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The Relationship Between Acute Stress Disorder and Posttraumatic Stress Disorder in the Neonatal Intensive Care Unit

Received April 2, 2007; revised May 31, 2007; accepted June 5, 2007. From the Dept. of Psychiatry and Behavioral Sciences and the Dept. of Pediatrics, Stanford University School of Medicine; Lucile Packard Children’s Hospital, Palo Alto, CA. Send correspondence and reprint requests to Richard Shaw, M.B., B.S., Associate Professor, Dept. of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, 401 Quarry Rd., Palo Alto, CA 94305-5719. e-mail: rjshaw{at}stanford.edu
© 2009 The Academy of Psychosomatic Medicine

BACKGROUND: Having an infant hospitalized in the neonatal intensive care unit (NICU) is a highly stressful event for parents. Researchers have proposed posttraumatic stress disorder (PTSD) as a model to explain the psychological reaction of parents to their NICU experience. OBJECTIVE: The authors sought to examine the prevalence of PTSD in parents 4 months after the birth of their premature or sick infants and the relationship of PTSD and symptoms of acute stress disorder (ASD) immediately after their infant’s birth. METHOD: Eighteen parents completed a self-report measure of ASD at baseline in addition to self-report measures of PTSD and depression at a 4-month follow-up assessment. RESULTS: In the sample, 33% of fathers and 9% of mothers met criteria for PTSD. ASD symptoms were significantly correlated with both PTSD and depression. Fathers showed a more delayed onset in their PTSD symptoms, but, by 4 months, were at even greater risk than mothers. DISCUSSION: The relatively high levels of psychological distress experienced by parents coupled with the potential negative outcomes on the parent and infant suggest that it is important to try to prepare parents for the expected psychological reactions that may occur in the event of a NICU hospitalization and also to support parents during the transition to home care.

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