Prevalence, comorbidity and course of trauma reactions in young burn‐injured children

Abstract

These outcomes are likely to have serious repercussions for a young child's medical and psychosocial recovery as well as their normal developmental trajectories. It is recommended that screening, prevention and early intervention resources are incorporated into paediatric health care settings to optimise children's psychological adjustment following burn injury.

The relationship between behavioural problems in preschool children and parental distress after a paediatric burn event

“…Further, it is possible that children have experienced behaviour or emotional difficulties during and shortly after hospitalisation, but this would not have been captured in our first assessment of behaviour problems scheduled at 3 months postburn. Finally, although the current findings suggest a generally favourable behavioural outcome for young children with burns, results from recent diagnostic interview studies with parents have shown considerable rates of posttraumatic stress disorder and for instance oppositional defiant disorder in very young children with burns [6,10,11]. Perhaps, clinical parent interviews that focus on posttraumatic stress responses, such as intense psychological distress at cues related to the event, avoidance of stimuli related to the trauma, or sleep problems, are more sensitive to detect particular problematic domains for these young burn survivors.…”

“…In the longer run, rehabilitation and reconstructive surgeries may be necessary. Permanent alterations to the child's appearance, functional limitations, and issues in social life may be further challenges for children [6] and may elicit parental worries about the future of their child [7].…”

“…Previous studies in preschool children with burns have described externalising as well as internalising difficulties. Mothers reported for instance, by means of a semi-structured interview, that disturbed behaviours, such as anxiety and increased temper tantrums, were present in 56 % of hospitalised preschool children [9], and 16 % of preschool children met criteria for newly diagnosed separation anxiety disorder and oppositional defiant disorder at 6 months postburn as measured with a diagnostic interview with the primary caregiver [6]. Traumatic stress symptomatology was present in 25-29 % in the first months [6,10], and in 13 % of preschool children at an average of 1 year postburn [11].…”

“…Mothers reported for instance, by means of a semi-structured interview, that disturbed behaviours, such as anxiety and increased temper tantrums, were present in 56 % of hospitalised preschool children [9], and 16 % of preschool children met criteria for newly diagnosed separation anxiety disorder and oppositional defiant disorder at 6 months postburn as measured with a diagnostic interview with the primary caregiver [6]. Traumatic stress symptomatology was present in 25-29 % in the first months [6,10], and in 13 % of preschool children at an average of 1 year postburn [11]. In a Dutch-Belgian study on child internalising problems conducted during the child's hospitalisation, 25 % of 2-to 14-year-old children displayed problems in the clinical range [12] and a US study found significantly higher levels of internalising problem behaviour than a normative sample at an average of 1 year postburn [13].…”

“…Moreover, study samples were relatively small (n's between 17 and 76), with the exception of one Australian study on 130 young burn survivors with minor burn injuries [6]. Further, mothers were the principal informants on child postburn emotional and behavioural outcome in virtually all paediatric burn studies [15].…”