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The relationship between acute stress disorder and posttraumatic stress disorder in injured children

Richard A Bryant1, Karen Salmon, Emma Sinclair

  • 1School of Psychology, University of New South Wales, Sydney, Australia. R.Bryant@unsw.edu.au

Journal of Traumatic Stress
|December 25, 2007
PubMed

Insights

This study found that current acute stress disorder (ASD) criteria may not effectively identify injured children at high risk for developing posttraumatic stress disorder (PTSD). Acute stress reactions without dissociation better predicted PTSD than full ASD diagnoses.

Area of Science:

  • Pediatric Psychology
  • Trauma Studies
  • Child Psychiatry

Background:

  • Posttraumatic stress disorder (PTSD) is a significant concern following traumatic injury in children.
  • Acute stress disorder (ASD) is an early indicator of potential PTSD, but its diagnostic utility in pediatric populations requires further investigation.
  • Early identification of children at risk for PTSD is crucial for timely intervention.

Purpose of the Study:

  • To examine the relationship between acute stress disorder (ASD) and the subsequent development of posttraumatic stress disorder (PTSD) in children aged 7-13 years who sustained traumatic injuries.
  • To evaluate the predictive value of current ASD diagnostic criteria and specific symptom clusters for PTSD development in this pediatric cohort.
  • To determine if modifications to ASD criteria could improve the identification of high-risk children.

Main Methods:

  • A cohort of 76 children (7-13 years) admitted to a hospital for traumatic injuries were assessed for ASD.
  • A subset of 62 children were followed up at 6 months post-trauma and assessed for PTSD using the PTSD Reaction Index.
  • Statistical analyses were performed to compare ASD diagnoses with 6-month PTSD outcomes and to assess the predictive accuracy of different symptom presentations.

Main Results:

  • 10% of injured children met the criteria for ASD at the acute phase.
  • 13% of the total cohort met the criteria for PTSD at 6 months post-trauma.
  • Children diagnosed with ASD were significantly more likely to develop PTSD, with 25% of this subgroup meeting PTSD criteria at 6 months.
  • Acute stress reactions that included symptoms other than dissociation showed a stronger predictive relationship with PTSD than the full ASD diagnosis.

Conclusions:

  • The current diagnostic criteria for ASD may not be optimal for identifying younger children at high risk for developing PTSD after traumatic injury.
  • Specific acute stress reactions, particularly those lacking dissociative symptoms, may serve as more sensitive indicators of future PTSD development in pediatric trauma survivors.
  • Further research is warranted to refine early screening tools and diagnostic criteria for ASD in children to improve PTSD risk prediction and facilitate early intervention.

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