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

• Published in: Journal of pediatric health care 2016-11, Vol.30 (6), p.558-568
• Main Authors: Brown, Ruth C., PhD, Nugent, Nicole R., PhD, Hawn, Sage E., BS, Koenen, Karestan C., PhD, Miller, Alisa, PhD, Amstadter, Ananda B., PhD, Saxe, Glenn, MD
• Format: Article
• Language: English
• Subjects: Accidents - psychology; acute stress disorder; Adolescent; Advanced Practice Nursing; Boston; Checklist; Child; Disease Progression; Exposure to Violence - psychology; Female; Health Surveys; Hospitalization; Humans; longitudinal; Longitudinal Studies; Male; Pediatrics; posttraumatic stress disorder; 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; Trauma; Wounds and Injuries - physiopathology; Wounds and Injuries - psychology
• ISSN: 0891-5245; 1532-656X
• DOI: 10.1016/j.pedhc.2015.11.015

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.