Post‐traumatic stress trajectories of children and their parents over the year following intensive care discharge: A secondary analysis

Abstract

AbstractBackgroundNew research in the field of psychological trauma has emphasized (a) the heterogeneity of psychological reactions after traumatic events and (b) the existence of distinct symptom trajectories.AimsIn this study, existing data on post‐traumatic stress disorder (PTSD) symptoms in 66 parent–child dyads were re‐examined in the light of this literature in order to establish whether a similar pattern of symptom trajectories also applies to this population.Study DesignA prospective observational cohort study. Participants' PTSD symptoms were assessed 3 and 12 months after discharge from a paediatric intensive care unit (PICU), using a short form of the Davidson Trauma Scale with parents and the Child Revised Impact of Events Scale with children aged 7–17 years.ResultsResults confirmed that the majority of children (58%) and parents (46%) exhibited a ‘Resilient’ PTSD trajectory over the year, in the sense that their scores remained in the non‐clinical range at both timepoints. Children displaying a ‘Resilient’ trajectory were more likely to have a parent who also displayed a ‘Resilient’ trajectory (p = .018). However, there was also evidence of a ‘Recovery’ trajectory in a significant minority in this sample and over 1 in 4 children and parents exhibited a ‘Chronic’ or ‘Delayed’ symptom trajectory.ConclusionsAlthough average PTSD scores reduced over time in this sample and ‘Resilient’ trajectories were common, a significant proportion of children and parents exhibited ‘Chronic’ and ‘Delayed’ symptom trajectories.Relevance to Clinical PracticeThese results suggest that, although the majority do well, a significant number of children and family members may develop chronic or delayed symptoms of PTSD in the year following PICU discharge. The monitoring of individual family members' symptoms beyond 3 months post‐discharge may help to determine those who might most benefit from further support.