98 JSPN Vol. 13, No. 2, April 2008 First received June 18, 2007; Revision received August 29, 2007; Accepted for publication October 22, 2007. Blackwell Publishing Inc First received June 18, 2007; Revision received August 29, 2007; Accepted for publication October 22, 2007. A Meta-Analysis of Risk Factors That Predict Psychopathology Following Accidental Trauma Catherine M. Cox, Justin A. Kenardy, and Joan K. Hendrikz PURPOSE. This meta-analysis aimed to explore the risk factors that place a child at risk of psychopathology following accidental trauma. DESIGN AND METHODS. The predictive power of 8 factors was examined via transforming and combining the effect sizes to yield a weighted average effect size for each factor. RESULTS. The results indicated that the majority of effect sizes, although significant, were inconsistent across the studies, yielding little conclusive evidence. However, pretrauma psychopathology and threat to life were strong and consistent predictors. PRACTICE IMPLICATIONS. Information gathered from such meta-analyses could be used in the identification of at-risk children and the development of screening tools. However, further widespread and comprehensive reviews of the potential risk factors and their relationships to psychopathology need to be investigated. Search terms: Meta-analysis, posttraumatic stress, psychological impact, risk factors, traumatic injury Catherine Cox, BSocSc, BArts (Hons), is a Doctoral Fellow, School of Psychology, University of Queensland; Justin A. Kenardy, PhD, FAPS, is a Professor, Schools of Medicine and Psychology, University of Queensland; and Joan K. Hendrikz, PGCert, is a Biostatistician, Centre of National Research on Disability and Rehabilitation Medicine, University of Queensland, Brisbane, Queensland, Australia. Many children will be exposed to a range of different traumas throughout their lives, but what is particularly common is unintentional or accidental physical injury. Results of the Australian National Health Survey indicated that injuries disproportionately affected young people within the population (Australian Bureau of Statistics, 2001) and that accidental injuries were the third and fifth leading causes of disease burden for young adults and for children, respectively (Mathers, Vos, & Stevenson, 1999). Accidental pediatric injuries can encompass a broad range of events, including sporting accidents, bicycle falls, and motor vehicle accidents. These accidents can result in a range of postinjury sequelae; however, the psychological impact of the injury on children after experiencing an accidental traumatic event is often underestimated. Throughout the literature, adverse outcomes of posttraumatic stress disorder (PTSD) and posttraumatic stress symptoms (PTSS) have been reported for children who have experienced accidental trauma (Bryant, Mayou, Wiggs, Ehlers, & Stores, 2004). These outcomes can include recurrent and intrusive thoughts or dreams of the event, intense physical and psychological distress if exposed to trauma cues, a persistent avoidance of trauma-related stimuli (e.g., thoughts, activities, or conversations), and increased arousal that can result in irritability and difficulties sleeping or concentrating (American Psychiatric Association, 2000). While acute distress is common in the weeks after a traumatic experience, evidence suggests that many of these symptoms are transient and the majority of children will naturally adapt and move on (Bryant, 2004).