Predicting the Transition From Acute Stress Disorder to Posttraumatic Stress Disorder in Children With Severe Injuries

J Pediatr Health Care. 2016 Nov-Dec;30(6):558-568. doi: 10.1016/j.pedhc.2015.11.015. Epub 2016 Jan 14.

Abstract

Introduction: The purpose of this study was to examine predictors of risk for and the transition between acute stress disorder (ASD) and posttraumatic stress disorder (PTSD) in a longitudinal sample of youth with severe injuries admitted to the hospital. These data would assist with treatment and discharge planning.

Methods: Youth were assessed for ASD during the initial hospital stay and were followed-up over an 18-month period for PTSD (n = 151). Youth were classified into four groups, including Resilient (ASD-, PTSD-), ASD Only (ASD+, PTSD-), PTSD Only (ASD-, PTSD+), and Chronic (ASD+, PTSD+). Demographic, psychiatric, social context, and injury-related factors were examined as predictors of diagnostic transition.

Results: The results of multivariate analysis of variance and pairwise comparisons found that peritraumatic dissociation, gender, and socioeconomic status were significant predictors after controlling for multiple testing.

Discussion: Results suggest that both within-child and contextual factors contribute to the longitudinal response to trauma in children. Clinicians should consider early screening and discharge planning, particularly for children most at risk.

Keywords: Trauma; acute stress disorder; longitudinal; posttraumatic stress disorder.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Accidents / psychology*
  • Adolescent
  • Boston
  • Checklist
  • Child
  • Disease Progression*
  • Exposure to Violence / psychology*
  • Female
  • Health Surveys
  • Hospitalization
  • Humans
  • Longitudinal Studies
  • Male
  • Prevalence
  • Risk Factors
  • Severity of Illness Index
  • Social Environment
  • Stress Disorders, Post-Traumatic* / diagnosis
  • Stress Disorders, Post-Traumatic* / psychology
  • Stress Disorders, Traumatic, Acute* / diagnosis
  • Stress Disorders, Traumatic, Acute* / psychology
  • Wounds and Injuries / physiopathology
  • Wounds and Injuries / psychology*