Psychological trauma in children and adolescents with burns
This thesis examines and describes children's and adolescent's responses to burn injuries, with a specific focus on traumatic responses. Fifty five children, adolescents and their parents took part in this longitudinal study, a recruitment rate of 35% of the total population. All of the children had sustained accidental burn injuries of varying severity at least one month before their first assessment. Children were aged between three and eighteen years, and the mean age was seven years. Children under 6 years were not personally assessed. Parents reported on these children using the Child Behaviour Checklist (CBCL), and the Posttraumatic Stress Reaction Index- parent version (PTS-RI). Children over six years took part in the Diagnostic Interview for Children and Adolescents (DICA), and completed the Impact of Events Scale (IES), the Children's Posttraumatic Stress Reaction Index (C-PTS-RI), the Fear Survey Schedule (FSS) and the Depression Self-Rating Scale (DSRS). Parents of these children also completed DICA, the PTS-RI and the CBCL. At six months, all procedures were repeated. Generally, children and adolescents adjusted well following their burn injuries. Traumatic symptoms had been experienced by over half the children, with intrusive symptoms most common. 14% had a PTSD diagnosis at some time since their burn injury. A quarter of the children were reported to have general borderline or clinical behavioural problems using the CBCL. Over half the children reported symptoms of depression. The results are described with reference to the existing literature on children's traumatic responses and children's responses to burn injuries. It is suggested that there may be a "normal" acute trauma response following burn injury. Theory surrounding children's response to burn injury is examined and directions for a new theory encompassing trauma and injury in the context of development are proposed. The methodological limitations to the study are discussed and recommendations are made.