ABSTRACT
There has been a recent increase in research focusing on child complex traumatic stress following prolonged or repeated trauma. These traumatic stress reactions often affect many aspects of the child's functioning, including psychological, behavioral, and physical health. In addition, complex traumatic stress experienced by youth with serious medical conditions may influence health issues such as medical adherence, emotional adjustment to illness, and pain management. This article reviews and delineates the current state of the literature on the impact of complex traumatic stress in childhood on mental and physical health as well as on these pediatric health-related issues. To date, few empirical studies have directly addressed this association. Several features associated with complex traumatic stress, such as emotion regulation difficulties, disruptive behavior, and family conflict, have indirectly been demonstrated to interfere with pediatric adherence, medical coping, and pain management. This demonstrates the need for more focused research in this area.
Subject(s)
Adaptation, Psychological , Pediatrics , Stress Disorders, Post-Traumatic/psychology , Stress Disorders, Post-Traumatic/therapy , Health Services Needs and Demand , Humans , Pain Management , Research , Risk FactorsABSTRACT
OBJECTIVE: To review the recent empirical literature concerning development of posttraumatic stress symptoms following pediatric injury and summarize risk and predictive factors that will inform clinical practice and research. METHODS: A systematic search of online databases such as PsycInfo, PILOTS, MedLine, and PubMed was performed. Further studies were identified through the reference lists of selected articles. RESULTS: Pre-injury psychological problems, the child's subjective experience of trauma severity/life threat, elevated heart rate immediately following the trauma, beliefs regarding initial symptoms, active thought suppression, and parental posttraumatic stress appear to be consistent predictors of persisting posttraumatic stress in children following injury. CONCLUSIONS: Specific variables may be useful in predicting posttraumatic stress following injury, which are discussed in terms of existing models of pediatric traumatic stress. Methodologies of included studies are also discussed.
Subject(s)
Stress Disorders, Post-Traumatic/diagnosis , Wounds and Injuries/complications , Child , Child, Preschool , Humans , Stress Disorders, Post-Traumatic/etiologyABSTRACT
OBJECTIVE: The purpose of this study was to identify and evaluate variables that have the greatest impact on psychological adjustment after burn injury among children, adolescents, and young adults. METHODS: Meta-analytical procedures were utilized to determine the strength of association indices of identified impact variables. Only 13 articles were utilized due to the scarcity of and statistical limitations of the research. RESULTS: The body location variable (.26) had the greatest mean strength of association in relation to psychological adjustment. The burn injury variable (.21) had the second greatest mean strength of association. Finally, both the parental adjustment variable and the child premorbid psychological functioning variable (.15) had the third greatest mean strength of association. CONCLUSIONS: A major implication of this research is that the impact variables identified will be useful in targeting burn patients who are at risk for psychological adjustment problems.
Subject(s)
Adaptation, Psychological , Burns/epidemiology , Burns/psychology , Social Adjustment , Anxiety/epidemiology , Anxiety/psychology , Child , Humans , Social SupportABSTRACT
OBJECTIVE: The present study attempted to examine specific differences in the Post-Traumatic Stress Disorder (PTSD) symptomatology among abused children with and without concurrent depression. METHOD: PTSD and depressive symptoms were identified that discriminate between 98 children divided into three groups: (1) abused children with PTSD, (2) nonabused children who meet criteria for Major Depressive Disorder (MDD), and (3) abused children with both PTSD and MDD. RESULTS: Analyses revealed that nine items reflecting depressive symptomatology, primarily vegetative symptoms, differentiated the diagnostic groups (PTSD-only, MDD-only, and the combined group). A discriminant analysis revealed that the sum of responses to the nine significant items adequately predicted diagnostic classification for those with PTSD and depression, but did not correctly diagnose any in the combined group. Analyses also revealed that three post-trauma symptoms, including psychological amnesia, flashbacks/reenactments, and sleep difficulties, discriminated between the groups. The PTSD-only group reported more episodes of psychological amnesia while the PTSD and MDD group experienced more flashbacks. CONCLUSIONS: For the sample of abused children examined, these results illuminate differences with respect to PTSD symptom presentation for those children with PTSD who have a concurrent depressive disorder and their nondepressed counterparts. Children with PTSD who have a concurrent depression report greater levels of intrusive PTSD-related symptoms.
