425 Psychosocial Posttraumatic Growth in Pediatric Burn Survivors

Abstract

Post-traumatic stress symptoms (PTSS) and other emotional/behavioral challenges are common in children exposed to traumatic events. However, many children also experience positive psychological benefits, termed posttraumatic growth (PTG). PTG has been found in a variety of pediatric populations, as well as in adult burn patients. However, to our knowledge the specific construct of PTG has not been assessed in pediatric burn survivors. This study examined prevalence of PTG, demographic/burn injury correlates of PTG, and associations between PTG and PTSS. Participants were part of a larger Burn Model System national database and included children between the ages of 8 and 17. Participants completed the Child PTSD Symptom Scale (CPSS) and Post Traumatic Growth Inventory-Child (PTGI-C). Demographic and burn injury data were also gathered. Linear regression models were completed at 6 months to predict PTGI scores. One model included demographic and injury characteristics as predictors and one model included the psychosocial CPSS score as a predictor. A total of 59 individuals had data for PTGI at 6 months post-burn. The mean PTGI score was 20.6, indicating moderate posttraumatic growth. PTGI scores at 6 months were significantly different (p<.01) between the ethnicity groups, with Hispanic participants indicating higher levels of PTG (mean = 23.5) than non-Hispanic participants (mean = 14.9). Regression results indicate other burns (i.e., non-fire/electric) (p=.01) and TBSA (p<.001) are significantly related to PTGI scores. Those with burns other than flame have on average 9.07 points higher PTGI scores, and for each 10% increase in TBSA, there is an average increase of 2.21 points in PTGI scores after adjusting for other factors (age, ethnicity, type of burn, amputation, and sex). With CPSS scores included in the model, regression results indicate that burns other than flame (p=.01), TBSA (p<.001), and CPSS scores (p=.02) are significantly related to PTGI after adjusting for other factors. For each point increase in CPSS total score, there is an average decrease of 0.27 points in PTGI scores. The majority of children exhibit at least some psychosocial growth following a burn. Hispanic children exhibit significantly more growth than their non-Hispanic peers. Fire/flame injured children exhibit less growth than those burned by other mechanisms. As traumatic stress symptoms increase, PTG slightly decreases. Mental health providers should screen for PTG and look for ways to facilitate PTG, especially in groups that exhibit low rates of growth. Moderate levels of posttraumatic growth occur in most pediatric burn patients. Data on PTG and PTSS should be gathered at discharge in order to better examine change over time and to guide interventions.