Persistence of Posttraumatic Stress in Violently Injured Youth Seen in the Emergency Department | Adolescent Medicine | JAMA Pediatrics | JAMA Network
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August 2002

Persistence of Posttraumatic Stress in Violently Injured Youth Seen in the Emergency Department

Author Affiliations

From the Divisions of Emergency Medicine (Dr Fein, Mss Gavin and Blanchard, and Mr Huang) and General Pediatrics (Dr Kassam-Adams), the Children's Hospital of Philadelphia, Emergency Department (Dr Datner), the Hospital of the University of Pennsylvania, and Departments of Pediatrics (Dr Fein, Mss Gavin and Blanchard, and Mr Huang), Child and Adolescent Psychiatry (Dr Kassam-Adams), and Emergency Medicine (Dr Datner), the University of Pennsylvania School of Medicine, Philadelphia.

Arch Pediatr Adolesc Med. 2002;156(8):836-840. doi:10.1001/archpedi.156.8.836

Objective  To determine if symptoms of posttraumatic stress, initially evaluated in the emergency department (ED) setting, persist over time.

Design  Prospective cohort study.

Setting  Two urban, academic medical center EDs.

Patients  Sixty-nine injured patients, aged 12 to 24 years, were assessed for acute posttraumatic stress symptoms at the time of their enrollment in an ongoing ED-based study of intentional youth violence, and assessed for posttraumatic stress symptoms up to 5 months later.

Main Outcome Measures  The Immediate Stress Reaction Checklist, administered during the ED visit, and the Symptom Checklist of the Child and Adolescent Trauma Survey, administered during routine telephone follow-up.

Results  Patients in the emergency department reported a range of acute stress symptoms on the Immediate Stress Reaction Checklist, with 25% reporting clinically significant distress. On follow-up assessment, 15% reported significant posttraumatic stress symptoms. The severity of acute stress symptoms was strongly associated with the severity of posttraumatic stress symptoms at follow-up (r = 0.55, P<.005). Age, sex, injury type, and time from injury to follow-up were not associated with the degree of acute stress or posttraumatic stress symptom severity at initial or follow-up assessment.

Conclusion  This study provides preliminary evidence that acute stress symptoms, assessed in the ED in the immediate aftermath of a traumatic injury, are useful indicators of risk for later posttraumatic stress.