Week 9 - Clinical Psychology

Question 1

What is peaediatric medical traumatic stress?

Answer 1

A set of psychological and physiological responses in children and their families to pain, injury, medical procedures, and invasive or frightening treatment experiences.

Question 2

What are some of the immediate reactions to a child experiencing medical traumatic stress?

Answer 2

Fear, agitation, nightmares, difficulty sleeping, clinginess, crying and distress, difficulty concentrating.

Question 3

What are the three groups of potential traumatic stress patterns displayed by parents?

Answer 3

Withdrawal/unresponsive/unavailable
Overprotective/constricting
Re-enacating/endangering/frightening

Question 4

What are the three potential PTSD symptom trajectories for children following accidental injury?

Answer 4

• Resilient (57%)
• Recovering (33%) - they start with high symptomology which then drops
• Chronic (10%) - symptoms remain at a high level and they don’t seem to recover

Question 5

What are the three potential trajectories for parental distress symptoms following the accident of a child?

Answer 5

• Stable low (78%)
• Moderate stable (14%) - this group is the most concerning
• High declining (8%)

Question 6

What are some common reactions for a child experiencing PTSD?

Answer 6

Excessive clinginess
Avoidance of reminders
Irritability and temper tantrums
Distress around reminders
Disobedience
Nightmares
Hyperactivity
Increased agression

Question 7

What are the components of the web-based early intervention for children and their parents following accidental injury?

Answer 7

• Normalising reactions
• Promoting positive outcomes as norm
• Encouraging use of good coping strategies
• Stratified for age cohort (younger vs. adolescent)
• Parent information, including advice to seek help only if worsening or failure to improve.

Question 8

Why is it important to re-screen at risk children following an accidental injury?

Answer 8

To take into account natural remission and pick up more genuine cases and catch those with chronic distress

Question 9

What did the results of the web-based early intervention RCT find?

Answer 9

That high risk children who received no intervention got significantly worse

Question 10

What are the goals and focus during the Peritrauma phase?

Answer 10

To change the subjective experience of the PTE, to screen for risk and to use a prevention intervention.

Question 11

What are the goals and focus during the Acute phase?

Answer 11

To prevent post-traumatic stress, screen for risk and identify the family’s competencies, and use prevention and early intervention to target moderators, mediators and risk factors.

Question 12

What are the goals and focus during the Ongoing phase?

Answer 12

To reduce post-traumatic stress, to screen for traumatic stress and support needs, and use a trauma focused CBT treatment.

Question 13

Define the components of the peadiatric medical traumatic stress model.

Answer 13

• Developmental, aged based responses
• Process may unfold at different points in the course of illness and treatment
• Family perspective, child, parent, sibling - all can present differently
• Not a PTSD diagnosis - it is broader and can include anxiety, depression,etc.
• Commonality across conditions
• Range of responses: resilient to chronic

Question 14

What are the prevalence rates of PTSD in children following:
accidental injury
PICU admission

Answer 14

Accidental injury: 10 - 20%

PICU admission: 20 - 30%

Question 15

What are the differences between physical recovery and psychological recovery for traumatically injured children who have PTSD?

Answer 15

Although there is a delay, their physical health tends to recover over time. However there tends to be no recovery in their psychosocial health (over 18 months).