Pretrauma problems, prior stressor exposure, and gender as predictors of change in posttraumatic stress symptoms among physically injured children and adolescents.
OBJECTIVE
This study addressed predictors of change in posttraumatic stress symptoms (PTSS) among youths who had experienced physical injuries. The influences of pretrauma internalizing and externalizing problems, prior stressor exposure, and gender were investigated. Additionally, gender was examined as a moderator of the associations between internalizing problems and PTSS, externalizing problems and PTSS, and prior stressor exposure and PTSS.


METHODS
Participants were 157 children and adolescents (75% male; age M = 13.30 years, SD = 3.60; 44% Caucasian, 39% African American, 13% Hispanic, and 4% other) admitted to 2 hospitals for physical injuries. Youths and their parents completed measures of PTSS (Child Posttraumatic Stress Reaction Index), internalizing and externalizing problems (Child Behavior Checklist), and prior stressor exposure (Coddington Life Events Scale, Child) during the hospital stay; youths completed up to 3 additional PTSS assessments targeted at 3, 6, and 12 months postinjury.


RESULTS
Multilevel regression analyses revealed a significant average decline in PTSS over time (p < .05) that followed a curvilinear trajectory. Externalizing problems, prior stressor exposure, and female gender predicted higher initial PTSS levels (p < .05). Gender moderated the influence of internalizing problems, externalizing problems, and prior stressor exposure on decline in PTSS over time (p < .05). Patterns of recovery for those with high and low levels of each characteristic differed for girls and boys.


CONCLUSIONS
Findings suggest targets for clinical consideration, both with respect to identifying subgroups of children and adolescents that may warrant early assessment and monitoring and timing of more directed PTSS treatment intervention.
Behavioral Science Division, National Center for PTSD, VA Boston Healthcare System, and Division of Psychiatry, Boston University School of Medicine, USA.
Susan
S
Doron-LaMarca
Dawne S
DS
Vogt
Daniel W
DW
King
Lynda A
LA
King
Glenn N
GN
Saxe
D000293:Adolescent; D002648:Child; D005260:Female; D006801:Humans; D008016:Life Change Events; D008297:Male; D012044:Regression Analysis; D012307:Risk Factors; D012737:Sex Factors; D013313:Stress Disorders, Post-Traumatic / Q000175:diagnosis* / Q000209:etiology / Q000523:psychology; D013315:Stress, Psychological / Q000523:psychology*; D014947:Wounds and Injuries / Q000150:complications / Q000523:psychology*