Mothers' emotions after paediatric burn injury: longitudinal associations with posttraumatic stress-and depressive symptoms

Abstract

Background: A child’s burn injury is an emotional experience that places parents at risk of developing posttraumatic stress disorder (PTSD) symptoms. Although the wide range of emotions implicated in PTSD is acknowledged, longitudinal research examining changes in emotions and PTSD over time is scarce (McLean & Foa, 2017).  Objective: To examine the longitudinal relationships of mothers’ trauma-related emotions with symptoms of posttraumatic stress and depression 18 months after their child’s burn injury. Method: Mothers (n = 296) reported intensity of burn-related emotions within the first month (T1) and at 12 months postburn (T2). The Impact of Event Scale (IES) and the depression subscale of the Hospital and Anxiety Depression Scale (HADS-D) were administered at T1 and 18 months postburn (T3).  Results: Based on two Exploratory Factor Analyses (EFA), emotion variables were merged into two factors: basic emotions (fear, sadness, horror and anger) and self-conscious emotions (guilt and shame). Path analyses indicated that persistence of basic emotions (from T1 to T2) was related to persistence of posttraumatic stress- and depressive symptoms. Self-conscious emotions showed concurrent associations with posttraumatic stress-and depressive symptoms at T1 and were longitudinally related to depressive, but not posttraumatic stress, symptoms.  Conclusions: Initial high levels of basic emotions that persist appear to increase the risk of chronic posttraumatic stress and of co-occurring depressive symptoms. Over and above these relationships, self-conscious emotions are indicated to contribute to long-term depressive symptoms