PHILADELPHIA, PA - Post-traumatic stress disorder, or PTSD, is a common, but overlooked result of childhood traffic injury in both children and their parents, say Nancy Kassam-Adams, Ph.D., and Flaura Winston, MD, PhD, co-authors of a study appearing in the December issue of Pediatrics. This is the first study of its kind in the United States to examine PTSD in children and parents after traffic crashes.
PTSD is a group of symptoms and psychological reactions that may follow a traumatic experience. According to the study authors, even children who suffer minor injuries following a traffic incident are still at risk for developing this disorder.
"It might seem obvious that children with severe injuries could have a hard time coping afterwards, but we found that children with little or no physical injury were also at risk for developing PTSD, as were their parents," said Dr. Kassam-Adams.
The study was conducted at The Children's Hospital of Philadelphia, where researchers assessed the injury circumstances of 102 patients between the ages of 3 and 18, who were involved in traffic-related incidents and brought to the Hospital's Pediatric Emergency Department and Level 1 Trauma Center.
Seven to twelve months later, researchers talked with the parents of these children about their own and their children's psychological responses. According to the researchers, 25 percent of these children and 15 percent of their parents suffered PTSD, but only 46 percent of the parents of affected children sought help of any kind for their child, including talking to friends or family members. In addition, only 20 percent of the affected parents sought help for themselves.
"It's striking that so many parents and children had not reached out for help even from their family and friends, although the parents reported to us that they were quite upset by the injury and the crash," said Dr. Winston.
In determining which children were most likely to develop PTSD after an incident, researchers found that older children, as well as those children whose parents developed PTSD, were at a higher risk. In contrast, parents were more likely to have PTSD after an incident if their child was younger, if their child developed PTSD, or if the parent witnessed the incident in which the child was injured.
According to the study authors, traffic injury remains the leading health threat to children in the United States. In 1996, 938,000 children under 21 years of age were injured as passengers in cars, 39,000 pedestrians and 33,000 bicyclists.
Dr. Kassam-Adams and Winston are researchers at TraumaLink, a comprehensive pediatric trauma research center based at The Children's Hospital of Philadelphia and the University of Pennsylvania. At TraumaLink, work is conducted in all phases of an injury: pre-event, event, and post-event, in order to identify modifiable risk factors for poor injury outcome.
This research was made possible by funding received from the Agency for Health Care Policy and Research (AHCPR) and the Maternal and Child Health Bureau (MCHB), Health Resources and Services Administration.
The Children's Hospital of Philadelphia, the nation's first children's hospital, is a world-renowned leader in patient care, education and research. This 373-bed multispecialty hospital provides comprehensive pediatric services, including home care, to children from before birth through age 19. The hospital has more than 17,000 admissions, and provides care in more than 600,000 outpatient visits annually.
Journal
PEDIATRICS