title: Child and adolescent internalizing and externalizing problems 12 months postburn: the potential role of preburn functioning, parental posttraumatic stress, and informant bias.
abstract: Adjustment after pediatric burn injury may be a challenge for children as well as their parents. This prospective study examined associations of internalizing and externalizing problems in children and adolescents 12 months postburn with preburn functioning, and parental acute and chronic posttraumatic stress symptoms (PTSS) from different perspectives. Child, mother, and father reports of 90 children (9-18 years), collected within the first month and 12 months postburn, were analyzed. Results indicated that overall, child and parental appraisals of pre- and postburn behavioral problems were not significantly different from reference data. Rates of (sub)clinical postburn behavioral problems ranged from 6 to 17 %, depending on the informant. Pre- and postburn behavioral problems were significantly related, but only from the parents' perspective. Path models showed an association between parental PTSS 12 months postburn and parental reports of child internalizing problems, as well as a significant indirect relationship from parental acute stress symptoms via PTSS 12 months postburn. Notably, no associations between parental PTSS and child reports of postburn behavioral problems were found. In conclusion, parental observations of child externalizing problems appear to be influenced by their perspectives on the child's preburn functioning, while parental observations of internalizing problems are also related to long-term parental PTSS. However, these factors seem of no great value in predicting behavioral problems from the child's perspective, suggesting substantial informant deviations. To optimize adjustment, clinical burn practice is recommended to adopt a family perspective including parent perception of preburn functioning and parental PTSS in assessment and intervention.
authors.affiliation: Association of Dutch Burn Centres, P. O. Box 1015, 1940 EA, Beverwijk, The Netherlands. megberts@burns.nl.|Department of Clinical and Health Psychology, Utrecht University, Utrecht, The Netherlands. megberts@burns.nl.
authors.forename: Marthe R
authors.initials: MR
authors.lastname: Egberts
authors.affiliation: Department of Methodology and Statistics, Faculty of Social Sciences, Utrecht University, Utrecht, The Netherlands.|Optentia Research Program, Faculty of Humanities, North-West University, Vanderbijlpark, South Africa.
authors.forename: Rens
authors.initials: R
authors.lastname: van de Schoot
authors.affiliation: Burn Centre Red Cross Hospital, Beverwijk, The Netherlands.
authors.forename: Anita
authors.initials: A
authors.lastname: Boekelaar
authors.affiliation: Burn Centre University Hospital Gent, Ghent, Belgium.
authors.forename: Hannelore
authors.initials: H
authors.lastname: Hendrickx
authors.affiliation: Department of Clinical and Health Psychology, Utrecht University, Utrecht, The Netherlands.
authors.forename: Rinie
authors.initials: R
authors.lastname: Geenen
authors.affiliation: Association of Dutch Burn Centres, P. O. Box 1015, 1940 EA, Beverwijk, The Netherlands.|Department of Clinical and Health Psychology, Utrecht University, Utrecht, The Netherlands.
authors.forename: Nancy E E
authors.initials: NE
authors.lastname: Van Loey
mesh_terms: D000293:Adolescent; D000294:Adolescent Behavior / Q000523:psychology*; D002056:Burns / Q000523:psychology*; D002648:Child; D002652:Child Behavior / Q000523:psychology*; D005260:Female; D006801:Humans; D008297:Male; D010290:Parents / Q000523:psychology*; D000066553:Problem Behavior / Q000523:psychology*; D011446:Prospective Studies; D013313:Stress Disorders, Post-Traumatic / Q000523:psychology*
keywords: Behavioral problems; Burns; Children; Cross-informant agreement; Parental posttraumatic stress; Preburn functioning