After the ABCs: The Importance of Psychological Screening for Children and Parents After a Traumatic Event

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Abstract

Background

The effects of trauma do not end after resuscitation. The Screening Tool for Early Predictors of Post Traumatic Stress Disorder (STEPP) is validated for pediatric trauma victims and their parents. This would help identifying children and caregivers at risk for posttraumatic stress disorder (PTSD) and highlight mechanisms of trauma that increase risk.

Methods

A retrospective review of 142 children and parents admitted to a Level I pediatric trauma center was completed. Variables of age, gender, injury severity score, and mechanism of injury were compared by Student’s t test for normally distributed independent samples and chi-square for categorical variables. A p value of <.05 was considered significant.

Results

Over 80% of eligible trauma patients and parents underwent a STEPP evaluation. More than 30% (n = 43) were positive. Positive pediatric evaluations were likely to be female; however, age and injury severity score between the two groups were not statistically significant. Although not statically significant, parental STEPP examinations were more likely to be positive than the screen of the injured child, which might have clinical significance. Pediatric STEPP evaluations were mostly positive after motor vehicle crashes and animal bites.

Conclusion

The STEPP evaluation on pediatric trauma patients and parents is a valuable tool to screen for risk of PTSD. Certain mechanisms of injury resulted in higher rates of positive STEPP evaluations, yet limiting screening based on mechanisms of injury, age, or gender could result in delayed identification of PTSD risk. Screening parents is a key component of the STEPP evaluation, especially when there is discordance between the two.

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