Predicting posttraumatic stress following pediatric injury: a systematic review.

OBJECTIVE To review the recent empirical literature concerning development of posttraumatic stress symptoms following pediatric injury and summarize risk and predictive factors that will inform clinical practice and research. METHODS A systematic search of online databases such as PsycInfo, PILOTS, MedLine, and PubMed was performed. Further studies were identified through the reference lists of selected articles. RESULTS Pre-injury psychological problems, the child's subjective experience of trauma severity/life threat, elevated heart rate immediately following the trauma, beliefs regarding initial symptoms, active thought suppression, and parental posttraumatic stress appear to be consistent predictors of persisting posttraumatic stress in children following injury. CONCLUSIONS Specific variables may be useful in predicting posttraumatic stress following injury, which are discussed in terms of existing models of pediatric traumatic stress. Methodologies of included studies are also discussed.