Objectives

Litigation is common in the context of Post-traumatic Stress Disorder (PTSD) and mild Traumatic Brain Injury (mTBI), adding contradicting motivations to individuals' engagement in psychotherapeutic interventions. This study's main goal was to explore the relationship between litigation status and emotional distress among children with PTSD following motor vehicle accidents (MVAs). We also present preliminary findings from a pilot study on treatment efficacy for children with PTSD, with and without litigation.

Methods

Participants included 76 children with PTSD following MVA and their main caregiving parent. The associations between litigation status (litigation involvement, litigation phase, and litigation's emotional impact) and children's global distress, PTSD, persistent post-concussion symptoms (PPCS), and sub-optimal effort, and parents' PTSD symptoms were assessed before and after intervention for PTSD. Comorbid mTBI was explored as a possible moderating factor.

Results

Involvement in litigation was not related to children's and parents' pre-intervention distress, nor to the presence of mTBI or to children's effort. However, higher emotional impact of litigation on parents was associated with children's higher PPCS pre-intervention. A pilot study on intervention outcomes found an improvement both in children with and without litigation involvement. A greater decrease in PPCS following intervention was found in children of parents with higher emotional impact of litigation.

Conclusions

The emotional impact of litigation on parents should be considered while addressing children in litigation context. However, this study's preliminary findings suggest that children with litigation involvement may benefit from treatment, thus litigation should not serve solely as an exclusion criterion for psychological intervention. A larger study should further explore this issue.

中文翻译：

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参与车祸后 PTSD 儿童的诉讼：与情绪困扰和治疗结果的关联

目标

在创伤后应激障碍 (PTSD) 和轻度创伤性脑损伤 (mTBI) 的背景下，诉讼很常见，这为个人参与心理治疗干预增加了相互矛盾的动机。本研究的主要目的是探讨机动车事故 (MVA) 后患有 PTSD 的儿童的诉讼状态与情绪困扰之间的关系。我们还介绍了一项关于 PTSD 儿童治疗效果的试点研究的初步结果，无论是否有诉讼。

方法

参与者包括 76 名患有 MVA 后 PTSD 的儿童及其主要照料父母。在干预前后评估诉讼状态（诉讼参与、诉讼阶段和诉讼的情绪影响）与儿童的整体痛苦、创伤后应激障碍、持续性脑震荡后症状（PPCS）和次优努力以及父母的创伤后应激障碍症状之间的关联对于创伤后应激障碍。共病 mTBI 被视为可能的调节因素。

结果

参与诉讼与儿童和父母的干预前痛苦无关，也与 mTBI 的存在或儿童的努力无关。然而，诉讼对父母的较高情绪影响与儿童较高的 PPCS 预干预有关。一项关于干预结果的试点研究发现，有和没有诉讼参与的儿童都有所改善。在诉讼情绪影响较大的父母的孩子中，发现干预后 PPCS 的下降幅度更大。

结论

在诉讼背景下处理儿童问题时，应考虑诉讼对父母的情感影响。然而，这项研究的初步结果表明，参与诉讼的儿童可能会从治疗中受益，因此诉讼不应仅作为心理干预的排除标准。更大规模的研究应该进一步探讨这个问题。