Mather Fiona J, Tate Robyn L, Hannan Timothy J
Department of Psychology, University of Sydney, NSW, Australia.
Brain Inj. 2003 Dec;17(12):1077-87. doi: 10.1080/0269905031000114045.
It is now recognized that post-traumatic stress disorder (PTSD) can occur following road traffic accidents, but controversy exists about the possibility of PTSD in people sustaining traumatic brain injury (TBI). The present investigation examined the frequency, course and comorbidity of PTSD in children with and without mild TBI after traffic accidents.
Interviews were conducted with 43 children and their parents 6 weeks after a traffic accident,assessing PTSD and associated symptomatology. Fourteen children sustained mild TBI and 29 had no TBI. A sub-set (n=32) was re-interviewed 7 weeks later.
Children both with and without TBI reported PTSD symptomatology, but no significant group differences were found. At initial assessment, 74% of children were classified as having clinically significant PTSD symptomatology (86% and 69% in groups with and without TBI, respectively), which was strongly associated with report of general anxiety. At follow-up, PTSD symptomatology decreased, but 44% remained symptomatic (38% and 46% for those with and without TBI, respectively). Child and parental report of PTSD symptomatology were not significantly correlated.
Presence of mild TBI did not influence the likelihood of experiencing PTSD symptomatology following a traffic accident. Given that PTSD symptomatology is a common consequence of traffic accidents in children, there is a clear need for provision of systematic assessment and, where appropriate, the implementation of intervention strategies to treat children.
现在人们认识到，创伤后应激障碍（PTSD）可发生于道路交通事故之后，但对于创伤性脑损伤（TBI）患者发生PTSD的可能性存在争议。本研究调查了交通事故后有或无轻度TBI的儿童中PTSD的发生率、病程及共病情况。
在交通事故发生6周后，对43名儿童及其父母进行访谈，评估PTSD及相关症状。14名儿童有轻度TBI，29名儿童无TBI。7周后对其中一部分儿童（n = 32）进行了再次访谈。
有和无TBI的儿童均报告有PTSD症状，但未发现显著的组间差异。在初次评估时，74%的儿童被归类为有临床显著的PTSD症状（有TBI组和无TBI组分别为86%和69%），这与广泛性焦虑报告密切相关。在随访时，PTSD症状有所减轻，但仍有44%的儿童有症状（有TBI组和无TBI组分别为38%和46%）。儿童和父母对PTSD症状的报告无显著相关性。
轻度TBI的存在并不影响交通事故后出现PTSD症状的可能性。鉴于PTSD症状是儿童交通事故的常见后果，显然需要提供系统评估，并在适当情况下实施干预策略来治疗儿童。
