Emergency department evaluation of acute stress disorder symptoms in violently injured youths
Emergency department evaluation of acute stress disorder symptoms in violently injured youths
复制标题
DOI：
10.1067/mem.2001.118225
复制
发表时间：
2001-10-01
影响因子：
6.2
通讯作者：
Datner, EM
中科院分区：
文献类型：
--
作者：
Fein, JA;Kassam-Adams, N;Datner, EM
研究目的：我们评估了在急诊室评估急性应激障碍 (ASD) 症状的可行性，并对这些症状在遭受暴力伤害的城市儿童和年轻人中的患病率、严重程度和变异性进行了初步估计。方法：对年龄在 8 至 24 岁之间的暴力受伤患者进行了即时压力反应检查表 (ISRC)，这些患者在 10 周的时间内到 2 个城市学术医疗中心急诊室就诊。 ISRC 旨在在创伤事件发生后立即评估儿童和青少年的 ASD 症状。使用症状严重程度总和和症状计数来描述反应。结果：在 109 名已确定的青少年中，有 81 人参与。 59 名 (73%) 的研究参与者报告了受伤事件期间的恐惧、无助或恐惧。大量青少年报告了以下每一类 ASD 症状：创伤周围解离症，63 例（78%）；创伤后解离，33（41%）；重新体验侵入性想法或图像，66 (82%)；回避，53（65%）；和过度警觉，32（39%）。 ISRC 在该队列中表现出较高的内部一致性（Cronbach α=.88）。结论：ISRC 可用于评估遭受暴力伤害的青少年在受伤后的短期内的急性应激反应。尽管这些反应似乎很常见，但不同症状类别之间存在很大差异。这些结果支持需要进一步调查即时压力反应与暴力伤害的长期情绪影响之间的关系。临床医生应考虑评估因人际暴力而受伤的儿童和青少年的情绪反应，即使这些伤害看起来很轻微。
Study objective: We assess the feasibility of evaluating acute Stress disorder (ASD) symptoms in the emergency department and provide an initial estimate of the prevalence, severity, and variability of these symptoms in violently injured urban children and young adults.Methods: The Immediate Stress Response Checklist (ISRC) was administered-to violently injured patients between the ages of 8 and 24 years who presented to 2 urban, academic medical center EDs during a 10-week period. The ISRC is designed to assess ASD symptoms in children and youths immediately after a traumatic event. Responses are described using summed symptom severity scores and counts of symptoms.Results: Out of 109 identified youths, 81 participated. Fear, helplessness, or horror during the injury event was reported by 59 (73%) of study participants. Each of the following categories of ASD symptoms was reported by a significant number of youths: peritrauma dissociation, 63 (78%); posttrauma dissociation, 33 (41%); re-experiencing intrusive thoughts or images, 66 (82%); avoidance, 53 (65%); and hyperarousal, 32 (39%). The ISRC demonstrated high internal consistency (Cronbach alpha=.88) in this cohort.Conclusion: The ISRC can be used to assess acute-stress reactions in violently injured youths in the immediate period after injury. Although these reactions appear to be common, there is substantial variability among distinct symptom categories. These results support the need for further investigation of the relationship between immediate stress responses and longer-term emotional impact of violent injury. Clinicians should consider assessing the emotional responses of children and adolescents who are injured by interpersonal violence, even when these injuries seem minor.