title: A novel adaptation of a parent-child observational assessment tool for appraisals and coping in children exposed to acute trauma.
abstract: BACKGROUND
  Millions of children worldwide are exposed to acute potentially traumatic events (PTEs) annually. Many children and their families experience significant emotional distress and/or functional impairment following PTEs. While current research has begun to highlight a role for early appraisals and coping in promoting or preventing full recovery from PTEs, the exact nature of the relationships among appraisals, coping, and traumatic stress reactions as well as how appraisals and coping behaviors are influenced by the child's environment (e.g., parents) remains unclear; assessment tools that reach beyond self-report are needed to improve this understanding.
  
  
  OBJECTIVE
  The objective of the current study is to describe the newly created Trauma Ambiguous Situations Tool (TAST; i.e., an observational child-parent interview and discussion task that allows assessment of appraisals, coping, and parent-child processes) and to report on initial feasibility and validation of TAST implemented with child-parent dyads in which children were exposed to a PTE.
  
  
  METHODS
  As part of a larger study on the role of biopsychosocial factors in posttraumatic stress reactions, children (aged 8-13) and parents (n=25 child-parent dyads) completed the TAST during the child's hospitalization for injury.
  
  
  RESULTS
  Children and parents engaged well with the TAST. The time to administer the TAST was feasible, even in a peri-trauma context. The TAST solicited a wide array of appraisals (threat and neutral) and coping solutions (proactive and avoidant). Forced-choice and open-ended appraisal assessments provided unique information. The parent-child discussion portion of the TAST allowed for direct observation of parent-child processes and demonstrated parental influence on children's appraisals and coping solutions.
  
  
  CONCLUSIONS
  The TAST is a promising new research tool, which may help to explicate how parents influence their child's developing appraisals and coping solutions following a PTE. More research should examine the relationships of appraisals, coping, and parent-child processes assessed by the TAST with traumatic stress outcomes.
authors.affiliation: The Center for Injury Research and Prevention, The Children's Hospital of Philadelphia, Philadelphia, PA, USA.|Department of Psychiatry, University of Pennsylvania, Philadelphia, PA, USA.|Department of Pediatrics, Kentucky Children's Hospital, Lexington, KY, USA.|College of Medicine, University of Kentucky, Lexington, KY, USA; meghan.marsac@uky.edu.
authors.forename: Meghan L
authors.initials: ML
authors.lastname: Marsac
authors.affiliation: The Center for Injury Research and Prevention, The Children's Hospital of Philadelphia, Philadelphia, PA, USA.|Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.
authors.forename: Nancy
authors.initials: N
authors.lastname: Kassam-Adams
keywords: PTSD; Parent–child interaction; appraisals; assessment; coping; recovery; trauma