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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
PubMed

Insights

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.
Abstract

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