PTSD in children after accidents
May 28, 2014

After An Injury, Many Children Can Be Affected By PTSD

April Flowers for - Your Universe Online

When a child on a bicycle is struck by oncoming traffic, the results can be devastating. From life-threatening head injuries to bone fractures, the children are definitely the losers. As it turns out, their bodies heal faster than their minds.

Eva Olofsson, a research student at the University of Gothenburg's Sahlgrenska Academy, found that one in three Swedish children involved in such an accident suffers from posttraumatic stress disorder (PTSD).

Olofsson's thesis reveals that one in five children involved in such an accident may still be suffering from mental and psychosocial problems a year after the event. Despite this, only six out of 10 Swedish children and adolescents involved in traffic accidents were found to have been wearing a helmet.

One study performed by Olofsson found that 30 percent of the children suffered from PTSD one month after the accident. The PTSD lasts between three and six months for at least one in six of the children.

“The children often experience much stress and fear in association with the accident, and may feel that their life is in danger. This can cause posttraumatic stress disorder (anxiety disorder) in the long term, and this may constitute a major obstacle in their everyday lives,” Olofsson said in a recent statement.

Olofsson conducted a second study by surveying 292 children injured in traffic accidents in the Gothenburg region concerning residual consequences of their accident. Analysis of the questionnaire revealed that one year after the accident 22 percent still suffered from the mental and psychosocial problems associated with the accident.

Only 16 percent of the children surveyed suffered from residual physical problems. Olofsson did not find, however, that the residual mental problems were related to the severity of the physical injuries.

“My results suggest that the experience of having an accident has a greater effect that the actual physical injuries. To be injured as an unprotected pedestrian in an accident with a vehicle can be experienced are more stressful, more frightening and more threatening than, for example, a cycling accident with no-one else involved. We saw also that receiving care as an inpatient, with procedures that may be experienced as frightening in an unfamiliar environment, may produce more stress than receiving care at a clinic and being allowed home the same day.”

For children, bicycle accidents are the most common cause of traffic injuries. Olofsson's study reveals that there has been a significant increase in the number of children who are injured while wearing a helmet. In 1993, for example, 40 percent of the injured children were wearing a helmet versus the 80 percent in 2006.

From 1993 to 2006, the number of children with skull or brain injuries after a cycling accident fell at Drottning Silvia's Children's Hospital in Gothenburg, but the decrease was not significant. The hospital also saw a fall in the number of children with facial injuries due to cycling injuries. In contrast, the number of injuries to the arms increased during this time.

“We can see that a cycle helmet provides good protection against severe and life-threatening skull and brain injuries, in all types of cycling accident. Further, a helmet protects against facial injuries,” said Olofsson.

Despite this, Olofsson found that teenagers were significantly less likely to wear a helmet. This is especially true of girls. She found that less than 60 percent of Swedish children wore a helmet when cycling to and from school in 2013, despite 2005 legislation making it illegal for anyone under 16 to ride without a helmet. Only 32 percent of all cyclists, adult and child alike, wore a helmet when cycling.

As a result of 20 years in the nursing field, Olofsson has a great deal of experience working with children injured in traffic accidents.

“Children are very vulnerable in traffic. It’s important to determine what consequences a traffic injury may have for them, such that they can receive optimal care,” she said.

Olofsson suggests that Accident & Emergency healthcare services need to develop procedures to identify children at risk for long-term PTSD problems from accidents, as well as for following-up with such children.

It is important to note that the World Health Organization (WHO) has found that for children 15 – 17 years old, traffic injuries are the leading cause of death globally. In Sweden, the number of child traffic fatalities has fallen from 43 per year in the period 1999-2003 to 20 per year in 2011, making Sweden's child traffic death rate one of the lowest in the world.