Posttraumatic stress among children in automobile accidents

The post traumatic symptoms of children (6-16 yrs) involved in automobile accidents were assessed an average of 9 months following the event. Measures included children's ratings of post traumatic symptoms on the Reaction Index, the Impact of Events Scale, and the Diagnostic Interview for Children and Adolescents-Revised (DICA-R). Results indicated a range of posttraumatic symptomatology among accident victims. Despite low levels of physical injury, approximately one fourth of the sample children reported moderate to severe levels of trauma. As expected, higher injury levels were related to more PTSD symptoms on the diagnostic interview. When controlling for injury level, bicyclists and pedestrians reported higher levels of PTSD symptoms than motor vehicle occupants. Younger children reported higher levels and more frequent PTSD symptoms. As indicated on the diagnostic interview, prior history of an accident was related to fewer PTSD symptoms, suggesting a buffering effect of prior history. Also, children who reported higher levels of social support reported less frequent PTSD symptoms. Lastly, reciprocal processes of fear and avoidance were supported as greater self-reported fear was related to increased PTSD symptomatology. A discussion of the differences between self-report and interview measures of PTSD is included, as factors related to PTSD varied according to the measurement utilized. The importance of direct assessment of children's symptoms is stressed and areas of future research are suggested.