Pediatric Amputations: PTSD, Behavioral Tendencies and Quality of Life

Abstract

The present study examined children and adolescents between 11-18 years of age who had experienced traumatic amputations due to an acute physical injury (burns, severing, and crushing accidents). In order to account for variance which may have impacted the results of the study, evaluations were conducted between a group of children/adolescents with amputations and a comparison group of children/adolescents who had been hospitalized due to a non-head injury, non-death motor vehicle accident. The goal of this study was to assess symptoms of PTSD, provide a description of the internalized and externalized behaviors, and examine the quality of life (QOL)(health habits, school work, physical fitness, social support, emotional feelings, and family communications) expressed by children/adolescents who had experienced an amputation. Findings indicated a significant difference in PTSD symptomatology between groups. While no differences were found between groups in regard to internalizing and externalizing behavioral tendencies and QOL, an interaction between group and gender was evident for externalizing behaviors and QOL. Female amputees reported higher levels of externalized behavioral tendencies and lower levels of QOL in comparison to their male counterparts. An inverse relationship between symptoms of PTSD and QOL was also demonstrated. In addition, lack of social support and family communication was found to be related to symptoms of PTSD for the amputee sample. While the generalizability of these results is limited due to the small sample size, findings are of significant clinical importance. Results indicated that a substantial number of children/adolescents who experience the loss of a limb due to an acute physical injury experience unrecognized psychological distress. Although those who had experienced an amputation did not meet a clinically significant elevation, the group mean placed their scores in the mild category of PTSD. As a whole, the comparison group mean for PTSD placed their group mean score in the doubtful category of symptomatology indicating that the reported symptoms of PTSD for the amputees were above and beyond the traumatizing experience of hospitalization and of an accident for this sample