Separation Anxiety as a Mediator Between Acute Morphine Administration and PTSD Symptoms in Injured Children

Emerging evidence suggests that individuals who receive morphine while hospitalized demonstrate a decrease in symptoms of posttraumatic stress disorder (PTSD). However, the mechanisms of effects are not yet well understood. The goal of the current study was to examine three possible mediators for this effect. Sixty-one injured (burns, motor vehicle accidents, falls, and assaults) children were assessed during hospitalization and again 3 months post discharge. Assessment included acute and follow-up child report measures of pain, PTSD, and anxiety symptoms, as well as a medical record review for medication administration and pulse during hospitalization. Pathway analyses were conducted to test the potential mediating roles of pain reduction, noradrenergic attenuation, and separation anxiety on the association between morphine and PTSD. Results suggest that a reduction in separation anxiety may mediate the association between morphine administration and PTSD symptom reduction at 3 months. These findings have implications for our understanding of morphine's effects on psychological functioning following an acute injury and for direct clinical care.