Posttraumatic Stress Following Acute Medical Trauma in Children: A Proposed Model of Bio-Psycho-Social Processes During the Peri-Trauma Period

Meghan L. Marsac, Nancy Kassam-Adams, Douglas L. Delahanty, Keith Widaman, Lamia P. Barakat

Research output: Contribution to journalArticlepeer-review

68 Scopus citations


Millions of children worldwide experience acute medical events. Children’s responses to these events range from transient distress to significant posttraumatic stress disorder symptoms (PTSS). While many models suggest explanations for the development and maintenance of PTSS in adults, very few have focused on children. Current models of child PTSS are primarily restricted to the post-trauma period, thus neglecting the critical peri-trauma period when screening and preventive interventions may be most easily implemented. Research on PTSS in response to pediatric medical trauma typically examines predictors in isolation, often overlooking potentially important interactions. This paper proposes a new model utilizing the bio-psycho-social framework and focusing on peri-trauma processes of acute medical events. Understanding the relationships among bio-psycho-social factors during peri-trauma can inform early identification of at-risk children, preventive interventions and clinical care. Recommendations for future research, including the need to examine PTSS in the context of multiple influences, are discussed.

Original languageEnglish
Pages (from-to)399-411
Number of pages13
JournalClinical Child and Family Psychology Review
Issue number4
StatePublished - Nov 7 2014

Bibliographical note

Funding Information:
Acknowledgments This work was supported by a Mentored Career Award Grant 1K23MH093618-01A1 from the National Institute of Mental Health. Additionally, we would like to thank Aimee Hilden-brand and Katherine Donlon for supporting this manuscript preparation.

Publisher Copyright:
© 2014, Springer Science+Business Media New York.


  • Acute medical trauma
  • Bio-psycho-social model
  • Child PTSD
  • Child PTSS
  • Medical traumatic stress
  • Peri-trauma

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Education
  • Developmental and Educational Psychology
  • Clinical Psychology
  • Psychiatry and Mental health


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