Els van Meijel

131 Summary | Chapter 8 impairment at T2. To prevent adverse long-term psychological consequences we recommend identifying and monitoring parents at risk and offering them timely treatment. Special attention is required for parents with acute stress symptoms and parents with children at risk for permanent physical impairment. Further research is necessary to confirm the prevalence of long-term PTSS in parents, and to confirm the role of factors associated with PTSS severity and their possible interaction. Posttraumatic stress in young children after an accident Chapter 6 provided the results of an exploratory study to examine algorithms for posttraumatic stress reactions in accidentally injured children up to 8 years old. Both the DSM-5 algorithm for posttraumatic stress disorder (PTSD) in children 6 years and younger and Scheeringa’s alternative PTSD algorithm (PTSD-AA) were intended to be more developmentally sensitive for young children than the DSM-IV PTSD algorithm. We compared the three algorithms simultaneously and explored diagnostic outcomes of the algorithms in young child survivors of accidental trauma. Parents of 98 young children (0-7 years) involved in an accident between 2006 and 2012 participated in a semi-structured telephone interview to assess child’s posttraumatic stress symptoms. A total of 9 of the children (9.2%) showed substantial PTSS. Of these children, 2 met the criteria of all three algorithms, 7 met both the DSM-5 subtype for children 6 years and younger and the PTSD-AA algorithm, and 2 did not fully meet any of the algorithms (subsyndromal PTSD). For young children, the DSM-5 subtype for children 6 years and younger and the PTSD-AA algorithm appear to be better suited than the previous DSM-IV algorithm. Our results suggest that the DSM-5 subtype for PTSD in children 6 years and younger is an important improvement in identifying young children with PTSD compared to the DSM-IV algorithm. Nevertheless, clinicians should still be aware that some children with subsyndromal PTSDwhomay need trauma-focused treatment can stay unidentified. General discussion In Chapter 7 , we reflected on the main themes and issues regarding posttraumatic stress following accidental injury in children and their parents that emerged from our findings. The rationale for screening for risk and its possible negative side effects