Parent-child interaction and childhood post-traumatic stress: A prospective study

There is to date no comprehensive theoretical account of how PTSD develops in children. Theories of adult PTSD (e.g. Brewin, Dalgleish & Joseph, 1996, Ehlers & Clarke, 2000) exist yet their applicability to childhood PTSD is somewhat limited, as they fail to account for the developmental level of the child and the child’s context (dependency on their parent/s). Previous research in the field has demonstrated the influential role of family risk factors. Further, parent-child interaction has been found to be influential in many other childhood mental health problems, though has not been studied in children who have experienced a trauma. The present study aims to investigate the influence of parent-child interaction on the development of PTSD using observational methods. The current sample of children presenting to A&E following a traumatic event was observed completing two interaction tasks with their primary caregiver within four weeks of the event. The tasks consisted of a difficult anagram task and a discussion task about the trauma. Both interactions were analysed and coded for warmth/criticism and over-involvement. The discussion task was also analysed for parental avoidance, help in re-appraising the child’s sense of threat, and parental management of fear. The parents and children were re-assessed at a 3-month follow up. Parental avoidance, poor management of fear and little help with re­ appraising threat were strongly associated with child PTSD symptoms at Time 1. Warm/critical and over-involved parenting behaviours were not significantly associated with child PTSD symptoms. None of the parenting behaviours significantly affected the rate of change of the child’s symptoms, yet there was a trend between parental involvement in the discussion task and change in child PTSD symptoms over time.