-Original-

Post-Traumatic Stress Disorder among Children Involved in Traffic Accidents and Their Parents in Japan

Mio Yoshino¹, Takahiro Ueda¹, Haruki Takada², Aya Kanno³, Miho Maeda^1,4, Hisashi Matsumoto⁵, Yutaka Matsui⁶, Takeshi Asano³ and Yasuhiko Itoh¹

¹Department of Pediatrics, Nippon Medical School Hospital, Tokyo, Japan
²Department of Clinical Psychology, Faculty of Psychology, Iryo Sosei University, Fukushima, Japan
³Department of Pediatrics, Nippon Medical School Chiba Hokusoh Hospital, Chiba, Japan
⁴Department of Pediatric Dentistry, School of Life Dentistry at Tokyo, Nippon Dental University, Tokyo, Japan
⁵Shock and Trauma Center, Nippon Medical School Chiba Hokusoh Hospital, Chiba, Japan
⁶Graduate School of Comprehensive Human Science, Tsukuba University, Tokyo, Japan

Background: Children who survive traffic accidents, and their parents, may develop post-traumatic stress disorder (PTSD) or related symptoms (depression or anxiety), which can hinder the children's development and the parents' ability to provide effective care. In Japan, the PTSD incidence rate after traffic accidents and its related factors remain unclarified.
Methods: The participants were 79 children and 104 parents. The children were aged 3-18 years when injured. From August through December 2015, participants completed a self-reported questionnaire survey that comprised the 15-item Post-traumatic Stress Symptoms for Children and the Japanese version of the Impact of Event Scale-Revised. The children's Injury Severity Score (ISS) was also obtained from their medical records. Correlation analysis, analysis of variance, and multiple regression analysis were conducted.
Results: Among the children and parents, 10.1% and 22.1%, respectively, were deemed to be at high risk of PTSD. Their stress scores were significantly positively correlated with each other and negatively correlated with the children's age at the time of the accident. Parents who witnessed their children's accidents and those whose children were hospitalized were more stressed. Neither the children's nor the parents' risk for PTSD was associated with ISS or the amount of time since the accident.
Conclusions: A system that simultaneously works with children and parents to support both parties' psychological recovery is required. To ensure psychological care post-injury, it is necessary to evaluate PTSD risk, regardless of injury severity. Implementing preventive and early interventions can prove more valuable than awaiting natural recovery.

J Nippon Med Sch 2022; 89: 47-55

Keywords
children, parent-child relationship, post-traumatic stress disorder, traffic accident

Correspondence to
Takahiro Ueda, MD, PhD, Department of Pediatrics, Nippon Medical School Hospital, 1-1-5 Sendagi, Bunkyo-ku, Tokyo 113-8603, Japan
yuri878t@nms.ac.jp

Received, October 21, 2020
Accepted, February 3, 2021