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Predicting child PTSD: the relationship between acute stress disorder and PTSD in injured children

Nancy Kassam-Adams1, Flaura Koplin Winston

  • 1TraumaLink, Division of General Pediatrics, The Children's Hospital of Philadelphia, PA 19104, USA. nlkaphd@mail.med.upenn.edu

Journal of the American Academy of Child and Adolescent Psychiatry
|June 10, 2004
PubMed

Insights

A significant number of injured children develop acute stress disorder (ASD) and posttraumatic stress disorder (PTSD). Subsyndromal ASD symptoms were more effective predictors of PTSD than full ASD criteria.

Area of Science:

  • Pediatric trauma
  • Child psychology
  • Trauma and stressor-related disorders

Background:

  • Injured children are at risk for developing acute stress disorder (ASD) and posttraumatic stress disorder (PTSD).
  • Understanding the prevalence and predictive utility of early trauma responses is crucial for intervention.

Purpose of the Study:

  • To determine the prevalence of ASD and PTSD in children hospitalized for injuries.
  • To assess the effectiveness of ASD as a predictor of PTSD in this population.

Main Methods:

  • Prospective study of 243 children hospitalized for traffic crash injuries.
  • ASD assessed within 1 month post-injury; PTSD assessed 3+ months post-injury.
  • Correlations and predictive values calculated to evaluate ASD's utility in predicting PTSD.

Main Results:

  • 8% of children met ASD criteria; 14% had subsyndromal ASD.
  • 6% met PTSD criteria; 11% had subsyndromal PTSD.
  • Subsyndromal ASD symptoms were more predictive of PTSD than full ASD criteria; overall prediction sensitivity was low.

Conclusions:

  • Traumatic stress disorders affect a substantial minority of injured children.
  • ASD may not be an optimal categorical predictor for PTSD in children.
  • Further research into valid assessment and triage models for early posttrauma services is warranted.
Abstract

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