Journal of Pediatric Psychology Advance Access originally published online on August 10, 2005
Journal of Pediatric Psychology 2006 31(4):343-355; doi:10.1093/jpepsy/jsj054
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An Integrative Model of Pediatric Medical Traumatic Stress
1 The Children’s Hospital of Philadelphia and 2 The University of Pennsylvania
All correspondence concerning this article should be addressed to Anne E. Kazak, PhD, ABPP, The Children’s Hospital of Philadelphia, 34th Street and Civic Center Boulevard, Room 1486 CHOP North, Philadelphia, Pennsylvania 19104-4399. E-mail: kazak{at}email.chop.edu.
Received May 19, 2004; revisions received August 12, 2004 and November 17, 2004; accepted December 9, 2004
Objective To guide assessment and intervention for patients and families, a model for assessing and treating pediatric medical traumatic stress (PMTS) is presented that integrates the literature across pediatric conditions. Methods A model with three general phases is outlined—I, peritrauma; II, early, ongoing, and evolving responses; and III, longer-term PMTS. Relevant literature for each is reviewed and discussed with respect to implications for intervention for patients and families. Results Commonalities across conditions, the range of normative responses to potentially traumatic events (PTEs), the importance of preexisting psychological well-being, developmental considerations, and a social ecological orientation are highlighted. Conclusions Growing empirical support exists to guide the development of assessment and intervention related to PMTS for patients with pediatric illness and their parents. The need for interventions across the course of pediatric illness and injury that target patients, families, and/or healthcare teams is apparent. The model provides a basis for further development of evidence-based treatments.
Key words: cancer; families; intervention; pediatric illness; pediatric injury; posttraumatic stress disorder; posttraumatic stress; transplantation.
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