Acute stress disorder symptomatology during hospitalization for pediatric injury

Objective: To examine and identity predictors of acute stress disorder (ASD ) and ASD symptomatology (ASDS) in children hospitalized for injuries. Meth od: Fifty-four youths were assessed while hospitalized for injuries. Depend ent variables were parent and nurse ratings of children's ASDS. Independent variables included children's prior trauma exposure and behavior problems, injury severity and permanence, brain injury, injury or death to family/fr iend(s), parental distress, and child reports of the injury/hospitalization experience as meeting criterion A for ASD. Results: A total of 92.6% of ch ildren felt the current experience met criterion A, compared with 64.8% of parents. According to parent questionnaires, 4 subjects (7.4%) met DSM-IV c riteria for ASD while another 12 (22.2%) had clinically significant but sub syndromal ASDS. Children's ASDS, as reported by parents, correlated highly with parental distress and ratings of children's prior psychopathology, and modestly with injury severity and family/friend(s) injured or killed. Nurs es' ratings of children's ASDS correlated strictly with injury- and acciden t-related variables, and not with parent ratings of children's ASDS. Conclu sions: Children perceive injuries and hospitalizations as stressful. ASDS i s widely though divergently reported by parents and nurses in children hosp italized for injury. Parental distress, children's prior psychopathology, a nd injury-related factors may be useful predictors of children's postinjury ASDS.