Els van Meijel

79 Parental posttraumatic stress | Chapter 5 Introduction Accidental injury in children also affects the parents and puts them at risk for developing substantial posttraumatic stress symptoms (PTSS) (Kassam-Adams et al., 2009; Le Brocque et al., 2010). The prevalence of PTSS in parents 3-6 months after their child’s accidental trauma is 10%–15%. In a preceding study, self-reported PTSS was measured in 135 parents, 3 months after their child’s accidental injury. Symptoms at a clinically significant level were reported by nearly 10% of the parents (van Meijel et al., 2015). Kassam-Adams and colleagues assessed self-reported PTSD in 251 parents of children with traffic-related injuries (Kassam-Adams et al., 2009). They found partial or full posttraumatic stress disorder (PTSD) in 15% of the parents approximately 6 months post-injury. A systematic review on pediatric medical traumatic stress (PMTS) reported a prevalence of parental PMTS ranging from 0% to 18% at ten months or more post-injury (Price et al., 2016). PMTS was defined as ‘a set of psychological and physiological responses of children and their families to pain, injury, serious illness, medical procedures, and invasive or frightening treatment experiences’, often including posttraumatic stress reactions (Price et al., 2016). While data are supportive for long-term PTSS and related impairment in parents (Kazak et al., 2006), there is a lack of long-term follow-up studies. We only found one study with a 1 and 11 years follow-up period (Bakker et al., 2010) in 48 mothers of children with burns. PTSS was assessed by self-report. At 1 year and 11 years after their child’s burn event, 17% of the mothers reported clinically significant symptoms. In general, parents’ well-being has an effect on the child’s functioning (Alisic et al., 2011). PTSS in parents, short and long-term, affects children in various ways. It is longitudinally related to poorer recovery of PTSS in the child (Landolt et al., 2012). Parental PTSS increases the risk of child PTSD (Kolaitis et al., 2011) and parents’ early symptoms are a risk factor for persistent posttraumatic stress in injured children (Kassam-Adams et al., 2013). A meta-analysis reported significant effect sizes for the relationship between parent and child PTSS, suggesting that parental PTSS, especially maternal, may be a risk factor for child PTSS (Morris et al., 2012). Authors of the Integrative Trajectory Model of Pediatric Medical Traumatic Stress (Price et al., 2016) also stressed the role of parents following their child’s injury. The Integrative Trajectory Model of Pediatric Medical Stress provides a conceptual framework for traumatic stress responses across pediatric injuries and illnesses (Kazak et al., 2006; Price et al.,