Child coping, parent coping assistance, and post-traumatic stress following paediatric physical injury

Background Following a physical injury, many children exhibit long-term psychological reactions such as post-traumatic stress symptoms (PTSS). Children's coping strategies, and the ways that others help them cope with injury (i.e. coping assistance), are understudied, potentially malleable variables that could be targeted in preventive interventions. The objectives of the current research were to describe child coping behaviour and parent coping assistance following a child's injury, and to investigate the relationships among coping, coping assistance and child PTSS. Method Participants included 82 children with injuries and one parent of each child. Children completed measures of coping and coping assistance 2 weeks after their injury (T1). Children also completed measures of coping and PTSS at a 3-month follow-up (T2). Parents reported on the coping assistance they provided to their child at T1. Results Children reported using an average of six coping strategies (out of 10) with wishful thinking, social support, distraction, and cognitive restructuring endorsed most frequently. Child-reported social withdrawal and resignation 2 weeks after his or her injury (T1) were related to subsequent PTSS (T2). Social withdrawal at T2 was related to concurrent child PTSS (T2). Children were more likely to seek social support when their parents reported helping their child cope. No relationships were identified between active coping behaviours or parent coping assistance and PTSS outcomes. Conclusions Findings suggest that children's coping strategies (particularly social withdrawal and resignation) play a possibly important, complex role in the development of traumatic stress symptoms. When parents help their child cope, children are more likely to seek out social support, suggesting that they will be more able to ask their parents for help as needed. Future research should identify effective strategies to prevent PTSS including how parents can best support their child following paediatric injury.