Acute stress disorder and posttraumatic stress disorder in children and adolescents involved in assaults or motor vehicle accidents.
OBJECTIVE
The authors investigated acute stress disorder and later posttraumatic stress disorder (PTSD) in children and adolescents who had been involved in assaults or motor vehicle accidents.


METHODS
They interviewed 93 patients 10-16 years old who were seen in an emergency department for having been assaulted or involved in a motor vehicle accident within 4 weeks after the assault or accident to assess acute stress disorder. At 6 months, they reinterviewed 64 (68.8%) of the patients to assess PTSD.


RESULTS
At initial interview, 18 (19.4%) of the 93 patients had acute stress disorder and 23 (24.7%) met all acute stress disorder criteria except dissociation. At 6 months, eight of the 64 patients (12.5%) had PTSD. Acute stress disorder and PTSD did not differ in prevalence between patients who had been assaulted and those who had been in accidents. Sensitivity and specificity statistics and regression modeling revealed that the diagnosis of acute stress disorder was a good predictor of later PTSD but that dissociation did not play a significant role.


CONCLUSIONS
Acute stress disorder has merit as a predictor of later PTSD in children and adolescents, but dissociation has questionable utility.
Department of Psychology, Institute of Psychiatry, De Crespigny Park, London SE5 8AF, U.K. r.meiser-stedman@iop.kcl.ac.uk
Richard
R
Meiser-Stedman
William
W
Yule
Patrick
P
Smith
Ed
E
Glucksman
Tim
T
Dalgleish
D000063:Accidents, Traffic / Q000523:psychology*; D000293:Adolescent; D002648:Child; D015897:Comorbidity; D039721:Diagnostic and Statistical Manual of Mental Disorders; D004213:Dissociative Disorders / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology; D005260:Female; D006801:Humans; D008016:Life Change Events; D016015:Logistic Models; D008297:Male; D015995:Prevalence; D011569:Psychiatric Status Rating Scales / Q000706:statistics & numerical data; D012307:Risk Factors; D012680:Sensitivity and Specificity; D013313:Stress Disorders, Post-Traumatic / Q000175:diagnosis* / Q000453:epidemiology / Q000523:psychology; D040701:Stress Disorders, Traumatic, Acute / Q000175:diagnosis* / Q000453:epidemiology / Q000523:psychology; D014754:Violence / Q000523:psychology*