Burns patients were assessed 12 months following their injury to determine the factors that predict development of post-traumatic stress disorder (PTSD). Among 35 patients, 31 per cent suffered PTSD, 29 per cent suffered subclinical PTSD reactions and 40 per cent displayed no PTSD symptoms. Concern over scarring and an avoidant coping style accounted for 61 per cent of the variance in post-traumatic stress symptomatology. Only half of the patients reporting PTSD had sought professional assistance. The results indicate that postinjury adjustment factors are critical determinants of PTSD development following burns. Implications for therapeutic interventions are discussed.