Persistence of posttraumatic stress in violently injured youth seen in the emergency department

Arch Pediatr Adolesc Med. 2002 Aug;156(8):836-40. 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.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Academic Medical Centers
  • Acute Disease
  • Adolescent
  • Adult
  • Chi-Square Distribution
  • Child
  • Emergency Service, Hospital
  • Female
  • Humans
  • Male
  • Philadelphia / epidemiology
  • Prospective Studies
  • Severity of Illness Index
  • Stress Disorders, Post-Traumatic / diagnosis*
  • Stress Disorders, Post-Traumatic / epidemiology
  • Surveys and Questionnaires
  • Urban Population
  • Violence / psychology*
  • Wounds and Injuries / psychology*