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Pathways to PTSD, part I: Children with burns
Glenn N Saxe1, Frederick Stoddard, Erin Hall
1Department of Child and Adolescent Psychiatry, Boston University School of Medicine, Dowling 1 North, 1 Boston Medical Center Place, Boston, MA 02118, USA. glenn.saxe@bmc.org
The American Journal of Psychiatry
|July 5, 2005
Summary
This study identified two main pathways to posttraumatic stress disorder (PTSD) in burned children: one through separation anxiety and another through acute dissociation. These factors significantly predict PTSD symptoms in pediatric burn survivors.
Area of Science:
- Pediatric Psychology
- Trauma Studies
- Burn Injury Research
Background:
- Childhood trauma can lead to long-term psychological distress.
- Burn injuries are a significant source of acute trauma in children.
- Understanding risk factors for pediatric posttraumatic stress disorder (PTSD) is crucial for effective intervention.
Purpose of the Study:
- To develop and validate a predictive model for posttraumatic stress disorder (PTSD) in children experiencing acute burns.
- To identify key biobehavioral pathways contributing to PTSD development after burn injury.
Main Methods:
- Seventy-two children (ages 7-17) hospitalized for acute burns participated.
- Self-report measures of psychopathology and environmental stress were administered during hospitalization and at 3-month follow-up.
- Path analysis was employed to model risk factors for PTSD.
Main Results:
- Two significant pathways to PTSD were identified: burn size/pain to separation anxiety to PTSD, and burn size to acute dissociation to PTSD.
- These pathways collectively explained nearly 60% of the variance in PTSD symptoms.
- The developed model demonstrated excellent fit indices.
Conclusions:
- Childhood PTSD following burns has a complex etiology.
- Two independent pathways, potentially mediated by distinct biobehavioral systems, contribute to PTSD development.
- These findings highlight the importance of assessing separation anxiety and dissociation in burned children.