Els van Meijel

60 Chapter 4 | Results of a 2–4-year follow-up study In their meta-analysis, Alisic et al. (2014) found a prevalence of 9.7% PTSD for non- interpersonal trauma, including accidents. In this meta-analysis, PTSD was assessed by clinical interview and the age range was 2–18 years. In a follow-up study of road accident victims (aged 6 to 20 years) that was conducted up to 18 months after the accident, Gillies et al. (2003) found that 19% of the participants had ongoing problems with physical injury. Measured by child self-report, 34% of the children had continuing or delayed onset symptoms of PTSD. In a literature review to determine the prevalence of PTSD among 5–18-year-old children and adolescents injured in traffic, Olofsson et al. (2009) reported a prevalence of 13% at 3–6 months after the accident. PTSD in the included studies was assessed by diagnostic interview and/or self-report. They included only one study with a 2–18-month follow-up of victims of motor vehicle accidents, which reported 14% PTSD. In a meta-analytic study on changes in the prevalence of child posttraumatic stress disorder in the year following trauma, the prevalence decreased from 21% in the acute phase to 11% after 1 year (Hiller et al., 2016). The majority of the studies included in this meta-analytic study focused on accidental injury and non-intentional trauma exposure in children 5–18 years old. Measurement of PTSD was done by self-report with a cut-off value, or by diagnostic interview. Previous studies suggest that physical impairment, psychosocial consequences, trauma history, new traumatic events and trauma-focused psychotherapy are associated with the occurrence of long-term PTSD (Copeland et al., 2007; Gillies et al., 2003; Janssens et al., 2009; Landolt et al., 2005; Mehta & Ameratunga, 2012; NICE, 2005; Zatzick et al., 2008). Pain after accidental injury contributes to later PTSD or PTSS in children and adolescents (Hildenbrand et al., 2016); in particular, severe acute pain is associated with PTSS 3 months later (van Meijel et al., 2019). The long-term effects of acute pain in accidentally injured children have not been reported as yet. Although non-injured or mildly injured children can also develop PTSD (Olofsson et al., 2009), serious injury with long-term physical impairment as a consequence may be associated with long-term health and mental health problems. A long-term follow-up study in children 7 years after major trauma revealed that about 40% of the children were physically impaired and half of this group was restricted in daily activities (Janssens et al., 2009). Gillies and colleagues suggested that continuing physical problems may contribute to ongoing psychological distress (Gillies et al., 2003).