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American Academy of Pediatrics
Article

Evaluation of an Early Risk Screener for PTSD in Preschool Children After Accidental Injury

Didier N. Kramer, Matthias B. Hertli and Markus A. Landolt
Pediatrics October 2013, 132 (4) e945-e951; DOI: https://doi.org/10.1542/peds.2013-0713
Didier N. Kramer
Department of Psychosomatics and Psychiatry, University Children’s Hospital Zurich, Zurich, Switzerland
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Matthias B. Hertli
Department of Psychosomatics and Psychiatry, University Children’s Hospital Zurich, Zurich, Switzerland
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Markus A. Landolt
Department of Psychosomatics and Psychiatry, University Children’s Hospital Zurich, Zurich, Switzerland
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Abstract

OBJECTIVES: To evaluate the effectiveness and most powerful selection of predictors of an early screening tool for posttraumatic stress disorder (PTSD) in a sample of 87 children ages 2 to 6 years after unintentional injury.

METHODS: The examined screener was administered within 6 to 13 days post accident and consisted of an adapted version of the Pediatric Emotional Distress Scale (PEDS), the PEDS-ES (PEDS Early Screener), and questions on 5 additional risk factors (preexisting child behavioral problems, parental preexisting chronic mental or physical illness, pretraumatic life events in the family, parental feelings of guilt, parental posttraumatic stress). The PTSD Semi-structured Interview and Observational Record for Infants and Young Children served as criterion measure 6 months after the accident. A case was deemed positive when meeting criteria for full or partial PTSD.

RESULTS: Use of the PEDS-ES without the additional risk factors performed best, with good sensitivity (85%) and moderate specificity (63%) for full or partial PTSD.

CONCLUSIONS: The PEDS-ES allows for successful early screening of preschool-aged children after single accidental trauma. It may be used within a stepped-care model for early identification of individuals designated for possible secondary preventative interventions.

  • accident
  • injuries
  • assessment and surveillance
  • mental health
  • public health
  • Abbreviations:
    AUC —
    area under the curve
    CI —
    confidence interval
    CTSQ —
    Child Trauma Screening Questionnaire
    NPV —
    negative predictive value
    PEDS —
    Pediatric Emotional Distress Scale
    PPV —
    positive predictive value
    PTSD —
    posttraumatic stress disorder
    PTSDSSI —
    PTSD Semi-structured Interview and Observational Record for Infants and Young Children
    ROC —
    receiver operating characteristic
    STEPP —
    Screening Tool for Early Predictors of PTSD
    STEPP-AUS —
    Australian Version of the Screening Tool for Early Predictors of PTSD
    • Accepted July 19, 2013.
    • Copyright © 2013 by the American Academy of Pediatrics

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    Pediatrics
    Vol. 132, Issue 4
    1 Oct 2013
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    Evaluation of an Early Risk Screener for PTSD in Preschool Children After Accidental Injury
    Didier N. Kramer, Matthias B. Hertli, Markus A. Landolt
    Pediatrics Oct 2013, 132 (4) e945-e951; DOI: 10.1542/peds.2013-0713

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    Evaluation of an Early Risk Screener for PTSD in Preschool Children After Accidental Injury
    Didier N. Kramer, Matthias B. Hertli, Markus A. Landolt
    Pediatrics Oct 2013, 132 (4) e945-e951; DOI: 10.1542/peds.2013-0713
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