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首页> 外文期刊>Journal of the American Academy of Child and Adolescent Psychiatry >Acute stress symptoms in children: Results from an international data archive
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Acute stress symptoms in children: Results from an international data archive

机译：儿童急性应激症状：国际数据档案的结果

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Objective: To describe the prevalence of acute stress disorder (ASD) symptoms and to examine proposed DSM-5 symptom criteria in relation to concurrent functional impairment in children and adolescents. Method: From an international archive, datasets were identified that included assessment of acute traumatic stress reactions and concurrent impairment in children and adolescents 5 to 17 years of age. Data came from 15 studies conducted in the United States, United Kingdom, Australia, and Switzerland and included 1,645 children and adolescents. Dichotomized items were created to indicate the presence or absence of each of the 14 proposed ASD symptoms and functional impairment. The performance of a proposed diagnostic criterion (number of ASD symptoms required) was examined as a predictor of concurrent impairment. Results: Each ASD symptom was endorsed by 14% to 51% of children and adolescents; 41% reported clinically relevant impairment. Children and adolescents reported from 0 to 13 symptoms (mean = 3.6). Individual ASD symptoms were associated with greater likelihood of functional impairment. The DSM-5 proposed eight-symptom requirement was met by 202 individuals (12.3%) and had low sensitivity (0.25) in predicting concurrent clinically relevant impairment. Requiring fewer symptoms (three to four) greatly improved sensitivity while maintaining moderate specificity. Conclusions: This group of symptoms appears to capture aspects of traumatic stress reactions that can create distress and interfere with children's and adolescents' ability to function in the acute post-trauma phase. Results provide a benchmark for comparison with adult samples; a smaller proportion of children and adolescents met the eight-symptom criterion than reported for adults. Symptom requirements for the ASD diagnosis may need to be lowered to optimally identify children and adolescents whose acute distress warrants clinical attention.
机译：目的：描述急性应激障碍（ASD）症状的患病率，并研究与儿童和青少年并发功能障碍相关的DSM-5症状标准。方法：从一个国际档案库中，识别出包括5至17岁儿童和青少年的急性创伤应激反应和并发损伤评估的数据集。数据来自在美国，英国，澳大利亚和瑞士进行的15项研究，其中包括1,645名儿童和青少年。创建二分项目以指示14种拟议的ASD症状和功能障碍中每一种的存在与否。检查拟议的诊断标准的性能（所需的ASD症状数）作为并发损伤的预测指标。结果：每种ASD症状得到14％至51％的儿童和青少年的认可; 41％的患者报告临床相关损伤。儿童和青少年报告了0到13种症状（平均= 3.6）。个别的ASD症状与功能障碍的可能性更大。 DSM-5提出的8症状要求已由202名个体（12.3％）满足，并且在预测并发临床相关损伤方面敏感性较低（0.25）。只需较少的症状（三到四个），就可以大大提高敏感性，同时保持中等特异性。结论：这组症状似乎反映了创伤性应激反应的各个方面，这些方面可能会造成困扰并干扰儿童和青少年在急性创伤后阶段的功能。结果提供了与成人样本进行比较的基准;与成人相比，符合八症状标准的儿童和青少年比例较小。可能需要降低对ASD诊断的症状要求，以最佳地识别急性窘迫值得临床关注的儿童和青少年。

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