title: PMTS and stress response sequences in parents of children with spina bifida.
abstract: OBJECTIVE
  To test the presence and progress of Pediatric Medical Traumatic Stress (PMTS) symptoms in parents of children with spina bifida (SB).
  
  
  METHODS
  Parents of 23 newborns with SB were interviewed prospectively and parents of 58 school-aged children with SB were interviewed retrospectively. PMTS symptoms were assessed with 17 DSM-IV criteria for the clusters Intrusion, Avoidance, and Increased Arousal.
  
  
  RESULTS
  Within 3 months after the SB diagnosis, 75% of the parents met diagnostic criteria for symptoms of Intrusion and Increased Arousal, but not of Avoidance. In parents of school-aged children with SB, PMTS symptoms had declined in the first 4 years of the child's life and stabilized during the school years. Approximately 30% of the mothers and 20% of the fathers still met diagnostic criteria for Intrusion, Avoidance and Increased Arousal. In mothers of children with open SB, symptoms of Intrusion and Increased Arousal had decreased more slowly than in mothers of children with closed SB.
  
  
  CONCLUSIONS
  An SB diagnosis initially provokes traumatic stress symptoms in three-quarters of the parents; however, in most of them, these symptoms diminish during the first 4 years of the child's life. In a minority of the parents, severe stress symptoms persist beyond middle childhood. Professional psychological help may need to be offered to this selective group of parents whose levels of stress do not decline after the child's preschool years. Longitudinal research is needed to further investigate and confirm the trends that were found in parents' psychological adjustment to SB.
authors.affiliation: Pediatric Psychology, Tilburg University, P.O. Box 90153, 5000 LE Tilburg, The Netherlands. i.p.r.vermaes@uvt.nl
authors.forename: Ignace P R
authors.initials: IP
authors.lastname: Vermaes
authors.forename: Jan R M
authors.initials: JR
authors.lastname: Gerris
authors.forename: Reinier A
authors.initials: RA
authors.lastname: Mullaart
authors.forename: Niels
authors.initials: N
authors.lastname: Geerdink
authors.forename: Jan M A M
authors.initials: JM
authors.lastname: Janssens
mesh_terms: D000328:Adult; D001143:Arousal / Q000502:physiology; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D010290:Parents / Q000523:psychology*; D011446:Prospective Studies; D011569:Psychiatric Status Rating Scales; D012189:Retrospective Studies; D016135:Spinal Dysraphism / Q000523:psychology*; D040921:Stress Disorders, Traumatic / Q000503:physiopathology* / Q000523:psychology*; D013315:Stress, Psychological / Q000503:physiopathology* / Q000523:psychology*