Systematic Review: A Reevaluation and Update of the Integrative (Trajectory) Model of Pediatric Medical Traumatic Stress

Abstract

Based on new evidence, the renamed Integrative Trajectory Model includes phases corresponding with medical events, adds family-centered trajectories, reaffirms a competency-based framework, and suggests updated assessment and intervention implications.

Knowledge and training in paediatric medical traumatic stress and trauma-informed care among emergency medical professionals in low- and middle-income countries

“…Further, as time constraints were frequently identified as a barrier to providing trauma-informed care, training programmes that are developed for staff in these regions should aim to be brief and time efficient. It is important to note that medical and nursing staff would not be expected to replace mental health workers but rather provide routine medical care in a way that acknowledges the impact of trauma and minimizes distress, thus altering the subjective experience of the event and the immediate aftermath (Kazak et al, 2006; Marsac et al, 2014; Price et al, 2015). Several preventative approaches including the DEF protocol (Stuber, Schneider, Kassam-Adams, Kazak, & Saxe, 2006) which provide evidence based guidelines on implementing trauma-informed care and information provision (Kenardy et al, 2008) are designed to be incorporated into routine care and add little burden on time (in the Medical Traumatic Stress Toolkit: Kassam-Adams, 2014; Kenardy et al, 2008; Ko et al, 2008; Marsac et al, 2015).…”

“…In addition to training, both emergency staff and children and families should be provided with user-friendly screening and education tools (Kazak, 2006; Price et al, 2015). Whilst we acknowledge that the need for medical training must take priority (Obermeyer et al, 2015), we would argue that training and education on paediatric medical traumatic stress and trauma-informed care would be valuable considering the high prevalence of trauma.…”

“…Childhood injuries can have profound and lifelong psychological effects, with approximately one in six injured children experiencing psychological sequelae, including paediatric medical traumatic stress (Kassam-Adams, Marsac, Hildenbrand, & Winston, 2013; Price, Kassam-Adams, Alderfer, Christofferson, & Kazak, 2015). Paediatric medical traumatic stress is defined as ‘a set of psychological and physiological responses of children and their families to pain, injury, serious illness, medical procedures and invasive or frightening treatment experiences’ (National Child Traumatic Stress Network, 2003).…”

“…Paediatric medical traumatic stress is defined as ‘a set of psychological and physiological responses of children and their families to pain, injury, serious illness, medical procedures and invasive or frightening treatment experiences’ (National Child Traumatic Stress Network, 2003). Paediatric medical traumatic stress can impair typical childhood development, result in lower health-related quality of life, compromise physical functioning and recovery, and lead to a greater reliance on the health care system (Landolt, Vollrath, Gnehm, & Sennhauser, 2009; Marsac, Kassam-Adams, Delahanty, Widaman, & Barakat, 2014; Price et al, 2015). …”

Eye movement desensitization and reprocessing (EMDR) in children and adolescents with subthreshold PTSD after medically related trauma: design of a randomized controlled trial

“…About one in every 10 children develops PTSD due to hospital admission and medical procedures (Bronner, Knoester, Bos, Last, & Grootenhuis, 2008). Some children fail to meet all criteria for a PTSD diagnosis, but still suffer from similar impairments (Carrion, Weems, Ray, & Reiss, 2002; Price, Kassam-Adams, Alderfer, Christofferson, & Kazak, 2016; Zhang, Ross, & Davidson, 2004). In general, the presence of impairing posttraumatic stress symptoms that do not meet the full diagnostic criteria for PTSD is referred to as subthreshold PTSD (McLaughlin et al, 2015).…”