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Early psychological intervention in accidentally injured children ages 2-16: a randomized controlled trial


Kramer, Didier N; Landolt, Markus A (2014). Early psychological intervention in accidentally injured children ages 2-16: a randomized controlled trial. European Journal of Psychotraumatology, 5:online.

Abstract

BACKGROUND
Road traffic accidents (RTA) and burns are frequent events in children. Although many children recover spontaneously, a considerable number develop long-term psychological sequelae. Evidence on early psychological interventions to prevent such long-term problems is still scarce for school-age children and completely lacking for pre-school children.
OBJECTIVES
To evaluate the efficacy of an early two-session cognitive-behavioral intervention in 108 children ages 2-16 after RTAs and burns.
METHODS
Children assessed at risk for the development of posttraumatic stress disorder (PTSD) were randomly assigned to either a control group offered treatment as usual or an intervention group. Primary outcomes were PTSD, behavioral problems, and depression symptoms. Baseline and blinded 3- and 6-month follow-up assessments were conducted.
RESULTS
In pre-school children, no intervention effects were found. School-age children in the intervention group exhibited significantly fewer internalizing problems at 3-month follow-up relative to controls and a borderline significant time-by-group effect for PTSD intrusion symptoms was found (p=0.06).
CONCLUSIONS
This is the first study examining the efficacy of an indicated, early psychological intervention among both school-age and pre-school-age children. Because the intervention was ineffective for young children, no evidence-based practice can currently be suggested. Given that parents of pre-school children perceived the intervention as helpful, brief counseling of parents in terms of psychoeducation and training in coping skills still should be provided by clinicians, despite the current lack of evidence. To prevent trauma-related disorders in school-age children, the intervention might be used in a step-wise manner, where only children at risk for long-term psychological maladjustment are provided with psychological support.

Abstract

BACKGROUND
Road traffic accidents (RTA) and burns are frequent events in children. Although many children recover spontaneously, a considerable number develop long-term psychological sequelae. Evidence on early psychological interventions to prevent such long-term problems is still scarce for school-age children and completely lacking for pre-school children.
OBJECTIVES
To evaluate the efficacy of an early two-session cognitive-behavioral intervention in 108 children ages 2-16 after RTAs and burns.
METHODS
Children assessed at risk for the development of posttraumatic stress disorder (PTSD) were randomly assigned to either a control group offered treatment as usual or an intervention group. Primary outcomes were PTSD, behavioral problems, and depression symptoms. Baseline and blinded 3- and 6-month follow-up assessments were conducted.
RESULTS
In pre-school children, no intervention effects were found. School-age children in the intervention group exhibited significantly fewer internalizing problems at 3-month follow-up relative to controls and a borderline significant time-by-group effect for PTSD intrusion symptoms was found (p=0.06).
CONCLUSIONS
This is the first study examining the efficacy of an indicated, early psychological intervention among both school-age and pre-school-age children. Because the intervention was ineffective for young children, no evidence-based practice can currently be suggested. Given that parents of pre-school children perceived the intervention as helpful, brief counseling of parents in terms of psychoeducation and training in coping skills still should be provided by clinicians, despite the current lack of evidence. To prevent trauma-related disorders in school-age children, the intervention might be used in a step-wise manner, where only children at risk for long-term psychological maladjustment are provided with psychological support.

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Additional indexing

Item Type:Journal Article, refereed, original work
Communities & Collections:04 Faculty of Medicine > University Children's Hospital Zurich > Medical Clinic
06 Faculty of Arts > Institute of Psychology
Dewey Decimal Classification:150 Psychology
610 Medicine & health
Language:English
Date:27 June 2014
Deposited On:21 Jul 2014 15:27
Last Modified:09 Aug 2017 01:24
Publisher:Co-Action Publishing
ISSN:2000-8066
Funders:Anna Mueller Grocholski Foundation
Free access at:PubMed ID. An embargo period may apply.
Publisher DOI:https://doi.org/10.3402/ejpt.v5.24402
PubMed ID:24987498

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