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Predicting posttraumatic stress symptoms in children after road traffic accidents
Markus A Landolt1, Margarete Vollrath, Karin Timm
1University Children's Hospital, Zurich, Switzerland. markus.landolt@kispi.unizh.ch
Insights
Posttraumatic stress symptoms (PTSSs) in children after road traffic accidents (RTAs) remain prevalent and may not decrease over time. Fathers' PTSD significantly predicts child PTSSs, highlighting the need for family-centered interventions.
Area of Science:
- Pediatric Psychology
- Trauma Studies
- Accident Medicine
Background:
- Road traffic accidents (RTAs) are a significant source of trauma for children.
- Understanding the psychological impact of RTAs on children and their families is crucial for effective intervention.
Purpose of the Study:
- To prospectively evaluate the prevalence, course, and predictors of posttraumatic stress symptoms (PTSSs) in children following RTAs.
- To assess the psychological impact on parents and its relation to child PTSSs.
Main Methods:
- A prospective study involving 68 children (aged 6.5-14.5 years) assessed 4-6 weeks and 12 months post-RTA using the Child PTSD Reaction Index.
- Mothers (n=60) and fathers (n=53) were assessed using the Posttraumatic Diagnostic Scale.
Main Results:
- The prevalence of moderate to severe PTSSs in children was approximately 16-18% at both assessment points.
- Child PTSSs at 12 months were predicted by earlier PTSSs and the severity of the father's posttraumatic stress disorder (PTSD).
- Five children exhibited a delayed onset of PTSSs; parental PTSD rates were higher initially, decreasing by 12 months.
Conclusions:
- Psychological assessment of children and parents after RTAs is essential.
- Monitoring for PTSSs should extend beyond the initial weeks due to the possibility of delayed onset.
- Fathers' PTSD impacts child PTSSs, advocating for their inclusion in family-based interventions for RTAs.
Objective:
To prospectively assess the prevalence, course, and predictors of posttraumatic stress symptoms (PTSSs) in children after road traffic accidents (RTAs).
Method:
Sixty-eight children (6.5-14.5 years old) were interviewed 4-6 weeks and 12 months after an RTA with the Child PTSD Reaction Index (response rate 58.6%). Their mothers (n = 60) and fathers (n = 53) were assessed with the Posttraumatic Diagnostic Scale.
Results:
The prevalence of moderate to severe PTSSs in children was 16.2% at 4-6 weeks, and 17.6% at 12 months. Mean PTSS scores did not decrease between the two assessments. Five children showed a delayed onset of PTSSs. Twelve mothers (20%) and six fathers (11.3%) met criteria for posttraumatic stress disorder (PTSD) at 4 to 6 weeks. At 12 months, three mothers (5.7%) and no fathers met diagnostic criteria. Child PTSSs at 12 months was significantly predicted by PTSS at 4-6 weeks and by severity of father's PTSD. Age, sex, injury severity, threat appraisal, and maternal PTSD did not significantly contribute to child PTSSs at follow-up.
Conclusions:
There is a need for careful psychological assessment of children and their parents after an RTA. The possibility of delayed onset of PTSSs implies a monitoring beyond the first weeks after the accident. The impact of fathers' PTSD on child PTSSs suggests that fathers ought to be actively involved in family-based prevention and treatment interventions of child PTSSs after RTAs.
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