Predicting the Transition From Acute Stress Disorder to Posttraumatic Stress Disorder in Children With Severe Injuries.

The data were collected before DSM-5, and the DSM-IV definition of acute stress disorder relied heavily on dissociation, so children with severe acute stress reactions may have been missed. The sample was modest, especially in the chronic and delayed groups, and many enrolled children were not included because they did not complete the hospital assessment and at least one follow-up. Attrition and missed assessments occurred during 18 months, and non-completers had shorter hospital stays, greater internalizing symptoms, and less family strain, so the analysed group may not represent all injured children. The study did not standardize or track post-discharge services, so some children may have received care that changed their outcomes. The sample included only children with injuries or burns, so findings may not apply to other trauma exposures. The study showed associations with later diagnostic groups, not that any single risk factor caused PTSD or that discharge planning prevents PTSD.

No author conflict-of-interest declaration is included in the supplied text. The publication types list NIH extramural research support.

Do not conclude that screening for dissociation or changing discharge planning prevents PTSD. This was an observational study, not a tested intervention, and 78 of 151 youth were resilient. Dissociation also did not separate children with only acute stress disorder from those who later developed only posttraumatic stress disorder.