Utility of Appraisals During Peri-Trauma as a Predictor of Post-Traumatic Stress Symptoms Following Pediatric Injury

Open Access
- Author:
- Kovalsky, Danielle Marie
- Area of Honors:
- Biobehavioral Health
- Degree:
- Bachelor of Science
- Document Type:
- Thesis
- Thesis Supervisors:
- Jennifer Elise Graham Engeland, Thesis Supervisor
David John Vandenbergh, Thesis Honors Advisor - Keywords:
- PTSD
Trauma
Injury
Pediatrics
Appraisals - Abstract:
- Every year, millions of children experience potentially traumatic injuries placing them at-risk of developing posttraumatic stress symptoms (PTSS). The peri-trauma period (i.e., the time of injury through early medical care) may represent a critical opportunity for screening and intervention by the medical team in order to identify children at risk for developing PTSS. This study examined the relationship between peri-trauma appraisals and subsequent PTSS in children following injury. Children hospitalized for injury (N=95; ages 8-13 years) completed self-report measures of PTSS at baseline (T1), 6-weeks (T2), and 12-weeks (T3) post-injury. At T1, child appraisals were assessed using a self-report measure, the Child Post-Traumatic Cognitions Inventory (cPTCI) and a newly developed, semi-structured interview about appraisals during ambiguous situations the Trauma-Related Ambiguous Situations Interview and Family Discussion Task (the TAS). Self-reported appraisals on the cPTCI during the peri-trauma period significantly predicted PTSS at T2 controlling for age and gender (β = 0.44, t(81) = 4.34, p <.01) and T3 (β = 0.47, t(66) = 3.52, p < .01), yet this association did not hold after also controlling for T1 PTSS. Meaning in this sample, self-report appraisals did predict later PTSS when controlling for baseline PTSS as previous research suggests. When controlling for age, gender, and T1 PTSS, negative global appraisals derived from the TAS significantly predicted PTSS at T2 (β = 2.41, t(81) = 2.29, p < .05), but not T3. These findings suggest a complex relationship between peri-trauma appraisals and subsequent PTSS. Additional research is needed to determine how to best assess appraisals (both global and trauma-specific) in the context of trauma.