title: PTSD, cyberbullying and peer violence: prevalence and correlates among adolescent emergency department patients.
abstract: OBJECTIVE
  Posttraumatic stress disorder (PTSD) is often underdiagnosed and undertreated among adolescents. The objective of this analysis was to describe the prevalence and correlates of symptoms consistent with PTSD among adolescents presenting to an urban emergency department (ED).
  
  
  METHODS
  A cross-sectional survey of adolescents aged 13-17 years presenting to the ED for any reason was conducted between August 2013 and March 2014. Validated self-report measures were used to measure mental health symptoms, violence exposure and risky behaviors. Multivariate logistic regression analysis was performed to determine adjusted differences in associations between symptoms consistent with PTSD and predicted correlates.
  
  
  RESULTS
  Of 353 adolescents, 23.2% reported current symptoms consistent with PTSD, 13.9% had moderate or higher depressive symptoms and 11.3% reported past-year suicidal ideation. Adolescents commonly reported physical peer violence (46.5%), cyberbullying (46.7%) and exposure to community violence (58.9%). On multivariate logistic regression, physical peer violence, cyberbullying victimization, exposure to community violence, female gender and alcohol or other drug use positively correlated with symptoms consistent with PTSD.
  
  
  CONCLUSIONS
  Among adolescents presenting to the ED for any reason, symptoms consistent with PTSD, depressive symptoms, physical peer violence, cyberbullying and community violence exposure are common and interrelated. Greater attention to PTSD, both disorder and symptom levels, and its cooccurring risk factors is needed.
authors.affiliation: Department of Emergency Medicine, Rhode Island Hospital/Alpert Medical School, Brown University, 593 Eddy Street, Claverick 2, Providence, RI 02903, USA; Brown University School of Public Health, 121 South Main Street, Providence, RI 02903, USA. Electronic address: mranney@lifespan.org.
authors.forename: Megan L
authors.initials: ML
authors.lastname: Ranney
authors.affiliation: Brown University School of Public Health, 121 South Main Street, Providence, RI 02903, USA. Electronic address: john_patena@alumni.brown.edu.
authors.forename: John V
authors.initials: JV
authors.lastname: Patena
authors.affiliation: Department of Psychiatry and Human Behavior, Alpert Medical School, Brown University, 222 Richmond Street, Providence, RI 02903, USA. Electronic address: nicole_nugent@brown.edu.
authors.forename: Nicole
authors.initials: N
authors.lastname: Nugent
authors.affiliation: Department of Psychiatry and Human Behavior, Alpert Medical School, Brown University, 222 Richmond Street, Providence, RI 02903, USA. Electronic address: anthony_spirito@brown.edu.
authors.forename: Anthony
authors.initials: A
authors.lastname: Spirito
authors.affiliation: Department of Emergency Medicine, University of Massachusetts Worcester, 55 Lake Avenue, North Worcester, MA 01655, USA. Electronic address: edward.boyer@childrens.harvard.edu.
authors.forename: Edward
authors.initials: E
authors.lastname: Boyer
authors.affiliation: Department of Psychiatry and Behavioral Sciences, University of Washington, 2815 Eastlake Avenue, Seattle, WA 98102, USA. Electronic address: dzatzick@u.washington.edu.
authors.forename: Douglas
authors.initials: D
authors.lastname: Zatzick
authors.affiliation: Department of Emergency Medicine, University of Michigan Medical School, 1301 Catherine Street, Ann Arbor, MI 48109, USA; Injury Control Research Center, University of Michigan, Ann Arbor, MI 48109-2800, USA. Electronic address: stroh@med.umich.edu.
authors.forename: Rebecca
authors.initials: R
authors.lastname: Cunningham
mesh_terms: D000293:Adolescent; D058445:Bullying / Q000706:statistics & numerical data*; D019548:Crime Victims / Q000706:statistics & numerical data*; D003430:Cross-Sectional Studies; D003863:Depression / Q000453:epidemiology; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D008297:Male; D010379:Peer Group; D015995:Prevalence; D013313:Stress Disorders, Post-Traumatic / Q000453:epidemiology*; D059020:Suicidal Ideation; D014754:Violence / Q000706:statistics & numerical data*
keywords: Adolescent; Cyberbullying; Emergency department; PTSD; Violence