title: Mediators of Initial Acute and Later Posttraumatic Stress in Youth in a PICU.
abstract: OBJECTIVE
  Youth in a PICU and their parents may experience initial symptoms of acute stress disorder and later symptoms of posttraumatic stress disorder. The objective of this study was to examine potential mediators of these conditions, including youth anxiety, depression, negative affect, and hospital fear, as well as parent anxiety and depression
  
  
  METHODS
  This study involved a short longitudinal design that encompassed initial assessments in a PICU setting and later assessments 4-7 weeks after discharge.
  
  
  METHODS
  Youth and their parents completed dependent measures in the hospital and at follow-up at the youth's home or an outpatient clinic setting.
  
  
  METHODS
  Fifty youth aged 9-17 yrs were admitted to a PICU for respiratory illness/asthma (30.0%), trauma (26.0%), surgery and after surgery recovery (20.0%), infections/viral illness (8.0%), neurologic disorder (6.0%), or other (10.0%). Parents (n = 50) were also assessed.
  
  
  METHODS
  None.
  
  
  RESULTS
  Measures were utilized for youth anxiety, acute stress, depression, negative affect, posttraumatic stress, and hospital fear, as well as parent anxiety, acute stress, depression, and posttraumatic stress. Some youth (26%) and parents (24%) had substantial posttraumatic stress disorder symptoms develop. Youth acute stress disorder symptoms in the PICU predicted later youth posttraumatic stress disorder symptoms, parent acute stress disorder symptoms in the PICU predicted later parent posttraumatic stress disorder symptoms, and youth acute stress disorder symptoms in the PICU predicted later parent posttraumatic stress disorder symptoms. Youth anxiety, negative affect, and hospital fear mediated initial youth acute stress disorder symptoms and later youth posttraumatic stress disorder symptoms.
  
  
  CONCLUSIONS
  Youth in a pediatric intensive care unit are at increased risk for posttraumatic stress disorder and should be screened for acute stress disorder.
authors.affiliation: 1University of Nevada, Las Vegas, Las Vegas, NV. 2University Medical Center, Las Vegas, Las Vegas, NV.
authors.forename: Stephanie
authors.initials: S
authors.lastname: Stowman
authors.forename: Christopher A
authors.initials: CA
authors.lastname: Kearney
authors.forename: Kshama
authors.initials: K
authors.lastname: Daphtary
mesh_terms: D000293:Adolescent; D000328:Adult; D000339:Affect; D001007:Anxiety / Q000523:psychology; D002648:Child; D003863:Depression / Q000523:psychology; D005239:Fear / Q000523:psychology; D005260:Female; D005500:Follow-Up Studies; D006760:Hospitalization; D006801:Humans; D015278:Intensive Care Units, Pediatric; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D010290:Parents / Q000523:psychology*; D010351:Patient Discharge; D010361:Patients / Q000523:psychology*; D012307:Risk Factors; D013313:Stress Disorders, Post-Traumatic / Q000453:epidemiology* / Q000523:psychology*; D040701:Stress Disorders, Traumatic, Acute / Q000523:psychology; D013997:Time Factors