Clinical predictors of posttraumatic stress disorder after closed head injury in children.
OBJECTIVE
To describe injury, demographic, and neuropsychiatric characteristics of children who develop posttraumatic stress disorder (PTSD) and posttraumatic stress symptoms (PTSS) after closed head injury (CHI).


METHODS
Ninety-five children with severe CHI and amnesia for the event were prospectively followed for 1 year. Structured interviews were administered twice to the parents: shortly after injury to cover the child's premorbid status, and 1 year after injury. The child was also interviewed twice: shortly after injury to cover current status, and 1 year after injury. Outcome measures were diagnostic status (PTSD by parent or child) and symptom severity (PTSS by parent or child).


RESULTS
Twelve children developed PTSD by 1 year after injury, 5 according to parent report, 5 according to child report, and 2 according to both parent and child report. Predictors of PTSD at 1 year post-CHI included female gender and early post-CHI anxiety symptoms. Predictors of PTSS at 1 year post-CHI were (1) premorbid psychosocial adversity, premorbid anxiety symptoms, and injury severity; and (2) early post-CHI depression symptoms and nonanxiety psychiatric diagnoses.


CONCLUSIONS
PTSD developed in 13% of children with severe CHI accompanied by traumatic amnesia. Predictors of PTSD and PTSS after CHI, according to parent and child report, are consistent with predictors of PTSD and PTSS that develop after non-head injury trauma.
Gerring
Joan P
JP
Johns Hopkins University School of Medicine, Baltimore, MD, USA. jgerring@jhmi.edu
Slomine
Beth
B
Vasa
Roma A
RA
Grados
Marco
M
Chen
Anita
A
Rising
William
W
Christensen
James R
JR
Denckla
Martha B
MB
Ernst
Monique
M
D000293:Adolescent; D000328:Adult; D000647:Amnesia / Q000209:etiology* / Q000523:psychology*; D002648:Child; D002675:Child, Preschool; D005260:Female; D016489:Head Injuries, Closed / Q000523:psychology*; D006801:Humans; D008297:Male; D015999:Multivariate Analysis; D011446:Prospective Studies; D012044:Regression Analysis; D012307:Risk Factors; D013313:Stress Disorders, Post-Traumatic / Q000453:epidemiology / Q000209:etiology*; D014481:United States / Q000453:epidemiology