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Better predictors are needed for posttraumatic stress disorder in children

Philadelphia -- Clinicians seeking to predict which acutely traumatized children are in need of more extensive follow-up should not rely solely on assessment of acute stress disorder (ASD) as a diagnostic tool. Research at The Children's Hospital of Philadelphia found that only one in five children who developed posttraumatic stress disorder (PTSD) would have been identified during the immediate post-trauma period using only ASD diagnostic criteria. The study appears in the April issue of the Journal of the American Academy of Child and Adolescent Psychiatry.

"Based on previous findings that have found a strong connection between ASD and future PTSD in adults, we set out to demonstrate sensitivity and specificity in predicting child PTSD among children with significant ASD symptoms," said lead author Nancy Kassam-Adams, Ph.D., associate director of behavioral research, TraumaLink at Children's Hospital. "Only when we used symptom subsets like dissociation or arousal did we find sensitive predictors for PTSD."

The study population included 243 children admitted to The Children's Hospital of Philadelphia for traffic-related injuries between July 1999 and October 2001. The children had been injured in a traffic crash in which the child was a motor vehicle passenger, a pedestrian or a bicyclist. The researchers assessed ASD symptoms within one month of the injury in 243 children. They assessed PTSD at least three months after the injury in 177 of the 243 children assessed previously.

Acute stress disorder is a group of symptoms and reactions that may occur within the first month after a traumatic experience. ASD symptoms include re-experiencing the trauma (unwanted and upsetting thoughts or memories), avoiding reminders of the trauma, hyperarousal (jumpiness), and dissociation (emotional numbing, feelings of unreality).

Post-traumatic stress disorder (PTSD) is diagnosed when the re-experiencing, avoidance and hyperarousal symptoms persi
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Contact: Suzanne Hill
Hillsu@email.chop.edu
267-426-6067
Children's Hospital of Philadelphia
31-Mar-2004


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