| Background. Posttraumatic stress disorder (PTSD) is a prevalent disorder that adversely affects the cognitive, developmental, and emotional health of children. Primary care has been identified as a key setting to facilitate the care for mental health conditions, including PTSD. However, childhood PTSD continues to be under-detected and under-treated. Little is known about the factors that affect pediatric practice in identifying and caring for traumatized children. The objective of this study was to determine the factors that influence pediatric identification, assessment, and treatment of childhood posttraumatic stress reactions.; Methods. Focus groups were conducted with primary care pediatricians; the results guided the development of a survey. The survey assessed factors affecting pediatric identification, assessment, and treatment of PTSD symptoms. The survey along with a {dollar}5 incentive was mailed to all primary care pediatricians in Massachusetts. Two reminders were sent to pediatricians who had not responded. A 43% (N=513) response rate was obtained.; Results. Pediatricians who felt more comfortable in exploring trauma were more likely to identify, assess, and treat posttraumatic stress symptoms. Five other factors directly increased pediatric identification, assessment, and treatment of childhood PTSD, namely: (1) perception of having adequate knowledge about PTSD, (2) perception that pediatricians should identify, assess, and treat PTSD, (3) perception of having adequate skills to discuss trauma, (4) lack of time pressure, and (5) perception that PTSD is prevalent. Furthermore, each of these five factors indirectly increased identification, assessment, and treatment of trauma by increasing, in part, pediatricians' comfort in exploring trauma. Finally, having received PTSD-specific training significantly increased pediatricians' comfort and their management of childhood PTSD.; Conclusions. Pediatricians who are comfortable in exploring trauma are more likely to identify, assess, and treat PTSD symptoms. Our findings suggest that increasing pediatric comfort and knowledge regarding PTSD will decrease the burden of PTSD on children, families, and the health care system. |
