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Acute Traumatic Stress Symptoms in Child Occupants and Their Parent Drivers After Crash Involvement
Flaura K. Winston, MD, PhD;
Chiara Baxt, PhD;
Nancy L. Kassam-Adams, PhD;
Michael R. Elliott, PhD;
Michael J. Kallan, MS
Arch Pediatr Adolesc Med. 2005;159:1074-1079.
Background Approximately 1 in 4 children hospitalized with injuries from traffic crashes and their parents experience symptoms of acute stress disorder (ASD). These families represent a minority of those exposed to the trauma of a crash. To date, no studies have explored the prevalence of ASD symptoms in the broader population of children and parents exposed to crashes.
Objective To describe the prevalence of and risk factors for ASD symptoms in children and their driver parents after vehicle crashes.
Design, Setting, and Participants Cross-sectional study via telephone survey of parent drivers and children (aged 5-15 years), using an exposure-based crash surveillance system. A probability sample of 1091 crashes involving 1483 children weighted to represent 24 376 children in 18 422 crashes was collected.
Main Outcome Measure(s) Parent-reported ASD symptoms and impairment.
Results Significant ASD symptoms occurred in 1.6% (95% confidence interval, 0.9%-2.3%) of children in crashes and 4.7% (95% confidence interval, 4.0%-5.5%) of parents. In children, ASD symptoms were independently associated with sustaining an injury and with receiving medical care; in parents, symptoms were independently associated with child injury, child receiving medical care, Hispanic ethnicity, lower income (<$40 000), and higher crash severity.
Conclusions Sustaining injuries and receiving medical treatment were strong predictors for developing ASD symptoms after crashes but ASD symptoms often occurred in the absence of these risk factors. Health care professionals should consider screening for traumatic stress symptoms in children and their parents when children are involved in traffic crashes, particularly if they sustain injuries.
Author Affiliations: Departments of Pediatrics (Dr Winston) and Biostatistics and Epidemiology (Dr Elliott and Mr Kallan), University of Pennsylvania and TraumaLink (Drs Winston and Kassam-Adams) and Center for Pediatric Traumatic Stress (Drs Baxt and Kassam-Adams), The Children’s Hospital of Philadelphia, Philadelphia. Dr Baxt is now with TraumaLink in addition to the Center for Pediatric Traumatic Stress.
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