PTSD symptomatology in pediatric-onset SCI as related to injury event

Introduction: Literature concerning posttraumatic stress disorder (PTSD) and pediatric spinal cord injury (SCI) focuses primarily on risks for developing symptoms related to the injury. However, individuals with SCI may experience PTSD unrelated to the injury. Methods: To compare PTSD Checklist-Civilian (PCL-C) scores for 2 groups with pediatric-onset SCI: 1) an SCI-Related Group who indicated their most significant stressor was related to their SCI (n= 52, C2-L3 LOI) and 2) SCI-Unrelated Group who indicated this stressor was unrelated to their SCI (n=27, C3-L2 LOI). Spearman’s rho and multiple regression analysis were used to explore relationships between coping mechanisms (Brief COPE), PCL-C, anxiety (Beck Anxiety Inventory), and depressive symptoms (PHQ-9). Results: The SCI-Unrelated Group had significantly higher PCL-C scores (median= 8.0) than the SCI-Related Group (median= 6.0, U= 437.0, p<.05). For the SCI-Unrelated Group, PCL-C scores were correlated with greater anxiety (rs=.585, p=.001) and depressive (rs=.383, p< .05) symptoms, while the SCI-Related Group had a weaker correlation with BAI scores (rs= .397, p,< .05) and Emotional Support subscale of the COPE (rs= .324, p< .019). BAI scores alone predicted PCL-C scores for the SCI-Unrelated Group, while BAI scores and negative coping mechanisms (substance use and behavioral disengagement) together predicted higher PCL-C scores for the SCI-Related Group. Conclusions: The SCI-Related Group reported less PTSD symptomatology, which may be a result of receiving psychological treatment and more emotional support to cope with stress related to SCI. Therefore, to maximize positive outcomes, monitoring possible psychopathology unrelated to the experience of SCI after injury is recommended.