A pilot study comparing traumatic stress symptoms by child and parent report across pediatric chronic illness groups.
OBJECTIVE
Researchers have recently used a framework of traumatic stress to describe the psychological functioning of children experiencing a chronic illness and their families; however, few studies are available directly comparing symptoms across disease groups. This study compared traumatic stress symptoms of youth being considered for solid organ and bone marrow transplantation, youth diagnosed with human immunodeficiency virus, youth diagnosed with sickle cell disease and their parents. Correlates of traumatic stress across these populations were also examined.


METHODS
Participants included 64 youth and caregiver dyads with previously scheduled appointments at 1 of 3 specialty clinics. Parents completed measures of family demographics, traumatic stress symptoms, and child functional status. Youth (n = 45) and parents each completed self-report and parent-proxy measures of youth traumatic stress symptoms.


RESULTS
Ten percent of youth by self-report, 18% of youth by parent-proxy report, and 13% of caregivers described symptoms suggestive of posttraumatic stress disorder. Parents of pediatric transplant self-reported greater symptoms than caregivers of youth with human immunodeficiency virus and sickle cell disease (p < .05). Although child functional impairment did not predict child symptoms, a trend was found where parents experiencing more traumatic stress symptoms themselves reported their children experienced greater symptoms by parent-proxy report (p =.07).


CONCLUSIONS
Findings suggest that although most children and parents across disease groups report subclinical levels of traumatic stress symptoms, traumatic stress symptoms may be especially salient for families of pediatric transplant candidates. Although interventions are currently available to treat posttraumatic stress disorder symptoms, they will likely need to be individualized to meet the needs of specific disease groups.
Ingerski
Lisa M
LM
Department of Clinical and Health Psychology, University of Florida, Gainesville, FL, USA. lisa.ingerski@cchmc.org
Shaw
Kimberly
K
Gray
Wendy N
WN
Janicke
David M
DM
D000293:Adolescent; D000328:Adult; D000368:Aged; D000755:Anemia, Sickle Cell / Q000523:psychology; D002648:Child; D002675:Child, Preschool; D002908:Chronic Disease / Q000453:epidemiology / Q000523:psychology*; D003430:Cross-Sectional Studies; D005260:Female; D006679:HIV Seropositivity / Q000523:psychology; D018380:Hematopoietic Stem Cell Transplantation / Q000523:psychology; D006801:Humans; D008297:Male; D008875:Middle Aged; D016377:Organ Transplantation / Q000523:psychology; D010290:Parents / Q000523:psychology*; D010552:Personality Assessment / Q000706:statistics & numerical data*; D010865:Pilot Projects; D013313:Stress Disorders, Post-Traumatic / Q000175:diagnosis* / Q000523:psychology; D055815:Young Adult
Arch Pediatr Adolesc Med. 2004 Sep;158(9):884-90
15351754
AIDS Patient Care STDS. 2007 Jul;21(7):501-8
17651031
Clin Psychol Rev. 2003 May;23(3):409-48
12729679
J Am Acad Child Adolesc Psychiatry. 1998 Feb;37(2):147-54
9473910
Pediatrics. 2005 May;115(5):e582-9
15867023
J Clin Oncol. 2005 Oct 20;23(30):7405-10
16157936
J Pediatr Psychol. 2006 May;31(4):343-55
16093522
J Pediatr Psychol. 2005 Dec;30(8):698-707
16093517
J Pediatr Psychol. 1997 Dec;22(6):843-59
9494321
J Pediatr Psychol. 2002 Oct-Nov;27(7):607-17
12228332
Child Care Health Dev. 2006 Jan;32(1):19-31
16398788
J Am Acad Child Adolesc Psychiatry. 2007 Aug;46(8):1051-1061
17667483
J Fam Psychol. 2004 Sep;18(3):493-504
15382974
J Pediatr Psychol. 1991 Feb;16(1):39-58
1826329
Pediatrics. 2000 Feb;105(2):E29
10654989
Diabetes Care. 2006 Jun;29(6):1389-91
16732028
J Clin Psychol. 2001 Apr;57(4):521-49
11255205
Am J Hematol. 2007 Feb;82(2):171-2
16924639
Curr HIV/AIDS Rep. 2007 May;4(2):93-9
17547831
Pediatrics. 2005 Jun;115(6):1640-4
15930227
Gen Hosp Psychiatry. 1998 Nov;20(6):345-52
9854646
J Child Psychol Psychiatry. 2003 Nov;44(8):1199-207
14626460
Matern Child Health J. 2008 Jan;12(1):1-14
17566855
J Trauma. 2005 Feb;58(2):353-63
15706200
J Heart Lung Transplant. 2007 Feb;26(2):120-6
17258144
J Pediatr Psychol. 2004 Apr-May;29(3):211-9
15131138
Curr Psychiatry Rep. 2004 Apr;6(2):96-100
15038911
J Child Psychol Psychiatry. 1999 Mar;40(3):363-74
10190338
Psychol Med. 1991 Aug;21(3):713-21
1946860
N Engl J Med. 2005 Aug 4;353(5):487-97
16079372