Posttraumatic stress disorder (PTSD) in injured children and their parents is common, but under-diagnosed, following a child's traumatic injury. Researchers at The Children's Hospital of Philadelphia have developed a simple screening tool, involving specific questions asked at the initial treatment visit, that can help predict the likelihood of a child or parent developing persistent PTSD. The Screening Tool for Early Predictors of PTSD (STEPP) is described in the August 6 issue of the Journal of the American Medical Association.

"Until now, health care providers did not have a simple way to tell, early on, who could be at risk of PTSD after a child injury," said Flaura K. Winston, M.D., Ph.D., study co-author and director of TraumaLink at Children's Hospital. "We hope that acute care physicians can use this screening tool to help determine who should be referred for psychological evaluation and intervention so that families can avoid PTSD."

PTSD is a group of symptoms and reactions that occurs following a traumatic event that persist for a long time (at least one month) and impair an individual's everyday functioning. Symptoms include re-experiencing the trauma (unwanted and upsetting thoughts or memories), avoiding reminders of the trauma, and hyperarousal (jumpiness).

Through their ongoing research, Dr. Winston and her colleagues found that severity of injury is not necessarily a predictor of PTSD. Instead, a combination of event-related factors, early physiological reactions such as heart rate, and early psychological responses serves to predict future development of PTSD.

STEPP was developed in a population of children who had traffic-related injuries and their parents. The STEPP method includes four yes/no questions asked of the parent, four yes/no questions asked of the child, and four items easily obtained from medical records.

To create STEPP, researchers had 171 families complete a 50-question risk factor survey at the ini
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Contact: Suzanne Hill
Hillsu@email.chop.edu
267-426-6067
Children's Hospital of Philadelphia
5-Aug-2003

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