Acute stress symptoms in children: Results from an international data archive

Kassam-Adams, Nancy, Palmieri, Patrick A., Rork, Kristine, Delehanty, Douglas L., Kenardy, Justin, Kohser, Kristen L., Landolt, Markus A., Le Brocque, Robyne, Marsac, Meghan L., Meiser-Stedman, Richard, Nixon, Reginald D. V., Bui, Eric and McGrath, Caitlin (2012) Acute stress symptoms in children: Results from an international data archive. Journal of the American Academy of Child & Adolescent Psychiatry, 51 8: 812-820.


Author Kassam-Adams, Nancy
Palmieri, Patrick A.
Rork, Kristine
Delehanty, Douglas L.
Kenardy, Justin
Kohser, Kristen L.
Landolt, Markus A.
Le Brocque, Robyne
Marsac, Meghan L.
Meiser-Stedman, Richard
Nixon, Reginald D. V.
Bui, Eric
McGrath, Caitlin
Title Acute stress symptoms in children: Results from an international data archive
Journal name Journal of the American Academy of Child & Adolescent Psychiatry  (ERA 2012 Listed)    (ERA 2010 Rank A)   Check publisher's open access policy
Publication date 2012-05-29
Sub-type Article
DOI 10.1016/j.jaac.2012.05.013
Volume number 51
Issue number 8
ISSN 0890-8567
1527-5418
Start page 812
End page 820
Total pages 9
Place of publication Amsterdam, Netherlands
Publisher Elsevier
Collection year 2013
Language eng
Formatted abstract Objective: To describe the prevalence of acute stress disorder (ASD) symptoms and to examine proposed DSM-5 symptom criteria in relation to concurrent functional impairment in children and adolescents.

Method: From an international archive, datasets were identified that included assessment of acute traumatic stress reactions and concurrent impairment in children and adolescents 5 to 17 years of age. Data came from 15 studies conducted in the United States, United Kingdom, Australia, and Switzerland and included 1,645 children and adolescents. Dichotomized items were created to indicate the presence or absence of each of the 14 proposed ASD symptoms and functional impairment. The performance of a proposed diagnostic criterion (number of ASD symptoms required) was examined as a predictor of concurrent impairment.

Results: Each ASD symptom was endorsed by 14% to 51% of children and adolescents; 41% reported clinically relevant impairment. Children and adolescents reported from 0 to 13 symptoms (mean = 3.6). Individual ASD symptoms were associated with greater likelihood of functional impairment. The DSM-5 proposed eight-symptom requirement was met by 202 individuals (12.3%) and had low sensitivity (0.25) in predicting concurrent clinically relevant impairment. Requiring fewer symptoms (three to four) greatly improved sensitivity while maintaining moderate specificity.

Conclusions: This group of symptoms appears to capture aspects of traumatic stress reactions that can create distress and interfere with children's and adolescents' ability to function in the acute post-trauma phase. Results provide a benchmark for comparison with adult samples; a smaller proportion of children and adolescents met the eight-symptom criterion than reported for adults. Symptom requirements for the ASD diagnosis may need to be lowered to optimally identify children and adolescents whose acute distress warrants clinical attention.
Keyword Acute stress disorder
Diagnostic criteria
Dsm-5
Q-Index Code C1
Q-Index Status Confirmed Code
Institutional Status UQ

Document type: Journal Article
Sub-type: Article
Collections: Official 2013 Collection
School of Medicine Publications
 
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Created: Thu, 09 Aug 2012, 14:06:30 EST by Chesne McGrath on behalf of Medicine - Royal Brisbane and Women's Hospital