The Course of Posttraumatic Stress in Children: Examination of Symptom Trajectories and Predictive Factors Following Admission to Pediatric Intensive Care

No Thumbnail Available
File version
Author(s)
Le Brocque, Robyne M
Dow, Belinda L
McMahon, Hayley
Crothers, Anna L
Kenardy, Justin A
Williams, Tara J
Long, Debbie A
Griffith University Author(s)
Primary Supervisor
Other Supervisors
Editor(s)
Date
2020
Size
File type(s)
Location
License
Abstract

OBJECTIVES: This study investigated trauma symptom trajectories of children 2-16 years old following admission to pediatric intensive care and identified factors that predicted a child's trauma symptom trajectory. DESIGN: Prospective longitudinal design. SETTING: Two tertiary care PICUs in Brisbane, Qld, Australia. PATIENTS: Children 2-16 years old admitted to PICU for longer than 8 hours. MEASUREMENTS MAIN RESULTS: Maternal reported child posttraumatic stress symptoms (n = 272) on the Trauma Symptom Checklist for Young Children were used to assess posttraumatic stress symptoms up to 12 months post admission. Semiparametric group-based trajectory analyses were completed to identify patterns over time. Age, gender, length of stay, premorbid functioning, maternal perceived threat to life, and maternal acute distress were assessed as potential risk factors. Three likely trajectory groups were identified. The majority of children were resilient (83.8%); however, a significant minority experienced chronic symptoms (12.9%) or elevated stress symptoms which resolved quickly (3.3%). After controlling for other variables, maternal report of premorbid internalizing behavior significantly predicted both chronic (odds ratio, 6.3) and recovery (odds ratio, 38.0) trajectories. Maternal acute distress significantly predicted child chronic symptom trajectories (odds ratio, 5.2). CONCLUSIONS: Children with elevated trauma symptoms postintensive care need timely and effective intervention. The majority of children with high levels of acute symptoms will continue to have chronic, ongoing posttraumatic stress symptoms. In addition, acute maternal distress and preexisting internalizing child behavior predict ongoing psychologic distress after discharge from the PICU. Screening in the acute period post-PICU admission may identify children likely to experience ongoing chronic posttraumatic distress symptoms and enable targeted treatment of children at risk. This is the first study to examine symptom trajectories in children following pediatric intensive care admission and includes a sample of very young children.

Journal Title

Pediatric Critical Care Medicine

Conference Title
Book Title
Edition
Volume

21

Issue

7

Thesis Type
Degree Program
School
Publisher link
Patent number
Funder(s)
Grant identifier(s)
Rights Statement
Rights Statement
Item Access Status
Note
Access the data
Related item(s)
Subject

Nursing

Science & Technology

Life Sciences & Biomedicine

Critical Care Medicine

General & Internal Medicine

Persistent link to this record
Citation

Le Brocque, RM; Dow, BL; McMahon, H; Crothers, AL; Kenardy, JA; Williams, TJ; Long, DA, The Course of Posttraumatic Stress in Children: Examination of Symptom Trajectories and Predictive Factors Following Admission to Pediatric Intensive Care, Pediatric Critical Care Medicine, 2020, 21 (7), pp. E399-E406

Collections