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

Abstract

Background: New 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. Aims: In 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 Design: A 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. Results: Results 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. Conclusions: Although 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 Practice: These 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.