Acute stress disorder is common among children and parents following pediatric traffic injury

June 05, 2002

Philadelphia -- In 90 percent of families with children injured in a traffic crash, the child or a parent will suffer at least one significant acute stress symptom, according to a study at The Children's Hospital of Philadelphia. And 25 percent of children and parents experience more pervasive symptoms that warrant clinical attention. Nancy Kassam-Adams, Ph.D. and Flaura K. Winston, M.D., Ph.D., co-authors of the study in the June 2002 issue of Pediatrics, offer guidelines for assessing acute stress symptoms in children and parents.

"The study investigated the range of acute stress symptoms in children and their parents to enable pediatricians to better identify and address the psychological impact of injury," said Dr. Kassam-Adams, associate director of behavioral research, TraumaLink at Children's Hospital. "Evidence about the prevalence of these symptoms in injured children can help physicians distinguish between normal reactions to trauma and reactions that require further care and follow-up."

The study population included 97 children who were admitted to The Children's Hospital of Philadelphia for traffic related injuries between July 1999 and May 2000. The children had been injured in a traffic crash in which the child was a passenger, a pedestrian, or a bicyclist.

"A key component to assessing acute stress is that pediatricians understand how both parents and children respond to a child's injury," states Dr. Winston, director of TraumaLink. "It is normal for parents to be very distressed in the aftermath of a child's injury, yet parents' own acute stress symptoms may influence a child's response to the traumatic event."

Acute stress disorder is a group of symptoms and reactions that may occur within the first month after a traumatic experience. ASD symptoms include re-experiencing the trauma (unwanted and upsetting thoughts or memories), avoiding reminders of the trauma, hyperarousal (jumpiness), and dissociation (numbing, feelings of unreality).

Post-traumatic stress disorder (PTSD) is diagnosed when these symptoms persist for a long time (at least one month) and begin to impair the individual's everyday functioning. Prior research indicates that even children with minor injuries from a traffic crash are at risk for developing PTSD, say Dr. Kassam-Adams and Dr. Winston. For adults, ASD symptoms soon after a traumatic event are a warning sign for developing PTSD. However, there has been little research available for pediatricians about ASD symptoms and later PTSD in injured children.

The Children's Hospital researchers found that acute stress symptoms were common within the first month after injury. Among injured children and their parents, more than four-fifths experienced at least one significant acute stress symptom. About one quarter of children and parents experienced broad acute distress, reporting symptoms of dissociation, re-experiencing, avoidance, and hyper-arousal. Forty percent of the families were affected by these more pervasive acute stress symptoms, with the injured child, the parent, or both reporting broad distress. Symptoms did not always co-occur in both parent and child.

"We need to identify effective ways for health care providers to support distressed parents, so that parents in turn can most effectively help their child to cope with a traumatic injury," stated Dr. Kassam-Adams.

The research outlined in the Pediatrics article has immediate implications for clinical practice, particularly regarding parent education and supportive care for families. The researchers offer these recommendations for pediatricians and other primary care providers treating a child who is injured in a traffic crash:

1. Routinely call the family several days and one to two weeks following the injury to ask about behavioral symptoms and family function.

2. Make use of the on-going physician-patient relationship to explore acute stress symptoms and any functional impairment in the injured child. A brief office visit with the child and parents could serve this purpose.

3. Explore the effect of the child's injury on the family. Remember that parents can experience acute stress symptoms following pediatric traffic injuries and these symptoms may limit the parent's ability to support the child.

4. Provide supportive care and encourage families to discuss the crash and their current feelings.

5. Provide a referral for further assessment and psychological care when a child's (or parent's) acute stress symptoms last for more than one month or impair everyday functioning.
-end-
The study, funded by the Maternal and Child Health Bureau, is part of the Child and Adolescent Reactions to Injury and Trauma Research Program at TraumaLink, an interdisciplinary pediatric trauma research center at The Children's Hospital of Philadelphia.

Founded in 1855 as the nation's first pediatric hospital, The Children's Hospital is recognized today as one of the leading treatment and research facilities for children in the world. Through its longstanding commitment to providing exceptional patient care, training new generations of pediatric healthcare professionals and pioneering major research initiatives, Children's Hospital has fostered medical discoveries, innovations and breakthroughs that have benefited children worldwide.

Children's Hospital of Philadelphia

Related PTSD Articles from Brightsurf:

'Brain fog' following COVID-19 recovery may indicate PTSD
A new report suggests that lingering ''brain fog'' and other neurological symptoms after COVID -19 recovery may be due to post-traumatic stress disorder (PTSD), an effect observed in past human coronavirus outbreaks such as SARS and MERS.

PTSD may double risk of dementia
People who have experienced post-traumatic stress disorder (PTSD) are up to twice as likely to develop dementia later in life, according to a new study by UCL researchers, published in the British Journal of Psychiatry.

How building features impact veterans with PTSD
The built environment, where someone lives (private) or works (public), influences a person's daily life and can help, or hinder, their mental health.

Work-related PTSD in nurses
A recent Journal of Clinical Nursing analysis of published studies examined the prevalence of post-traumatic stress disorder (PTSD) among nurses and identified factors associated with work-related PTSD among nurses.

PTSD and moral injury linked to pregnancy complications
Elevated symptoms of PTSD and moral injury can lead to pregnancy complications, found a Veterans Affairs study of women military veterans.

Early treatment for PTSD after a disaster has lasting effects
In 1988, a 6.9 magnitude earthquake struck near the northern Armenian city of Spitak.

Cyberbullying Linked to Increased Depression and PTSD
Cyberbullying had the impact of amplifying symptoms of depression and post-traumatic stress disorder in young people who were inpatients at an adolescent psychiatric hospital, according to a new study published in the Journal of Clinical Psychiatry.

Psychedelic drugs could help treat PTSD
Clinical trials suggest treatment that involves psychedelics can be more effective than psychotherapy alone.

Which is more effective for treating PTSD: Medication, or psychotherapy?
A systematic review and meta-analysis led by Jeffrey Sonis, MD, MPH, of the University of North Carolina School of Medicine, finds there is insufficient evidence at present to answer that question.

Cannabis could help alleviate depression and suicidality among people with PTSD
Cannabis may be helping Canadians cope with the effects of post-traumatic stress disorder (PTSD), new research suggests.

Read More: PTSD News and PTSD Current Events
Brightsurf.com is a participant in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising fees by advertising and linking to Amazon.com.