Predicting Posttraumatic Stress Symptoms in Children After Road Traffic Accidents

doi:10.1097/01.chi.0000181045.13960.67

Journal of the American Academy of Child & Adolescent Psychiatry

Volume 44, Issue 12, December 2005, Pages 1276-1283

https://doi.org/10.1097/01.chi.0000181045.13960.67 Get rights and content

ABSTRACT

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.

Section snippets

Aim of the Study

The purpose of this study was twofold:

1.
We aimed at prospectively assessing the prevalence and course of PTSSs in children 4-6 weeks and 12 months after an RTA. Based on previous findings, we expected to find clinically significant PTSSs in about 20%-25% of the sample, with a decrease over time.
2.
We aimed at investigating accident- and injury-related individual and parental predictors of PTSSs in children after an RTA. In accordance with earlier studies, we hypothesized that injury- and

Participants

Participants were assessed in four children's hospitals in the German-speaking part of Switzerland. Children were consecutively recruited over a period of 24 months. Parents and children were asked to participate in the study within the first 2 weeks after occurrence of an RTA if the following criteria were met: (1) hospitalization of at least 24 hours; (2) no severe head trauma; (3) age between 6.5 and 14.5 years; (4) fluency in German; and (5) no evidence of mental retardation (physician's

Characteristics of the Sample

Descriptive information about the sample is contained in Table 1. Of the sample, 85.3% was of Swiss origin, and 8.8% originated from a Mediterranean country (Italy, Spain, former Yugoslavia). Most families were from the upper or middle class, probably on account of the language requirement (many non-Swiss nationals are from the lower classes). Fifty-seven children (83.8%) lived with both biological parents. The children had received minor head injuries (58.8%), lower extremity fractures

DISCUSSION

This prospective study found that clinically significant PTSSs occur in a small but significant portion of school-age children as a consequence of RTAs, thus confirming our initial hypothesis. The prevalence of moderate to severe PTSSs was 16.2% at 4-6 weeks, and 17.6% at 12-month follow-up. This is consistent with earlier findings that 10%-35% of traffic-injured children have PTSD or clinically relevant PTSSs (de Vries et al., 1999; Di Gallo et al., 1997; Landolt et al., 2003; McDermott and

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This study was funded by grants from the Gebert-Ruef-Foundation, the Hugo and Elsa-Isler-Foundation, and the Anna-Mueller-Grocholski-Foundation.

Disclosure: The authors have no financial relationships to disclose.

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ARTICLESPredicting Posttraumatic Stress Symptoms in Children After Road Traffic Accidents

ABSTRACT

Objective

Method

Results

Conclusions

Section snippets

Aim of the Study

Participants

Characteristics of the Sample

DISCUSSION

J Am Acad Child Adolesc Psychiatry

Behav Res Ther

J Am Acad Child Adolesc Psychiatry

J Am Acad Child Adolesc Psychiatry

J Pediatr

J Am Acad Child Adolesc Psychiatry

J Pediatr Surg

J Psychosom Res

Diagnostic and Statistical Manual of Mental Disorders, DSM-IV-TR, Text Revision

Posttraumatic stress in children following acute physical injury

J Pediatr Psychol

Cross-cultural Research Methods

Psychological consequences of road traffic accidents for children and their mothers

Psychol Med

Transactional patterns of child, mother, and father adjustment in insulin-dependent diabetes mellitus: a prospective study

J Pediatr Psychol

Looking beyond the physical injury: posttraumatic stress disorder in children and parents after pediatric traffic injury

Pediatrics

Road traffic accidents: early psychological consequences in children and adolescents

Br J Psychiatry

Psychological consequences of road traffic accidents in children

Eur Child Adolesc Psychiatry

ARTICLES
Predicting Posttraumatic Stress Symptoms in Children After Road Traffic Accidents