Preventive intervention for trauma reactions in young injured children

Results of a multi‐site randomised controlled trial

Bibliographic Data

ID21344384
AuthorsAnn-Christin Haag (0000-0002-3865-8727, University Children's Hospital Zurich), Ann‐Christin Haag (Department of Psychosomatics and Psychiatry, and Children’s Research Centre University Children’s Hospital Zurich Zurich Switzerland), Markus A Landolt (0000-0003-0760-5558, Department of Psychosomatics and Psychiatry, and Children’s Research Centre University Children’s Hospital Zurich Zurich Switzerland), Justin Kenardy (0000-0001-9475-8450, The University of Queensland), Justin A Kenardy (School of Psychology University of Queensland Brisbane QLD Australia), Clemens M Schiestl (Division of Plastic Surgery University Children’s Hospital Zurich Zurich Switzerland), Clemens Schiestl (0009-0000-7174-6019, University Children's Hospital Zurich), Roy Kimble (0000-0002-2449-7707, Children's Medical Research Institute), Roy M Kimble (Centre for Children’s Burns and Trauma Research Centre for Child Health Research University of Queensland Brisbane QLD Australia), Alexandra C De Young (School of Psychology University of Queensland Brisbane QLD Australia), Alexandra De Young (0000-0003-3093-427X, Children's Medical Research Institute, corresponding author)
Year2020
Volume61
Issue9
Pages988-997
Publication date2020-09-01
Peer ReviewedYes
Open AccessYes
TypeARTICLE
VenueJournal of Child Psychology and Psychiatry (JOURNAL)
Journal identifiersISSN: 0021-9630 • E-ISSN: 1469-7610
PublisherWiley (PUBLISHER • GB)
DOI10.1111/jcpp.13193
PMID31912485
OpenAlexW3000651695
LanguageEN
Citations received3
References cited26

BACKGROUND: Young children are at particular risk for injury. Ten per cent to twenty-five per cent develop posttraumatic stress disorder (PTSD). However, no empirically supported preventive interventions exist. Therefore, this study evaluated the efficacy of a standardised targeted preventive intervention for PTSD in young injured children. METHODS: Injured children (1-6 years) were enrolled in a multi-site parallel-group superiority prospective randomised controlled trial (RCT) in Australia and Switzerland. Screening for PTSD risk occurred 6-8 days postaccident. Parents of children who screened 'high-risk' were randomised to a 2-session CBT-based intervention or treatment-as-usual (TAU). Primary outcomes were PTSD symptom (PTSS) severity, and secondary outcomes were PTSD diagnosis, functional impairment and behavioural difficulties at 3 and 6 months postinjury using blinded assessments. Trials were registered with the Australian New Zealand Clinical Trials Registry (ACTRN12614000325606) and ClinicalTrials.gov (NCT02088814). Trial status is complete. RESULTS: One hundred and thirty-three children screened 'high-risk' were assigned to intervention (n = 62) or TAU (n = 71). Multilevel intention-to-treat analyses revealed a significant intervention effect on PTSS severity over time (b = 60.06, 95% CI: 21.30-98.56). At 3 months, intervention children (M = 11.02, SD = 10.42, range 0-47) showed an accelerated reduction in PTSS severity scores compared to control children (M = 17.30, SD = 13.94, range 0-52; mean difference -6.97, 95% CI: -14.02 to 0.08, p adj. = .055, d = 0.51). On secondary outcomes, multilevel analyses revealed significant treatment effects for PTSD diagnosis, functional impairment and behavioural difficulties. CONCLUSIONS: This multi-site RCT provides promising preliminary evidence for the efficacy of a targeted preventive intervention for accelerating recovery from PTSS in young injured children. This has important clinical implications for the psychological support provided to young children and parents during the acute period following a single-event trauma

Clinical trial · Intervention (counseling) · Physical therapy · Psychiatry · Psychological intervention · Randomized controlled trial · Child Abuse and Trauma · Internal Medicine · Medicine · Posttraumatic Stress Disorder Research · Trauma and Emergency Care Studies · Pediatrics

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