The association between positive screen for future persistent posttraumatic stress symptoms and injury incident variables in the pediatric trauma care setting.
BACKGROUND
Posttraumatic stress (PTS) disorder after injury is a significant yet underaddressed issue in the trauma care setting. Parental anxiety may impact a child's risk of future, persistent PTS symptoms after injury. This study aimed to: (1) identify injury incident and demographic variables related to a positive screen for future, persistent PTS symptoms in children; and (2) examine the relationship between parental anxiety and a positive screen for future, persistent PTS symptoms in children.


METHODS
From November 2009 to August 2010, 124 patients were enrolled at a pediatric trauma center. Inclusion criteria were as follows: (1) age 7 years to 17 years; (2) hospitalized for at least 24 hours after physical trauma; and (3) English or Spanish speaking. State and trait anxiety were measured for both pediatric patients and their parents/guardians via the state trait anxiety inventory for children and state trait anxiety inventory, respectively. Risk for future, persistent PTS, among pediatric patients was assessed via the screening tool for early predictor of posttraumatic stress disorder (STEPP).


RESULTS
Of 116 participants assessed via the STEPP, 32 (28%) screened positive for risk of future, persistent PTS symptoms. Motor vehicle collision and parental presence at injury were associated with a positive STEPP screen. The effect of parental presence on positive STEPP screen was modified by parental trait anxiety. Children of anxious parents present at injury were over 14 times as likely to screen positive for risk of future, persistent PTS, as those without a parent present.


CONCLUSIONS
The risk of future, persistent PTS, after injury among the pediatric population is substantial. Parents with existing trait anxiety are shown to influence their child's risk for future, persistent PTS, particularly if present at the injury event. Further study of PTS prevention and control strategies are needed among this population within the trauma care setting.


METHODS
Epidemiological study, level II.
Trauma Services Department, Dell Children’s Medical Center of Central Texas, Trauma Services, Austin, Texas 78723, USA. svduzinski)seton.org
Sarah V
SV
Duzinski
Karla A
KA
Lawson
R Todd
RT
Maxson
Nilda M
NM
Garcia
Nicolina
N
Calfa
Kristina
K
Metz
Yesenia
Y
Marroquin
Prerna
P
Arora
Kimhoang
K
Nguyen
Catherine
C
Funk
Kevin
K
Stark
D000293:Adolescent; D017677:Age Distribution; D001007:Anxiety / Q000175:diagnosis / Q000453:epidemiology; D002648:Child; D002673:Child, Hospitalized / Q000706:statistics & numerical data; D002675:Child, Preschool; D015331:Cohort Studies; D015897:Comorbidity; D005260:Female; D005500:Follow-Up Studies; D006776:Hospitals, Pediatric; D006801:Humans; D015994:Incidence; D015601:Injury Severity Score; D007902:Length of Stay; D008297:Male; D020380:Needs Assessment; D010287:Parent-Child Relations; D010290:Parents / Q000523:psychology*; D011237:Predictive Value of Tests; D011446:Prospective Studies; D018570:Risk Assessment; D017678:Sex Distribution; D018434:Sickness Impact Profile; D013313:Stress Disorders, Post-Traumatic / Q000453:epidemiology* / Q000503:physiopathology / Q000517:prevention & control; D014193:Trauma Centers; D014481:United States; D014947:Wounds and Injuries / Q000175:diagnosis / Q000453:epidemiology* / Q000523:psychology* / Q000628:therapy