Posttraumatic stress symptoms in children after mild to moderate pediatric trauma: A longitudinal examination of symptom prevalence, correlates, and parent-child symptom reporting
ABSTRACT Full recovery from injury may be hindered by both physical ailments and psychologic distress. Little information is available on the psychologic response of children to physical trauma, although long-term dysfunction may result if psychologic needs are not identified and addressed. This study examined the prevalence and correlates of posttraumatic stress disorder (PTSD) symptoms in children and adolescents after an acute traumatic event resulting in mild to moderate physical injury. We were also interested in analyzing the discrepancies between parent/child reporting of the child's PTSD symptomatology. Because of the paucity of research evaluating interventions for pediatric PTSD, and as a secondary objective for this study, we collected preliminary data on the effectiveness of a single-session art therapy intervention designed to reduce PTSD symptoms.
From July 1998 through October 2000, 83 children/adolescents between the ages of 7 and 17 and their caregivers were interviewed within 24 hours of hospital admission and assessed for PTSD symptomatology, trauma history, and other measures of child and family functioning. Interviews were repeated at 1 month, 6 months, and 18 months after the initial hospitalization. Patients with at least mild symptomatology at the initial interview were randomized to receive either an art therapy intervention or standard hospital services alone.
A total of 69% of children were found to have at least mild PTSD symptoms at baseline, 57% at 1 month, 59% at 6 months, and 38% at 18 months postinjury. Younger age and the severity of parental PTSD symptoms were correlated with symptom presence in children. Parents initially underreported their child's symptom severity when compared with the child's report, but assessments converged over time. The art therapy intervention showed no sustained effects on the reduction of PTSD symptoms.
The presence of PTSD symptoms in children after traumatic injury is very high. Parental distress and characteristics of the family environment appear to be more relevant to the presence of child symptoms than the family make-up, course of hospitalization, or extent of the child's injuries. Parents may not initially recognize the degree to which their children experience such symptoms. The high presence of symptoms in this population underscores the need for treatment efficacy studies and parent/medical staff education in identification of PTSD.
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ABSTRACT: To assess the neuropsychological and behavioral profiles of school-aged children treated for atrial septal defect, secundum type (ASD-II) with open-heart surgery or catheterization.Journal of Pediatrics 10/2014; 166(1). DOI:10.1016/j.jpeds.2014.08.039 · 3.74 Impact Factor
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ABSTRACT: This study examines levels of traumatic stress reactions among youth attending school in the second year after the 1994 Rwandan genocide. From August to December 1995, the survey team visited 22 schools throughout Rwanda. The survey (n = 942; youth aged 8 to 19 years) assessed exposure to wartime violence and symptoms of posttraumatic stress disorder (PTSD), as outlined in the Diagnostic and Statistical Manual of Mental Disorders (4th ed., text rev.; DSM–IV; American Psychiatric Association, 2000). Mean symptom levels and the proportion of respondents meeting DSM–IV PTSD symptom criteria (“probable PTSD”) were examined for evidence of systematic decline over time. Multivariate analyses controlled for major confounders and the complex survey design. Overall, traumatic stress reactions increased among youth interviewed at successively later time points. For example, in the first third of the survey period, the “probable PTSD” rate was 48%; in the second, 54%; and in the third, 58%. The rise was confined to females. Among females, the adjusted odds of having “probable PTSD” in the last third of the study period was 2.71 (95% CI [1.66, 4.43]) fold higher than in the first. These results suggest that in planning health services in postconflict settings, humanitarian agencies should be alert to the possibility that traumatic stress reactions among youth may not decline with passage of time. Despite limitations in design, to date, this report represents the only formal structured evaluation of the mental health of youth living in the community, in the very early aftermath of catastrophic violence. (PsycINFO Database Record (c) 2014 APA, all rights reserved)Psychological Trauma Theory Research Practice and Policy 05/2014; 6(3):269. DOI:10.1037/a0035240 · 0.89 Impact Factor