Accuracy of the Pediatric Emotional Distress Scale - Early Screener to predict the risk for developing PTSD in young children after accidental injury.

Abstract

Early identification of posttraumatic stress disorder (PTSD) in children is important to prevent chronic symptoms and long-term negative consequences. However, PTSD often goes unrecognized in the emergency setting of hospitals and screening methods for young children are lacking.

To evaluate the accuracy of an early screening tool for PTSD in a sample of young children (0-7 years) after unintentional injury.

The Pediatric Emotional Distress Scale - Early Screener (PEDS-ES) was administered to parents of children referred to the Emergency Department within 7 days post-accident (n = 82), and a validated interview for PTSD was administered 3 months after the accident as criterion measure: the Diagnostic Infant and Preschool Assessment (DIPA). Diagnostic accuracy of the PEDS-ES was inspected using area under the curve analyses including sensitivity, specificity, Positive and Negative Predictive Value.

After three months PTSD diagnosis was established in 21% of the children. Use of the PEDS-ES within 7 days after the injury showed fair accuracy with AUC = .727. Sensitivity (0.65) and specificity (0.73) for the suggested cutoff of 8 were moderate for predicting PTSD diagnosis 3 months after the injury. The examination of cutoff values that achieve enhanced sensitivity in a screening context - where sensitivity is prioritized - while maintaining a high level of specificity suggests that a lower cutoff of around 6 points may serve as a more sensitive (sensitivity: 0.82; specificity: 0.56) valid alternative cutoff score.

The PEDS-ES allows for successful early screening of risk for traumatic stress symptoms in young children after single accidental injury. It enables early identification of individuals who are at risk for developing PTSD and need further monitoring of symptoms, diagnostic assessment and treatment.