5194.0: Wednesday, November 15, 2000 - 2:54 PM

Abstract #11479

Injury surveillance in a Level I Pediatric Trauma Center: Looking at Acute Stress Disorder symptoms in children and parents after traffic crashes

Nancy Kassam-Adams, PhD1, Flaura K. Winston, MD, PhD1, Cara M. Vivarelli, MPH1, and Perry Stafford, MD2. (1) The Children's Hospital of Philadelphia, TraumaLink, 34th St. & Civic Center Blvd, 3535 TraumaLink, 10th Floor, Suite 1024, Philadelphia, PA 19104, (2) The Children's Hospital of Philadelphia, Division of Pediatric and Thoracic Surgery

Background/Objective: Screening and evaluation of early psychological sequelae of traffic crashes in children and parents may allow acute care clinicians to target psychosocial interventions to those most at risk. Acute Stress Disorder (ASD) symptoms in the early post-injury period have predicted the future development of Post Traumatic Stress Disorder (PTSD) in other traumatized individuals. The study objective was to assess the prevalence of early ASD symptoms in children admitted to a pediatric trauma center, and in their parents. Design/Methods: Children and parents were enrolled as part of an ongoing prospective investigation of ASD and PTSD after pediatric traffic-related injury. Children ages 5-17, admitted to an urban Level I Pediatric Trauma Center, were evaluated within two weeks of injury. Trained interviewers administered verbal questionnaires in the child's hospital room or in the family's home soon after hospital discharge. Results: 15% of participants met symptom criteria for ASD, and many others reported significant acute stress responses (% children reported, % parents reported): intrusive thoughts/images (51%,46%); avoidance (56%,39%); hyperarousal (68%,76%); and dissociation (37%,20%). Conclusions: Symptoms of ASD are common in the immediate post-injury period for children and parents. Screening for ASD by acute care clinicians will help identify those at risk for developing PTSD. Prospective studies of the relationship between ASD and PTSD may aid in the development of effective secondary prevention strategies for injured children and parents at risk for PTSD.

Learning Objectives: Participants will be able to: 1) List the key elements of Acute Stress Disorder (ASD); 2) Describe the incidence of ASD in children and adolescents with traffic-related injuries; and 3) Discuss the implications of Emergency Department screening of ASD symptoms for secondary prevention of psychological sequelae of traffic-related injury

Keywords: Injuries, Psychological Indicators

Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: None
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.

The 128th Annual Meeting of APHA