Involvement in litigation in children with PTSD following motor vehicle accident: Associations with emotional distress and treatment outcomes

Maayan Shorer, Silvana Fennig, Alan Apter, Tammy Pilowsky Peleg

Research output: Contribution to journalArticlepeer-review


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.

Original languageEnglish
Article number101711
JournalInternational Journal of Law and Psychiatry
StatePublished - 1 Jul 2021
Externally publishedYes

Bibliographical note

Publisher Copyright:
© 2021 Elsevier Ltd


  • Children
  • Intervention efficacy
  • Litigation
  • Mild traumatic brain injury
  • Post-traumatic stress disorder


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