Related Experiment Video
Updated: Oct 30, 2025
Polar Histogram Visualization of Acute Stress Disorder Scale Scores for Comprehensive Clinical Assessment
Published on: December 6, 2024
Screening of Acute Traumatic Stress Disorder and Posttraumatic Stress Disorder in Pediatric Trauma Patients: A Pilot
Ashley Mazo1, Megan Waddell, Julia Raddatz
1Division of Pediatric Emergency Medicine, Department of Emergency Medicine, Atrium Health Carolinas Medical Center, Charlotte, North Carolina (Drs Mazo and Reynolds); Hemby Pediatric Trauma (Ms Waddell) and The F. H. "Sammy" Ross Jr. Trauma Center (Ms Raddatz and Dr Christmas), Department of Surgery, Atrium Health Carolinas Medical Center, Charlotte, North Carolina; Dayton Children's Hospital, Dayton, Ohio (Dr Blankenship); Department of Psychiatry, Atrium Health Behavioral Health-Charlotte, Charlotte, North Carolina (Dr Rachal); and Division of Pediatric Emergency Medicine, Department of Emergency Medicine, Atrium Health Levine Children's Hospital, Charlotte, North Carolina (Dr Reynolds). Dr Mazo is now at the Division of Pediatric Emergency Medicine, Children's Hospital Colorado-Colorado Springs.
Insights
Pediatric trauma patients are at risk for acute stress disorder and PTSD. This pilot study evaluated screening tools to identify high-risk children, but faced enrollment challenges.
Area of Science:
- Pediatric trauma
- Mental health outcomes
- Psychological screening
Background:
- Children with traumatic injuries face risks of acute stress disorder and posttraumatic stress disorder (PTSD).
- Early identification and intervention are crucial for improving mental health in pediatric trauma patients.
Purpose of the Study:
- To assess the feasibility of a study protocol comparing three screening tools.
- To identify pediatric trauma patients at high risk for developing acute stress disorder or PTSD.
Main Methods:
- A pilot study randomized pediatric trauma patients (aged 7-17) to one of three screening tools.
- Families completed the Child Report of Post-Traumatic Symptoms questionnaire at 30, 60, and 90-120 days post-injury.
- Sensitivity and negative predictive value of screening tools were compared for PTSD diagnosis.
Main Results:
- Fifty-two patients met inclusion criteria; only 29 completed follow-up questionnaires.
- The prevalence of acute stress disorder was 41% and PTSD was 31% in the study population.
- Low participant completion rates and enrollment challenges were noted.
Conclusions:
- The study aimed to evaluate three common screening instruments for traumatic stress symptoms in pediatric trauma patients.
- Limitations included using one tool as the gold standard and enrollment process issues.
- A significant number of patients were discharged before enrollment could occur.
Background:
Children who experience traumatic physical injuries are at risk of developing acute stress disorder and posttraumatic stress disorder (PTSD). Early identification and treatment of these high-risk children can lead to improved mental health outcomes in this population.
Objective:
This study assesses the feasibility of a study protocol that compares 3 screening tools for identifying patients at a high risk of later development of acute stress disorder or PTSD among pediatric trauma patients.
Methods:
This pilot study compared 3 questionnaires used as screening tools for predictors of later development of PTSD in a convenience sample of pediatric trauma patients aged 7-17 years. Patients were randomized to one of 3 screening tools. Families were contacted at 30, 60, and 90-120 days postinjury to complete the Child Report of Post-Traumatic Symptoms questionnaire. The sensitivity and negative predictive value of the screening tools were compared for the diagnosis of PTSD defined using the Child Report of Post-Traumatic Symptoms questionnaire.
Results:
Of the 263 patients identified for possible enrollment, 52 patients met full inclusion criteria and agreed to participate. Only 29 (55.7%) patients completed at least one follow-up questionnaire. The prevalence of acute stress disorder and PTSD in our population was 41% (95% CI [24, 61]) and 31% (95% CI [15, 51]), respectively.
Conclusions:
In this pilot study, we sought to determine the utility of the 3 commonly used screening instruments for measuring traumatic stress symptoms in pediatric trauma patients to predict the diagnosis of acute stress disorder or PTSD. Limitations include the use of the Child Report of Post-Traumatic Symptoms screening tool as the gold standard for calculating test characteristics and lack of 24/7 enrollment capabilities. As such, a significant portion of patients were discharged prior to our teams' engagement for enrollment.
