Depression, acute stress and behavioral risk factors in violently injured adolescents

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The objective of this study was to examine whether emergency department (ED) assessments of depressive and acute stress symptoms after an episode of interpersonal violence are associated with future risk behaviors, reinjury and posttraumatic stress disorder (PTSD) symptoms in adolescents.

Methods

Three hundred ninety-four injured adolescents (age range, 12–17 years) were assessed for depressive symptoms, acute stress symptoms and self-reported risk behaviors either during or immediately after an ED visit (T1). One hundred fifty-eight adolescents completed the follow-up assessment between 6 and 18 months later (T2), during which they were assessed again for self-reported risk behaviors, PTSD symptoms and reinjury.

Results

Depression ratings at T1 predicted risk behaviors at T2, controlling for risk behaviors at T1. Ratings of depression and acute stress at T1 predicted PTSD symptoms at T2 but did not significantly predict the self-reported incidence of violent reinjury at T2.

Conclusions

Assessment of depressive symptoms in adolescents who present to the ED after a violent event can help identify those in need of further and more formal assessments as well as, possibly, interventions to prevent future risk behaviors. Identification of depressive and acute stress symptoms can also help identify those violently injured youth who report subsequent PTSD symptoms.

Keywords: Depression; Violence; Injury; Acute stress; Emergency department

Megan E. Pailler Ph.D., Nancy Kassam-Adams Ph.D., Elizabeth M. Datner M.D. and Joel A. Fein M.D., M.P.H.

Division of Emergency Medicine, Children’s Hospital of Philadelphia, Philadelphia, PA 19104
Center for Injury Research and Prevention, Children’s Hospital of Philadelphia, Philadelphia, PA
Department of Emergency Medicine, University of Pennsylvania School of Medicine, Philadelphia, PA
Received 25 October 2006; accepted 9 April 2007.  Available online 23 June 2007.

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