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PMTS and stress response sequences in parents of children with spina bifida
Ignace P R Vermaes1, Jan R M Gerris, Reinier A Mullaart
1Pediatric Psychology, Tilburg University, P.O. Box 90153, 5000 LE Tilburg, The Netherlands. i.p.r.vermaes@uvt.nl
Insights
Pediatric Medical Traumatic Stress (PMTS) symptoms affect 75% of parents after a spina bifida (SB) diagnosis, but typically decrease within four years. Some parents experience persistent symptoms requiring professional support.
Area of Science:
- Pediatric Psychology
- Developmental Psychology
- Clinical Psychology
Background:
- Spina bifida (SB) is a complex congenital condition requiring significant parental adaptation.
- Parents of children with SB may experience psychological distress, including symptoms of Pediatric Medical Traumatic Stress (PMTS).
- Understanding the prevalence and trajectory of PMTS in parents of children with SB is crucial for timely intervention.
Purpose of the Study:
- To investigate the presence and progression of Pediatric Medical Traumatic Stress (PMTS) symptoms in parents of children diagnosed with spina bifida (SB).
- To identify patterns of PMTS symptom clusters (Intrusion, Avoidance, Increased Arousal) over time.
- To explore factors influencing the persistence or resolution of these symptoms.
Main Methods:
- Prospective interviews with parents of 23 newborns with SB and retrospective interviews with parents of 58 school-aged children with SB.
- Assessment of PMTS symptoms using 17 DSM-IV criteria across Intrusion, Avoidance, and Increased Arousal clusters.
- Comparison of symptom trajectories based on child's age and SB type (open vs. closed).
Main Results:
- Within three months of diagnosis, 75% of parents reported Intrusion and Increased Arousal symptoms, but not Avoidance.
- PMTS symptoms generally declined in the first four years and stabilized in school-aged children.
- Approximately 30% of mothers and 20% of fathers showed persistent symptoms; mothers of children with open SB experienced slower symptom reduction.
Conclusions:
- An SB diagnosis initially triggers significant traumatic stress in most parents, with symptoms typically diminishing within the first four years.
- A minority of parents experience persistent severe stress symptoms beyond middle childhood, indicating a need for targeted psychological support.
- Longitudinal research is recommended to confirm these findings and inform clinical practice for parental psychological adjustment to SB.
Objective:
To test the presence and progress of Pediatric Medical Traumatic Stress (PMTS) symptoms in parents of children with spina bifida (SB).
Methods:
Parents of 23 newborns with SB were interviewed prospectively and parents of 58 school-aged children with SB were interviewed retrospectively. PMTS symptoms were assessed with 17 DSM-IV criteria for the clusters Intrusion, Avoidance, and Increased Arousal.
Results:
Within 3 months after the SB diagnosis, 75% of the parents met diagnostic criteria for symptoms of Intrusion and Increased Arousal, but not of Avoidance. In parents of school-aged children with SB, PMTS symptoms had declined in the first 4 years of the child's life and stabilized during the school years. Approximately 30% of the mothers and 20% of the fathers still met diagnostic criteria for Intrusion, Avoidance and Increased Arousal. In mothers of children with open SB, symptoms of Intrusion and Increased Arousal had decreased more slowly than in mothers of children with closed SB.
Conclusions:
An SB diagnosis initially provokes traumatic stress symptoms in three-quarters of the parents; however, in most of them, these symptoms diminish during the first 4 years of the child's life. In a minority of the parents, severe stress symptoms persist beyond middle childhood. Professional psychological help may need to be offered to this selective group of parents whose levels of stress do not decline after the child's preschool years. Longitudinal research is needed to further investigate and confirm the trends that were found in parents' psychological adjustment to SB.
