• Markus A Landolt, Margarete Vollrath, Karin Timm, Hanspeter E Gnehm, and Felix H Sennhauser.
• University Children's Hospital, Zurich, Switzerland. markus.landolt@kispi.unizh.ch
• J Am Acad Child Adolesc Psychiatry. 2005 Dec 1;44(12):1276-83.

ObjectiveTo prospectively assess the prevalence, course, and predictors of posttraumatic stress symptoms (PTSSs) in children after road traffic accidents (RTAs).MethodSixty-eight children (6.5-14.5 years old) were interviewed 4-6 weeks and 12 months after an RTA with the Child PTSD Reaction Index (response rate 58.6%). Their mothers (n = 60) and fathers (n = 53) were assessed with the Posttraumatic Diagnostic Scale.ResultsThe prevalence of moderate to severe PTSSs in children was 16.2% at 4-6 weeks, and 17.6% at 12 months. Mean PTSS scores did not decrease between the two assessments. Five children showed a delayed onset of PTSSs. Twelve mothers (20%) and six fathers (11.3%) met criteria for posttraumatic stress disorder (PTSD) at 4 to 6 weeks. At 12 months, three mothers (5.7%) and no fathers met diagnostic criteria. Child PTSSs at 12 months was significantly predicted by PTSS at 4-6 weeks and by severity of father's PTSD. Age, sex, injury severity, threat appraisal, and maternal PTSD did not significantly contribute to child PTSSs at follow-up.ConclusionsThere is a need for careful psychological assessment of children and their parents after an RTA. The possibility of delayed onset of PTSSs implies a monitoring beyond the first weeks after the accident. The impact of fathers' PTSD on child PTSSs suggests that fathers ought to be actively involved in family-based prevention and treatment interventions of child PTSSs after RTAs.

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