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Abstract

Introduction: Children and their parents have an increased risk of developing posttraumatic stress disorder (PTSD) following admission to a pediatric intensive care unit (PICU). Posttraumatic growth (PTG) is the positive change some individuals undergo as they struggle following a traumatic event. Previous literature has demonstrated PTG in adults and children following other types of trauma, but has not been explored in the PICU. Methods: This study is a prospective, longitudinal observational study of children and their parents following admission to a large, urban PICU. English- and/or Spanish- speaking children (ages 8-17 years) admitted to the PICU with an anticipated admission of > 36 hours and their parent were included. Exclusion criteria include developmental delay, severe psychiatric disorder, intentional injury, traumatic brain injury, or inability to complete study measures. Subjects complete a comprehensive protocol, including assessments of child-parent PTSD [UCLA PTSD Reaction Index (UCLA-PTSD RI); PTSD Checklist – Civilian (PCL-C)], acute stress disorder [Acute Symptoms Checklist for Children (ASC-Kids); Stanford Acute Stress Reaction Questionnaire (SASRQ)], and PTG [revised PTG Inventory – Children (PTGI-C-R); PTGI] during admission and at 1- and 3-month follow up (f/u), and collection of physiologic/neuroendocrine data. Results: Seven children (M= 15 years; boys=6) and parents (M=40 years; mothers=7; Spanish-speaking=4) completed baseline and 3-month follow up. 43% children had PTSS (M=19, range=10-) and 1 met criteria for PTSD. Child PTG scores were high (M=23, SD=7.1). All parents had PTSS (M=23, range=); none met criteria for PTSD. Parent-reported PTG scores were also high (M=75, SD=40.7). In summary, 3 children and all parents had PTSS following admission to the PICU. Conclusions: Parents and their children showed significant symptoms of PTSD following admission to the PICU. Additionally, all children and their parents showed evidence of PTG 3 months after the event. This reflects the potential for positive adaptation following the family stress associated with pediatric critical illness. Better understanding of PTSD and PTG will aid in the development of intervention strategies to improve outcomes after pediatric critical illness.