Trauma and Abuse

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JAMA PEDIATRICS PATIENT PAGE

Posttraumatic Stress in Children Injuries are extremely common in childhood. In the United States, more than 20 million children experience unintentional injuries each year such as through falls and motor vehicle crashes. Furthermore, more than 200 000 children and adolescents each year are injured by violence.

It is common for parents and children to experience posttraumatic stress after a traumatic injury. Most children and parents report at least 1 severe traumatic stress reaction in the first month after a sig- nificant injury, and some have it after even a seemingly minor traf- fic accident without serious injury. The National Child Traumatic Stress Network defines “pediatric medical traumatic stress” as a set of mental and physical responses of children and their families to pain, injury, serious illness, medical procedures, and painful or fright- ening treatment experiences. About 19% of injured children de- velop significant posttraumatic stress symptoms that interfere with their functioning and healing after the injury.

Symptoms of posttraumatic stress include: 1. Repeating thoughts about the injury. 2. Avoiding reminders of the injury, which may include avoiding

people, feelings, or activities. 3. Increased arousal, which may include having an exaggerated

startle response (ie, jumping in response to a loud noise) or ex- periencing difficulty in concentrating.

4. Changes in mood. Consequences of posttraumatic stress may be disabling and in-

clude reduced quality of life, increased use of health care services, or difficulty in staying in school. Several treatment approaches for posttraumatic stress exist and have been shown to be effective. These include promoting strategies that help with coping, safe ex- posure to trauma-related triggers, and building skills in handling the distress that is felt. In many cases, it is helpful for both parents and children to work together on developing coping skills.

If you are worried that you or your child has symptoms of post- traumatic stress, talk with your pediatrician or physician. This month’s JAMA Pediatrics included a review article that summarizes the cur- rent research and evidence on how best to recognize and treat post- traumatic stress.

FOR MORE INFORMATION

National Child Traumatic Stress Network: http://www.nctsn.org

To find this and other JAMA Pediatrics Patient Pages, go to the Patient Page link on the JAMA Pediatrics website at jamapediatrics.com.

Author: Megan A. Moreno, MD, MSEd, MPH Resource: National Child Traumatic Stress Network Correction: This article was corrected online January 14, 2014, for a typographical error in the Acknowledgment section.

The JAMA Pediatrics Patient Page is a public service of JAMA Pediatrics. The information and recommendations appearing on this page are appropriate in most instances, but they are not a substitute for medical diagnosis. For specific information concerning your child’s medical condition, JAMA Pediatrics suggests that you consult your child’s physician. This page may be photocopied noncommercially by physicians and other health care professionals to share with patients. To purchase bulk reprints, call 312/464-0776.

1176 JAMA Pediatrics December 2013 Volume 167, Number 12 jamapediatrics.com

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