Parental posttraumatic stress symptoms as a moderator of child's acute biological response and subsequent posttraumatic stress symptoms in pediatric injury patients.

OBJECTIVE To examine how parental responses following pediatric injury may influence their child's posttraumatic stress symptoms (PTSS). METHODS Heart rate (HR) from 82 pediatric injury patients was measured during emergency medical services (EMSs) transport and following hospital admission. Twelve-hour urinary cortisol levels were assessed upon admission. Child PTSS and parental PTSS and general distress were assessed 6 weeks and 6 months after trauma. RESULTS Six-week parental PTSS predicted 6-month child PTSS even after controlling for demographics and general parent distress (DeltaR(2) = .08, p = .03). Parental PTSS moderated the relationship between (a) child cortisol levels and 6-month child PTSS (DeltaR2 = .08, p = .03) and between (b) hospital HR and 6-month child PTSS (DeltaR2 = .09, p = .03). CONCLUSION The present findings suggest that parental response to trauma may interact with child acute physiological responses to predict persistent child PTSS.

[1]  D. Delahanty,et al.  Emergency medical service and in-hospital vital signs as predictors of subsequent PTSD symptom severity in pediatric injury patients. , 2006, Journal of child psychology and psychiatry, and allied disciplines.

[2]  F. Winston,et al.  Heart rate and posttraumatic stress in injured children. , 2005, Archives of general psychiatry.

[3]  D. Delahanty,et al.  Initial urinary epinephrine and cortisol levels predict acute PTSD symptoms in child trauma victims , 2005, Psychoneuroendocrinology.

[4]  G. Stores,et al.  Psychological consequences of road traffic accidents for children and their mothers , 2004, Psychological Medicine.

[5]  F. Winston,et al.  Acute stress disorder symptoms in children and their parents after pediatric traffic injury. , 2002, Pediatrics.

[6]  H. Koplewicz,et al.  Child and Parent Response to the 1993 World Trade Center Bombing , 2002, Journal of traumatic stress.

[7]  E L Struening,et al.  Comorbidity, impairment, and suicidality in subthreshold PTSD. , 2001, The American journal of psychiatry.

[8]  S. Rabe-Hesketh,et al.  War exposure and maternal reactions in the psychological adjustment of children from Bosnia-Hercegovina. , 2001, Journal of child psychology and psychiatry, and allied disciplines.

[9]  W. Yule.  Post-traumatic stress disorder in children and adolescents , 2001 .

[10]  G. McHugo,et al.  Predicting posttraumatic stress after hospitalization for pediatric injury. , 2000, Journal of the American Academy of Child and Adolescent Psychiatry.

[11]  F. Winston,et al.  Looking beyond the physical injury: posttraumatic stress disorder in children and parents after pediatric traffic injury. , 1999, Pediatrics.

[12]  R. Emery,et al.  Posttraumatic stress in children following acute physical injury. , 1999, Journal of pediatric psychology.

[13]  R. Velleman,et al.  Prospective study of post-traumatic stress disorder in children involved in road traffic accidents , 1998, BMJ.

[14]  Sylvain Sorin,et al.  On the impact of an event , 1998, Int. J. Game Theory.

[15]  R. Kessler,et al.  Trauma and posttraumatic stress disorder in the community: the 1996 Detroit Area Survey of Trauma. , 1998, Archives of general psychiatry.

[16]  S. Orr,et al.  A prospective study of heart rate response following trauma and the subsequent development of posttraumatic stress disorder. , 1998, Archives of general psychiatry.

[17]  Francine Mandel,et al.  Posttraumatic Stress Disorder and Family Functioning in Adolescent Cancer , 1998, Journal of traumatic stress.

[18]  M. Stein,et al.  Full and partial posttraumatic stress disorder: findings from a community survey. , 1997, The American journal of psychiatry.

[19]  W. Silverman,et al.  The impact of exposure to crime and violence on urban youth. , 1996, The American journal of orthopsychiatry.

[20]  D. Charney,et al.  Deficits in short-term memory in adult survivors of childhood abuse , 1995, Psychiatry Research.

[21]  I. Levav,et al.  Nongenetic familial transmission of psychiatric disorders? Evidence from children of Holocaust survivors. , 1994, Journal of health and social behavior.

[22]  H. Reinherz,et al.  Prevalence of psychiatric disorders in a community population of older adolescents. , 1993, Journal of the American Academy of Child and Adolescent Psychiatry.

[23]  A. McFarlane.  Posttraumatic phenomena in a longitudinal study of children following a natural disaster. , 1987, Journal of the American Academy of Child and Adolescent Psychiatry.

[24]  Jacob Cohen,et al.  Applied multiple regression/correlation analysis for the behavioral sciences , 1979 .

[25]  H. B. Stoner,et al.  Measuring the severity of injury. , 1977, British medical journal.

[26]  J. P. Bull,et al.  The injury severity score of road traffic casualties in relation to mortality, time of death, hospital treatment time and disability , 1975 .

[27]  W. Haddon,et al.  The injury severity score: a method for describing patients with multiple injuries and evaluating emergency care. , 1974, The Journal of trauma.

[28]  Daniel S. Weiss,et al.  The Impact of Event Scale: Revised , 2007 .

[29]  R. Velleman,et al.  Recovery from post‐traumatic stress disorder in children following road traffic accidents: the role of talking and feeling understood , 2001 .

[30]  A. Maercker,et al.  Effects of Varying Diagnostic Criteria for Posttraumatic Stress Disorder Are Endorsing the Concept of Partial PTSD , 1999, Journal of traumatic stress.

[31]  B. Pfefferbaum,et al.  Contagion in stress. An infectious disease model for posttraumatic stress in children. , 1998, Child and adolescent psychiatric clinics of North America.

[32]  John-Paul Wilson,et al.  Assessing psychological trauma and PTSD , 1997 .

[33]  D. A. Kenny,et al.  The moderator-mediator variable distinction in social psychological research: conceptual, strategic, and statistical considerations. , 1986, Journal of personality and social psychology.