent and nurse ratings were used to assess ASDS.
Main Results:
- A high percentage of children (92.6%) perceived their experience as meeting ASD criterion A.
- Parent reports indicated 7.4% met DSM-IV criteria for ASD, with 22.2% experiencing subsyndromal ASDS.
- Parental distress and prior psychopathology were strong predictors of ASDS, alongside injury severity.
Conclusions:
- Children frequently experience stress related to injury and hospitalization.
- Parent and nurse reports of ASDS show divergence.
- Parental distress, prior child psychopathology, and injury characteristics are key predictors of pediatric ASDS.
Objective:
To examine and identify predictors of acute stress disorder (ASD) and ASD symptomatology (ASDS) in children hospitalized for injuries.
Method:
Fifty-four youths were assessed while hospitalized for injuries. Dependent variables were parent and nurse ratings of children's ASDS. Independent variables included children's prior trauma exposure and behavior problems, injury severity and permanence, brain injury, injury or death to family/friend(s), parental distress, and child reports of the injury/hospitalization experience as meeting criterion A for ASD.
Results:
A total of 92.6% of children felt the current experience met criterion A, compared with 64.8% of parents. According to parent questionnaires, 4 subjects (7.4%) met DSM-IV criteria for ASD while another 12 (22.2%) had clinically significant but subsyndromal ASDS. Children's ASDS, as reported by parents, correlated highly with parental distress and ratings of children's prior psychopathology, and modestly with injury severity and family/friend(s) injured or killed. Nurses' ratings of children's ASDS correlated strictly with injury- and accident-related variables, and not with parent ratings of children's ASDS.
Conclusions:
Children perceive injuries and hospitalizations as stressful. ASDS is widely though divergently reported by parents and nurses in children hospitalized for injury. Parental distress, children's prior psychopathology, and injury-related factors may be useful predictors of children's postinjury ASDS.