Trajectories of post-traumatic stress symptoms following traumatic injury: a secondary analysis of the recovery after stress treatment randomized controlled trial

AI Summary

Three PTSS recovery trajectories after paediatric injury identified: resilient, recovering, chronic.
ReSeT treatment associated with reduced chronic PTSS; chronic trajectory members predominantly received usual care.
Higher post-traumatic cognitions strongly linked to chronicity; they are modifiable targets for risk stratification and intervention.

TL;DR (AI Generated)

OBJECTIVE: To characterize heterogeneous post-traumatic stress (PTSS) recovery trajectories following pediatric traumatic injuries and identify clinical and psychological factors associated with trajectory membership.

PTSS symptoms, measured by the Child Post-traumatic Stress Scale (CPSS), were assessed prior to randomization, weekly during the 8-week intervention period, and at post-intervention (week 10).

Treatment condition, injury severity, and post-traumatic cognitions distinguished the trajectories, with those in the chronic trajectory belonging to the usual care group, having lower injury severity, and higher post-traumatic cognitions relative to those in the resilient trajectory.

Basic summary

J Pediatr Psychol. 2026 Nov 13:jsag075. doi: 10.1093/jpepsy/jsag075. Online ahead of print.

ABSTRACT

METHODS: Secondary analyses of a two-arm multisite randomized controlled trial comparing a brief online trauma-focused treatment [Reducing Stress after Trauma (ReSeT)] to usual care. Participants included children, ages 8-17, hospitalized following traumatic injuries and reporting elevated PTSS (per combined child and parent report), at 1 month post-injury. PTSS symptoms, measured by the Child Post-traumatic Stress Scale (CPSS), were assessed prior to randomization, weekly during the 8-week intervention period, and at post-intervention (week 10). We modeled child CPSS scores over time using group-based trajectory modeling. We included the following covariates: intervention group, age, sex, injury severity, resilience, post-traumatic cognitions, family functioning, and family income.

RESULTS: Eighty-seven participants, average age of 11.67 years (2.44), were included. Three trajectories were identified: resilient (n = 18), recovering (n = 49), and chronic (n = 20). Exploratory analyses examining the treatment conditions separately indicated similar trajectories. Treatment condition, injury severity, and post-traumatic cognitions distinguished the trajectories, with those in the chronic trajectory belonging to the usual care group, having lower injury severity, and higher post-traumatic cognitions relative to those in the resilient trajectory.

CONCLUSION: Findings provide support for the three-trajectory model of PTSS recovery following pediatric injury and highlight the potential efficacy of ReSeT in reducing chronic PTSS. Post-traumatic cognitions emerged as potent and potentially modifiable correlates of chronicity, underscoring the utility of addressing them in risk stratification and intervention.

PMID:43024782 | DOI:10.1093/jpepsy/jsag075

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