Die Psychologie des verunfallten Kindes

Zusammenfassung.

Eine bedeutsame Zahl von Kindern entwickelt nach Unfällen psychische Symptome, welche als post-traumatische Belastungsreaktionen bezeichnet werden können. Es wird ein Überblick über die Literatur zum Thema der psychischen Konsequenzen nach Unfällen im Kindesalter gegeben. Neben Klassifikation und Erfassung posttraumatischer psychischer Reaktionen, werden die Prävalenz, die Pathogenese, die Biologie sowie die Prävention und Behandlung solcher Störungen behandelt. Es wird empfohlen, dass zukünftig in der Behandlung des verunfallten Kindes vermehrt psycho-traumatologische Aspekte berücksichtigt werden.

The Psychology of Children after Trauma.

A significant number of child victims of accidents develops psychological symptoms which can be described as posttraumatic stress reactions. This article reviews the literature on psychological consequences of accidents. Classification, diagnosis, prevalence, pathogenesis, biology, prevention, and therapy of post-traumatic stress reactions in children and adolescents are discussed. Consideration of psychotraumatological aspects in the treatment of children and adolescents after accidents is recommended.

Unfall - Kind - Jugendliche - Psychologie - posttraumatische Belastungsstörung

Accident - Child - Adolescent - Psychology - Post-traumatic stress disorder

Literatur

• 1 Aaron J, Zaglul H, Emery R E. Posttraumatic stress in children following acute physical injury.  J Pediatr Psychol. 1999;  24 335
• 2 American Academy of Child and Adolescent Psychiatry AACAP . Summary and practice parameters for the assessment and treatment of children and adolescents with posttraumatic stress disorder.  J Am Acad Child Adolesc Psychiat. 1998;  37 997
• 3 American Psychiatric Association . Diagnostic and statistical manual of mental disorders, 3rd ed. Washington; American Psychiatric Association 1980
• 4 American Psychiatric Association . Diagnostic and statistical manual of mental disorders, 3rd ed. rev. Washington; American Psychiatric Association 1987
• 5 American Psychiatric Association . Diagnostic and statistical manual of mental disorders, 4th ed. Washington; American Psychiatric Association 1994
• 6 Blanchard E B, Hickling E J, Taylor A E. Psychiatric morbidity associated with motor vehicle accidents.  J Nerv Ment Dis. 1995;  183 495
• 7 DaCosta J M. On irritable heart: a clinical study of a form of functional cardiac disorder and its consequences.  Am J Med Sci. 1871;  61 2
• 8 De Bellis M D, Chrousus G P, Dorn L D, Burke L, Helmers K, Kling M A, Trickett P K, Putnam F W. Hypothalamic-pituitary-adrenal axis dysregulation in sexually abused girls.  J Clin Endocrinol Metab. 1994;  78 249
• 9 De Vries A PJ, Kassam-Adams N, Cnaan A, Sherman-Slate E, Gallagher P R, Winston F K. Looking beyond the physical injury: Posttraumatic stress disorder in children and parents after pediatric traffic injury.  Pediatrics. 1999;  104 1293
• 10 Di Gallo A, Barton J, Parry-Jones W L. Road traffic accidents: early psychological consequences in children and adolescents.  Br J Psychiat. 1997;  170 358
• 11 Dilling H, Mombour W, Schmidt M H (Hrsg). Internationale Klassifikation psychischer Störungen. ICD 10, Kapitel V (F). Bern; Huber 1991
• 12 Garmezy N, Rutter M. Acute reactions to stress. In: Rutter M, Hersov L (eds) Child and adolescent psychiatry: modern approaches, 2nd ed. Oxford; Blackwell 1985: 152
• 13 Green B L, Korol M, Grace M C, Vary M G, Leonard A C, Gleser G C, Smitson-Cohen S. Children and disaster: age, gender, and parental effects on PTSD symptoms.  J Am Acad Child Adolesc Psychiat. 1991;  30 945
• 14 Jones R W, Peterson L W. Post traumatic stress disorder in a child following an automobil accident.  J Fam Pract. 1993;  36 223
• 15 Joseph S A, Brewin C R, Yule W, Williams R. Causal attributions and posttraumatic stress in adolescents.  J Child Psychol Psychiat. 1993;  34 247
• 16 Joseph S, Masterson J. Posttraumatic stress disorder and traumatic brain injury: are they mutually exclusive?.  J Traum Stress. 1999;  12 437
• 17 Kemp A, Sibert J. Childhood accidents: epidemiology, trends, and prevention.  J Acid Emerg Med. 1997;  14 316
• 18 Landolt M A, Boehler U, Schwager C, Schallberger U, Nuessli R. Posttraumatic Stress Disorder in Paediatric Patients and Their Parents: An Exploratory Study.  J Paediatr Child Health. 1998;  34 539
• 19 Landolt M A, Vollrath M, Gnehm Hp E, Sennhauser F H. Das transaktionale Belastungsbewältigungsmodell. Zürich; Universitäts-Kinderklinik 1998
