Physician-reported practice of managing childhood posttraumatic stress in pediatric primary care.
OBJECTIVE
This study investigated pediatrician-reported practices in identifying, assessing, and treating traumatic exposure and posttraumatic stress disorder (PTSD) in children.


METHODS
Focus groups guided the development of a survey that was mailed to primary care pediatricians in Massachusetts in 2005. Descriptive statistics and multivariate analyses were used to describe clinical practices and perceived barriers to care.


RESULTS
A 60% (N=597) survey response-rate was obtained. On average, pediatricians reported that less than 8% of patients had psychological problems that may be related to traumatic exposure. Only 18% of pediatricians agreed that they had adequate knowledge of childhood PTSD. About 15% of pediatricians reported frequently learning about traumatic event(s) from direct inquiry in the past year. Only 10% of pediatricians reported frequent assessment and treatment of posttraumatic stress symptoms. Most pediatricians (72%) agreed that greater collaborations with mental health providers would improve pediatric assessment of PTSD. Finally, having received PTSD-specific training and believing that pediatricians should identify and manage PTSD were each significantly associated with learning about a traumatic event from direct inquiry.


CONCLUSIONS
Providing PTSD-specific training and changing pediatricians' attitudes about childhood PTSD may be useful first steps in improving care for children.
Banh
My K
MK
Department of Psychology, Boston University, Boston, MA 02215, USA. my.banh@gmail.com
Saxe
Glenn
G
Mangione
Thomas
T
Horton
Nicholas J
NJ
D000328:Adult; D001291:Attitude of Health Personnel; D002648:Child; D003299:Cooperative Behavior; D003469:Culture; D005260:Female; D006306:Health Surveys; D006801:Humans; D007318:Inservice Training; D008297:Male; D008403:Mass Screening; D008404:Massachusetts; D008875:Middle Aged; D010372:Pediatrics / Q000193:education; D011320:Primary Health Care; D012017:Referral and Consultation; D013313:Stress Disorders, Post-Traumatic / Q000175:diagnosis* / Q000523:psychology / Q000628:therapy; D011795:Surveys and Questionnaires