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An initial application of a biopsychosocial framework to predict posttraumatic stress following pediatric injury
Meghan L Marsac1, Nancy Kassam-Adams1, Douglas L Delahanty2
1The Center for Injury Research and Prevention, The Children's Hospital of Philadelphia.
Insights
Childhood injuries can lead to poor health. This study found that threat appraisals and avoidant coping significantly impact posttraumatic stress symptoms (PTSS) in children after injury, suggesting targets for intervention.
Area of Science:
- Pediatric Psychology
- Trauma Studies
- Child Health
Background:
- Unintentional injuries affect millions of children annually, leading to significant emotional and physical health consequences.
- Understanding the factors influencing emotional recovery is crucial for effective pediatric care.
Purpose of the Study:
- To examine biopsychosocial factors, including appraisals and coping, in relation to posttraumatic stress symptoms (PTSS) in children following injury.
- To test hypotheses regarding the predictive roles of threat appraisals and coping in the development of PTSS.
- To investigate the mediating role of coping and the predictive utility of heart rate and trauma history.
Main Methods:
- A longitudinal study involving 96 children hospitalized for injury, with assessments at 2 weeks, 6 weeks, and 12 weeks post-injury.
- Data collection included measures of trauma history, threat appraisals, coping strategies, and PTSS.
- Structural equation modeling was used to analyze the relationships between variables.
Main Results:
- Child heart rate was not significantly associated with PTSS or appraisals.
- Early global and trauma-specific threat appraisals at T1 predicted PTSS at T1.
- Avoidant coping at 6 weeks (T2) significantly mediated the relationship between PTSS at T1 and PTSS at 12 weeks (T3).
Conclusions:
- Threat appraisals and coping strategies play a significant role in the development of PTSS following pediatric injury.
- Early interventions targeting threat appraisals and promoting adaptive coping may help prevent or reduce PTSS.
- A biopsychosocial framework is valuable for understanding and predicting PTSS in pediatric populations.
Objective:
Each year millions of children suffer from unintentional injuries that result in poor emotional and physical health. This study examined selected biopsychosocial factors (i.e., child heart rate, peritrauma appraisals, early coping, trauma history) to elucidate their roles in promoting emotional recovery following injury. The study evaluated specific hypotheses that threat appraisals (global and trauma-specific) and coping would predict subsequent posttraumatic stress symptoms (PTSS), that coping would mediate the association between early and later PTSS, and that heart rate would predict PTSS and appraisals would mediate this association.
Method:
Participants were 96 children hospitalized for injury and assessed at 3 time points: T1 (within 2 weeks of injury), T2 (6-week follow-up), and T3 (12-week follow-up). Participants completed measures of trauma history and appraisals at T1, coping at T2, and PTSS at T1, T2, and T3. Heart rate was abstracted from medical records. Structural equation modeling was employed to evaluate study hypotheses.
Results:
Heart rate was not associated with PTSS or appraisals. Models including trauma history, appraisals, coping, and PTSS were constructed to test other study hypotheses and fit the data well. T1 global and trauma-specific threat appraisals were associated with T1 PTSS; T2 avoidant coping was a significant mediator of the relation between T1 and T3 PTSS.
Conclusion:
Findings confirm a role for appraisals and coping in the development of PTSS over the weeks following pediatric injury. Early appraisals and avoidant coping may be appropriate targets for prevention and early intervention. Future researchers should further explicate the utility of a biopsychosocial framework in predicting PTSS. (PsycINFO Database Record
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