• 20 Lask B. Paediatric liaison work. In: Rutter M, Taylor E, Hersov L (eds) Child and adolescent psychiatry: modern approaches. Oxford; Blackwell 1994: 996
• 21 Lazarus R S, Folkman S. Stress, appraisal and coping. New York; Springer
• 22 Levi R B, Drotar D, Yeates K O, Taylor H G. Posttraumatic stress symptoms in children following orthopedic or traumatic brain injury.  J Clin Child Psychol. 1999;  28 232
• 23 Marti D, Landolt M A. Does Bugs Bunny alleviate pain and stress in burned children undergoing dressing changes? 5th Workshop. Lissabon; European Club of Pediatric Burns 1997
• 24 Mayou R, Bryant B, Duthie R. Psychiatric consequences of road traffic accidents.  Br Med J. 1993;  307 647
• 25 Mayou R, Tyndel S, Bryant B. Long-term outcome of motor vehicle accident injury.  Psychosom Med. 1997;  59 578
• 26 Max J E, Castillo C S, Robin D A, Lindgren S D, Smith W L, Sto Y, Arndt S. Posttraumatic stress symptomatology after childhood traumatic brain injury.  J Nerv Ment Dis. 1998;  186 589
• 27 McFarlane A C. Posttraumatic phenomena in a longitudinal study of children following a natural disaster.  J Am Acad Child Adolesc Psychiat. 1987;  26 764
• 28 Mirza K AH, Bhadrinath I M, Goodyer I M, Gilmour C. Posttraumatic stress disorder in children and adolescents following road traffic accidents.  Br J Psychiat. 1998;  172 443
• 29 Mitchell J T, Everly G S. Critical incident stress debriefing: an operations manual for the prevention of trauma among emergency service and disaster workers. Baltimore; Chevron 1997
• 30 Nader K O. Assessing traumatic experiences in children. In: Wilson JP, Keane TM (eds.) Assessing psychological trauma and PTSD. New York; Guilford 1997: 291
• 31 Nader K O, Pynoos R, Fairbanks L, Frederick C. Children's PTSD reactions one year after a sniper attack at their school.   Am J Psychiat. 1990;  147 1526
• 32 Pfefferbaum B. Posttraumatic Stress Disorders in Children: A Review of the Past 10 Years.  J Am Acad Child Adolesc Psychiat. 1997;  36 1503
• 33 Rose S, Bission J. Brief early psychological interventions following trauma: a systematic review of the literature.  J Traum Stress. 1998;  11 697
• 34 Scheeringa M S, Zeanah C H, Drell M J, Larrieu J A. Two approaches to the diagnosis of posttraumatic stress disorder in infancy and early childhood.  J Am Acad Child Adolesc Psychiat. 1995;  34 191
• 35 Stallard P, Law F. Screening and psychological debriefing of adolescent survivors of life-threatening events.  Br J Psychiat. 1993;  163 660
• 36 Stallard P, Velleman R, Baldwin S. Prospective study of post-traumatic stress disorder in children involved in road traffic accidents.  Br Med J. 1998;  317 1619
• 37 Stoddard F J, Norman D K, Murphy J M, Beardslee W R. Psychiatric outcome of burned children and adolescents.  J Am Acad Child Adolesc Psychiat. 1989;  28 589
• 38 Thompson A, McArdle P, Dunne F. Psychiatric consequences of road traffic accidents. Children may be seriously affected.  Br Med J. 1993;  307 1282
• 39 Odwin O. Annotation: children's reactions to traumatic events.  J Child Psychol Psychiat. 1993;  34 115
• 40 Van der Kolk B. The body keeps the score: approaches to the psychobiology of posttraumatic stress disorder. In: Van der Kolk B, McFarlane AC, Weiseath L (eds) Traumatic Stress. New York; Guilford 1996: 214
• 41 Van der Kolk B. Zur Psychologie und Psychobiologie von Kindheitstraumata.  Praxis der Kinderpsychologie und Kinderpsychiatrie. 1998;  47 19
• 42 Yule W. Resilience and vulnerability in child survivors of disasters. In: Tizard B, Varma V (eds) Vulnerability and Resilience: A Festschrift for Ann and Alan Clarke. London; Jessica Kingsley 1992: 82
• 43 Yule W. Posttraumatic Stress Disorder. In: Rutter M, Hersov L (eds) Child and adolescent psychiatry: modern approaches. Oxford; Blackwell 1994: 392
• 44 Yule W. Posttraumatic stress disorder in children and its treatments. In: Miller T (ed) Children of Trauma. Madison; Intern Univ Press 1998: 219
• 45 Yule W, Udwin O. Screening child survivors for post-traumatic stress disorder: experiences from the „Jupiter” sinking.  Br J Clin Psychol. 1991;  30 131
• 46 Yule W, Williams R M. Posttraumatic stress reactions in children.  J Traum Stress. 1990;  3 279

1 Die Diagnosekriterien gemäß des in Europa gebräuchlicheren Klassifikationssystems ICD-10 unterscheiden sich nur unwesentlich von jenen des DSM-IV [5]. Da in der Forschungsliteratur fast ausschließlich auf die DSM-IV Kriterien Bezug genommen wird, werden diese in der Folge ausführlicher vorgestellt.