Incidence of and risk factors for acute stress disorder in children with injuries.
BACKGROUND
To assess the incidence of and risk factors for Acute Stress Disorder (ASD) in children with injuries. Numerous studies have documented the increased incidence of PTSD in those initially diagnosed with ASD. PTSD symptoms cause tremendous morbidity and may persist for many years in some children.


METHODS
Children hospitalized with one or more injuries were interviewed and assessed with the following: Child Stress Disorders Checklist (CSDC), Family Strains Scale, Brief Symptom Inventory (BSI) and Facial Pain Scale.


RESULTS
Participants included sixty-five children (ages 7-18 years). The mechanisms of injury varied (e.g. MVC, penetrating). The mean injury severity score was 8.9 +/- 7. The mean length of hospital stay was 4.6 +/- 4.6 days. Altogether, 18 (27.7%) of participants met DSM IV criteria for ASD during their acute hospital stay. Risk factors such as level of family stress, caregiver stress, child's experience of pain, and child's age were predictive of acute stress symptoms.


CONCLUSIONS
We have identified four risk factors of ASD that have implications for the treatment, and possibly, preventative intervention for PTSD. Further investigation and greater understanding of risk factors for ASD in children with injuries may facilitate the design of acute interventions to prevent the long-term negative outcomes of traumatic events.
Saxe
Glenn N
GN
Department of Child and Adolescent Psychiatry, Boston Medical Center, MA 02118, USA. glenn.saxe@bmc.org
Miller
Alisa
A
Bartholomew
David
D
Hall
Erin
E
Lopez
Carlos
C
Kaplow
Julie
J
Koenen
Karestan C
KC
Bosquet
Michelle
M
Allee
Lisa
L
Erikson
Ingrid
I
Moulton
Steve
S
D000293:Adolescent; D001900:Boston / Q000453:epidemiology; D002648:Child; D005190:Family; D006801:Humans; D015994:Incidence; D015601:Injury Severity Score; D010147:Pain Measurement; D012307:Risk Factors; D012923:Social Class; D040701:Stress Disorders, Traumatic, Acute / Q000175:diagnosis / Q000209:etiology*; D014947:Wounds and Injuries / Q000145:classification / Q000150:complications* / Q000523:psychology