Two-Year PTSD Prediction in Children via SCR (Wiltshire 2024)

What was investigated?

In this prospective follow-up study from Wayne State University and Emory University, researchers investigated whether skin conductance response measured during a trauma interview in children can predict PTSD severity two years later. This question had previously been examined only in adults — this study provides one of the first prospective findings for elementary school-age children. A central focus was also the role of individual trauma exposure as a moderating factor: Does the extent of experienced adversity change how strongly the physiological response predicts subsequent PTSD trajectories?

Methods

43 children who had already participated in the cross-sectional study by Wiltshire et al. 2022 were reassessed two years after the initial assessment. At the time of baseline measurement, the children were on average nine years old, predominantly from African American families in an urban environment with elevated violence exposure, recruited in Detroit. At baseline, skin conductance response was continuously measured during a standardized trauma interview (TESI-C). At the two-year follow-up, PTSD symptom severity was assessed via self-report. Statistical analysis examined whether and under what conditions baseline skin conductance response predicts subsequent PTSD scores.

Results

The researchers found a statistically significant interaction between skin conductance response and the extent of trauma exposure in predicting subsequent PTSD severity. The results showed a differentiated pattern:

• Children with lower trauma exposure who simultaneously exhibited higher skin conductance response during the interview reported significantly higher PTSD severity two years later — even after statistical control for baseline PTSD symptomatology
• In children with higher trauma exposure, this association was not observed, which the researchers interpret as a possible ceiling effect of PTSD symptomatology in heavily burdened children

The findings suggest that elevated physiological reactivity in moderately trauma-exposed children may indicate increased biological vulnerability — a finding that is clinically significant, as this group is easily overlooked in routine screening.

Significance

This study provides one of the first prospective findings demonstrating that skin conductance response during a trauma interview in children can predict the PTSD trajectory over two years. While corresponding evidence for adults was already available (Hinrichs et al. 2019), this work fills an important gap in pediatric research.

Practically significant is that this prediction was possible using a consumer sensor (eSense Skin Response) in a clinical interview setting — without elaborate laboratory equipment. The moderating role of trauma exposure also shows that physiological biomarkers in clinical contexts should always be interpreted in conjunction with individual trauma history.