Agreement on child traumatic stress symptoms after pediatric burn injury: The role of parents’ own stress reactions

Assessment of a child’s traumatic stress reactions after pediatric burn injury is complicated by informant disagreement and the possible distorting influence of parental stress symptoms. We examined the prevalence of child and parental traumatic stress symptoms within the first month and 3 months postburn. Moreover, agreement between children, mothers and fathers regarding child symptoms was examined, as well as the role of parents’ symptoms in the perception of their child’s symptoms. Child, mother and father reports of 100 children (8-18 years old) were analyzed within a Structural Equation Model. Results indicated that a minority of children experienced clinically significant traumatic stress symptoms, while the occurrence of parental symptoms was higher. Agreement on child symptoms varied substantially. Moreover, in mothers, traumatic stress symptoms were independently associated with their ratings of child symptoms in the first month postburn, regardless of children’s self-reported symptoms. Three months postburn, this was the case for both parents. In conclusion, mothers’ reactions to pediatric burn trauma seem to influence their perception of child symptoms, while later on, this is also the case for fathers’ reactions. Findings will be discussed in terms of the need to include multiple informants in assessing child symptoms in pediatric burn care.