A Pilot Study Comparing Traumatic Stress Symptoms by Child and Parent Report Across Pediatric Chronic Illness Groups

Abstract

Objective-Researchers have recently used a framework of traumatic stress to describe the psychological functioning of children experiencing a chronic illness and their families; however, few studies are available directly comparing symptoms across disease groups. The current study compared traumatic stress symptoms of youth being considered for solid organ and bone marrow transplantation, youth diagnosed with Human Immunodeficiency Virus (HIV), youth diagnosed with sickle cell disease (SCD) and their parents. Correlates of traumatic stress across these populations were also examined.Method-Participants included 64 youth and caregiver dyads with previously scheduled appointments at one of three specialty clinics. Parents completed measures of family demographics, traumatic stress symptoms, and child functional status. Youth (n=45) and parents each completed self-report and parent-proxy measures of youth traumatic stress symptoms.Results-10% of youth by self-report, 18% of youth by parent-proxy report, and 13% of caregivers described symptoms suggestive of PTSD. Parents of pediatric transplant self-reported greater symptoms than caregivers of youth with HIV and SCD (p<.05). While child functional impairment did not predict child symptoms, a trend was found where parents experiencing more traumatic stress symptoms themselves reported their children experienced greater symptoms by parent-proxy report (p=.07).Conclusion-Findings suggest that while most children and parents across disease groups report sub-clinical levels of traumatic stress symptoms, traumatic stress symptoms may be especially salient for families of pediatric transplant candidates. While interventions are currently available to treat PTSD symptoms, they will likely need to be individualized to meet the needs of specific disease groups.

The Role of Anxiety Control and Treatment Implications of Informant Agreement on Child PTSD Symptoms

“…As parental attunement and potential bias have received considerable attention as sources of discrepancy in parent–child reporting (Ghesquire et al, 2008; Ingerski et al, 2010; Shemesh et al, 2005), several important findings from this study are worth highlighting. First, the positive correlation between parent and child informants on total PTSD symptoms measured at pretreatment appeared to be relatively stronger than those previously found in non-clinical samples.…”

“…Frequently, parents own symptomatology has been considered as a potential factor that may bias parent-report of child psychopathology. Indeed, several studies have linked parent self-reported PTSD symptoms with their report of their child's symptoms (e.g., Ghesquire et al, 2008; Ingerski et al, 2010; Shemesh et al, 2005), perhaps reflecting that traumatic events are often experienced by multiple members of a family. Given our findings, caution is urged before attributing informant discrepancies to parental bias.…”

“…If this were true, it might be expected that discrepancies diminish over time as parents become more attuned, and indeed, two prospective studies have documented this convergence (Meiser-Stedman, Smith, Glucksman, Yule, & Dalgleish, 2007; Schreier, Ladakakos, Morabito, Chapman, & Knudson, 2005). There has been a considerable focus on parents’ own traumatic stress reactions as a potential explanation for limited attunement and inflated ratings of their children's symptoms compared to child self-report (e.g., Ghesquire et al, 2008; Ingerski, Shaw, Gray, & Janicke, 2010; Shemesh et al, 2005). Limited attunement may, however, be explained by individual differences within children.…”

Rates and Risk Factors for Post-Traumatic Stress Disorder Symptomatology among Adult Hematopoietic Cell Transplant Recipients and Their Informal Caregivers

“…18–21 There is more information about parent caregivers of children undergoing HCT or solid organ transplantation; in one such study 14% of caregivers and 15% of children self-reported PTSD. 22 …”

Network and Social Support in Children With Chronic Diseases: Understanding the Child's Perception

“…1 The United States is faced with a rate of 19.3% of children with special health care needs, 2 among which include those with diagnosis of a chronic disease, which accounts for 42% of health care costs for the child population. 3 In Brazil, research reveals that 9.1% of children aged zero to five years present with chronic diseases, as well as 9.7% of schoolchildren between six and thirteen and 11% of adolescents aged fourteen to nineteen years of the general total population.…”