Post-traumatic stress disorder in children following road traffic accidents: a comparison of those with and without mild traumatic brain injury.

BACKGROUND It is now recognized that post-traumatic stress disorder (PTSD) can occur following road traffic accidents, but controversy exists about the possibility of PTSD in people sustaining traumatic brain injury (TBI). The present investigation examined the frequency, course and comorbidity of PTSD in children with and without mild TBI after traffic accidents. METHOD Interviews were conducted with 43 children and their parents 6 weeks after a traffic accident,assessing PTSD and associated symptomatology. Fourteen children sustained mild TBI and 29 had no TBI. A sub-set (n=32) was re-interviewed 7 weeks later. RESULTS Children both with and without TBI reported PTSD symptomatology, but no significant group differences were found. At initial assessment, 74% of children were classified as having clinically significant PTSD symptomatology (86% and 69% in groups with and without TBI, respectively), which was strongly associated with report of general anxiety. At follow-up, PTSD symptomatology decreased, but 44% remained symptomatic (38% and 46% for those with and without TBI, respectively). Child and parental report of PTSD symptomatology were not significantly correlated. CONCLUSIONS Presence of mild TBI did not influence the likelihood of experiencing PTSD symptomatology following a traffic accident. Given that PTSD symptomatology is a common consequence of traffic accidents in children, there is a clear need for provision of systematic assessment and, where appropriate, the implementation of intervention strategies to treat children.