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Preventive intervention for trauma reactions in young injured children: results of a multi-site randomised controlled
Ann-Christin Haag1,2, Markus A Landolt1,3, Justin A Kenardy4
1Department of Psychosomatics and Psychiatry, and Children's Research Centre, University Children's Hospital Zurich, Zurich, Switzerland.
Insights
A new intervention helps young children recover faster from posttraumatic stress symptoms (PTSS) after injury. This study shows a targeted therapy significantly reduces PTSS severity and improves outcomes for children at high risk.
Area of Science:
- Pediatric Psychology
- Trauma and Injury Research
- Clinical Psychology
Background:
- Young children are highly vulnerable to injury and subsequent posttraumatic stress disorder (PTSD), with 10-25% developing the condition.
- Currently, no empirically supported preventive interventions exist to mitigate PTSD risk in young injured children.
- This study addresses the critical need for effective early interventions to prevent psychological distress in pediatric trauma survivors.
Purpose of the Study:
- To evaluate the efficacy of a standardized, targeted preventive intervention for posttraumatic stress symptoms (PTSS) in young children (1-6 years) following injury.
- To determine if the intervention accelerates recovery and reduces the incidence of PTSD diagnosis, functional impairment, and behavioral difficulties.
Main Methods:
- A multi-site, parallel-group, superiority randomized controlled trial (RCT) was conducted in Australia and Switzerland.
- High-risk injured children (1-6 years) were randomized to a 2-session CBT-based intervention or treatment-as-usual (TAU).
- Primary outcomes included PTSS severity, PTSD diagnosis, functional impairment, and behavioral difficulties assessed at 3 and 6 months post-injury.
Main Results:
- The intervention group (n=62) showed a significant effect on PTSS severity over time compared to the TAU group (n=71).
- At 3 months, children receiving the intervention exhibited an accelerated reduction in PTSS severity scores (mean difference -6.97).
- Significant treatment effects were also observed for PTSD diagnosis, functional impairment, and behavioral difficulties in the intervention group.
Conclusions:
- This multi-site RCT provides promising preliminary evidence for the efficacy of a targeted preventive intervention in young injured children.
- The intervention effectively accelerates recovery from PTSS and improves psychological outcomes in high-risk pediatric trauma survivors.
- Findings have significant clinical implications for early psychological support for young children and their parents post-trauma.
Background:
Young children are at particular risk for injury. Ten per cent to twenty-five per cent develop posttraumatic stress disorder (PTSD). However, no empirically supported preventive interventions exist. Therefore, this study evaluated the efficacy of a standardised targeted preventive intervention for PTSD in young injured children.
Methods:
Injured children (1-6 years) were enrolled in a multi-site parallel-group superiority prospective randomised controlled trial (RCT) in Australia and Switzerland. Screening for PTSD risk occurred 6-8 days postaccident. Parents of children who screened 'high-risk' were randomised to a 2-session CBT-based intervention or treatment-as-usual (TAU). Primary outcomes were PTSD symptom (PTSS) severity, and secondary outcomes were PTSD diagnosis, functional impairment and behavioural difficulties at 3 and 6 months postinjury using blinded assessments. Trials were registered with the Australian New Zealand Clinical Trials Registry (ACTRN12614000325606) and ClinicalTrials.gov (NCT02088814). Trial status is complete.
Results:
One hundred and thirty-three children screened 'high-risk' were assigned to intervention (n = 62) or TAU (n = 71). Multilevel intention-to-treat analyses revealed a significant intervention effect on PTSS severity over time (b = 60.06, 95% CI: 21.30-98.56). At 3 months, intervention children (M = 11.02, SD = 10.42, range 0-47) showed an accelerated reduction in PTSS severity scores compared to control children (M = 17.30, SD = 13.94, range 0-52; mean difference -6.97, 95% CI: -14.02 to 0.08, p adj. = .055, d = 0.51). On secondary outcomes, multilevel analyses revealed significant treatment effects for PTSD diagnosis, functional impairment and behavioural difficulties.
Conclusions:
This multi-site RCT provides promising preliminary evidence for the efficacy of a targeted preventive intervention for accelerating recovery from PTSS in young injured children. This has important clinical implications for the psychological support provided to young children and parents during the acute period following a single-event trauma.
