The broad, long-term objectives of this proposed project are to understand variables influencing the longitudinal course of post-traumatic symptoms among a sample of children who have experienced a similar traumatic event, an acute burn. This study aims to determine the influence of a variety of biopsychosocial variables on the emergence and persistence of post-traumatic symptoms in children hospitalized with an acute burn. Such knowledge can facilitate the early identification of children """"""""at risk"""""""" for PTSD. the current project proposes to evaluate 100 children between the ages of seven and seventeen who are hospitalized for an acute burn at the Shriners Burns Institute in Boston. Children and families will be evaluated shortly after the burn and data concerning a variety of """"""""risk factors"""""""" for PTSD will be collected. Such data include family stress, the stress of medical intervention, self-esteem and acute dissociative symptoms. Children and families will be evaluated for the presence of acute stress symptoms. Salivary cortisol and MHPG, as well as lymphocyte glucocorticoid receptors, will be assessed. Children will be reassessed at three months, one year and two years after discharge from the hospital. At each of these assessments, child and parent's post-traumatic symptoms, as well as variables such as pain, body image, family stress, medical/surgical treatment, and neuroendocrine function will be evaluated. Data will be analyzed using an innovative approach to examining longitudinal data suggested by Willett (1988). The trajectories of each child's post-traumatic symptoms over the two years of the study will be plotted. Multiple regression analyses will be used to determine the degree to which the variables studied influence the course of these symptoms.
