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Predictive validity of acute stress disorder in children and adolescents

Medical Research Council Cognition and Brain Sciences Unit, Cambridge, UK

Richard Meiser-Stedman, PhD

Institute of Psychiatry, University of London, UK

Nancy Kassam-Adams, PhD

The Children’s Hospital of Philadelphia, USA

Anke Ehlers, PhD

Institute of Psychiatry, University of London, UK

Flaura Winston, MD, PhD

The Children’s Hospital of Philadelphia, USA

Patrick Smith, PhD

Institute of Psychiatry, University of London, UK

Bridget Bryant, PhD and Richard A. Mayou, FRCPsych

Department of Psychiatry, University of Oxford, UK

William Yule, PhD

Institute of Psychiatry, University of London, UK.

Correspondence: Tim Dalgleish, Medical Research Council Cognition and Brain Sciences Unit, 15 Chaucer Road, Cambridge CB2 2EF, UK. Email: tim.dalgleish{at}mrc-cbu.cam.ac.uk

Declaration of interest

None.

Adult research suggests that the dissociation criterion of acute stress disorder has limited validity in predicting post-traumatic stress disorder (PTSD). We addressed this issue in child and adolescent survivors (n=367) of road accidents. Dissociation accounted for no significant unique variance in later PTSD, over and above other acute stress disorder criteria. Furthermore, thresholds of either three or more re-experiencing symptoms, or six or more re-experiencing/hyperarousal symptoms, were as effective at predicting PTSD as the full acute stress disorder diagnosis.