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Acute stress symptoms in young children with burns

Frederick J Stoddard1, Glenn Saxe2, Heidi Ronfeldt2

  • 1Drs. Stoddard, Saxe, and Ronfeldt are with the Department of Psychiatry, Shriners Burns Hospital, and Massachusetts General Hospital, Harvard Medical School, Boston; Dr. Saxe is also with the Boston University Medical Center/National Child Traumatic Stress Network; Dr. Sheridan is with the Department of Surgery, Shriners Burns Hospital, and Massachusetts General Hospital, Harvard Medical School, Boston; Ms. Drake is currently with and Ms. Burns and Edgren were formerly with the Department of Psychiatry, Shriners Burns Hospital..

Journal of the American Academy of Child and Adolescent Psychiatry
|December 6, 2005
PubMed

Insights

Young children with burns experience high rates of acute stress symptoms. Burn size, pain, pulse rate, and parental stress are key risk factors identified in a new predictive model.

Area of Science:

  • Pediatric burn care
  • Trauma psychology
  • Child development

Background:

  • Posttraumatic stress disorder (PTSD) research primarily focuses on older children, despite young children accounting for half of pediatric burn injuries.
  • Limited research exists on acute traumatic stress outcomes in infants and toddlers (12-48 months) following burn injuries.

Purpose of the Study:

  • To assess the prevalence of acute traumatic stress symptoms in acutely burned young children (12-48 months).
  • To develop a predictive model identifying risk factors for acute stress symptoms in this vulnerable population.

Main Methods:

  • Utilized the Posttraumatic Stress Disorder Semi-Structured Interview and Observational Record for Infants and Young Children.
  • Assessed behavioral and physiological responses, observed pain (Visual Analogue Scale), parental stress (Stanford Acute Stress Reaction Questionnaire), and burn severity (total body surface area).
  • Employed path analysis to construct a risk factor model.

Main Results:

  • Nearly 30% of the 52 participating young children exhibited acute stress symptoms.
  • Identified two independent pathways to acute stress symptoms: (1) burn size to hospital pulse rate, and (2) child's pain to parental stress.
  • The model explained 39% of the variance in acute stress symptoms with excellent fit.

Conclusions:

  • Young children with burns have a high prevalence of acute stress symptoms.
  • Burn size, pain, pulse rate, and parental stress symptoms are significant predictors of acute stress in young burn survivors.
Abstract

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