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Predicting Posttraumatic Stress Symptoms Longitudinally in a Representative Sample of Hospitalized Injured Adolescents

NCJ Number
216045
Journal
Journal of the American Academy of Child & Adolescent Psychiatry Volume: 45 Issue: 10 Dated: October 2006 Pages: 1188-1195
Author(s)
Douglas F. Zatzick M.D.; David C. Grossman M.D.; Joan Russo Ph.D.; Robert Pynoos M.D.; Lucy Berliner MSW; Gregory Jurkovich M.D.; Janice A. Sabin MSW; Wayne Katon M.D.; Angela Ghesquiere MSW; Elizabeth McCauley Ph.D.; Frederick P. Rivara M.D.
Date Published
October 2006
Length
8 pages
Annotation
Adolescents, who constitute a high-risk population for traumatic physical injury, were assessed for the development of posttraumatic stress disorder (PTSD) symptoms over time in representative samples.
Abstract
A substantial number of adolescents who were hospitalized for an injury had high PTSD symptom levels that persisted over the 12 months following their injuries. Clinical characteristics identified after the injury predicted the development of PTSD over the 12 months. Between 19 percent and 32 percent of adolescents screened positive for PTSD (had PTSD Reaction Index scores of approximately 38) over the 12 months after their injuries. Higher initial PTSD and depressive symptoms, higher heart rate while in the emergency department, greater objective event severity, and greater parental preinjury trauma were significant independent predictors of higher adolescent PTSD symptoms. The authors advise that real-world clinical trials that test screening and intervention procedures for representative samples of at-risk youths are warranted. The study was conduced between July 2002 and August 2003 and involved 108 randomly selected injured adolescent patients (ages 12-18) and their parents. Participants were interviewed as soon as possible after the injury and again at 2, 5, and 12 months after the injury. Initially, participants were screened for PTSD symptoms with the PTSD Reaction Index and for depressive symptoms with the Center of Epidemiologic Studies Depression Scale, as well as preinjury trauma. Random-coefficient regression was used to assess the association between initial clinical, injury, and demographic characteristics and the development and persistence of PTSD symptoms over time. 3 tables, 1 figure, and 48 references