Young burned children: the course of acute stress and physiological and behavioral responses.
OBJECTIVE
Symptoms of posttraumatic stress disorder (PTSD) are a focus of much research with older children, but little research has been conducted with young children, who account for about 40% of all pediatric burn injuries. This is a longitudinal study of 72 acutely burned children (12-48 months old) that assessed the course of acute posttraumatic symptoms and physiological reactivity.


METHODS
Parents were interviewed shortly after their child was admitted to the hospital and 1 month after discharge. PTSD symptoms were measured with the Diagnostic Interview for Children and Adolescents (DICA) module. Nurses recorded the child's physiological data throughout the hospital stay. The child's physical and behavioral responses were assessed in a laboratory at about 1 month after discharge.


RESULTS
Reduced social smiling in the children was related to PTSD symptoms, as measured by the DICA, and heart rate at 24 hours and 7 days. Reduced vocalization was related to the child's rating of pain at 24 hours. Smiling and vocalizations were also related to some DICA cluster scores but not avoidance.


CONCLUSIONS
Preschool children admitted to a burn unit demonstrated PTSD symptoms and physiological reactivity. There was a relation to the frequency of smiles and vocalizations.
Stoddard
Frederick J
FJ
Shriners Burns Hospital, Harvard Medical School, 51 Blossom St., Boston, MA 02114, USA. fstoddard@partners.org
Ronfeldt
Heidi
H
Kagan
Jerome
J
Drake
Jennifer E
JE
Snidman
Nancy
N
Murphy
J Michael
JM
Saxe
Glenn
G
Burns
Jennifer
J
Sheridan
Robert L
RL
D000367:Age Factors; D002053:Burn Units / Q000706:statistics & numerical data; D002056:Burns / Q000175:diagnosis* / Q000523:psychology; D002648:Child; D002673:Child, Hospitalized / Q000523:psychology / Q000706:statistics & numerical data; D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D006339:Heart Rate / Q000502:physiology; D006801:Humans; D007223:Infant; D008137:Longitudinal Studies; D008297:Male; D010147:Pain Measurement; D011569:Psychiatric Status Rating Scales; D012904:Smiling / Q000502:physiology; D013060:Speech / Q000502:physiology; D013313:Stress Disorders, Post-Traumatic / Q000175:diagnosis* / Q000523:psychology; D040701:Stress Disorders, Traumatic, Acute / Q000175:diagnosis / Q000523:psychology