Parental Responses to Child Trauma: the Role of Trauma Specific Behaviours and Parenting Style in Facilitating Child Psychological Adjustment

A significant proportion of children in the UK are exposed to potentially traumatic experiences (e.g., accidents, assaults) which are associated with the development of psychological difficulties. In particular, children are vulnerable to developing post-traumatic stress symptoms following trauma, including vivid and intrusive memories of the event, avoidance of reminders of the trauma, and broader problems with anxiety and mood. Such problems affect a significant proportion of UK children. For example, approximately 80,000 children are involved in motor vehicle accidents in the UK annually, and research suggests that approximately one third of these children will develop post-traumatic stress disorder (PTSD) as a consequence. The proposed research will help us to understand what factors influence child psychological adjustment following trauma, and particularly why some children and not others develop the symptoms of PTSD.

To date, research has focused on understanding individual characteristics that might contribute to child difficulties following trauma. Some important factors have been identified, including a particularly negative interpretation of the trauma (e.g., as a sign that the world is extremely dangerous, or the self is highly vulnerable), a disjointed and incomplete memory for the event, and problematic ways of coping (e.g., by suppressing thoughts of the trauma, or dwelling on it). In addition to these individual factors, the way in which children are supported by their parents is likely to be important, but has not been systematically studied. This omission is significant, as for most children their families are their main source of support following trauma. At present, there isn't sufficient evidence available to inform how parents can best support their child following a traumatic experience.

The proposed research will examine parental factors that influence child psychological adjustment following trauma. Based on the existing literature on relevant child processes, the following behaviours will be investigated: parental engagement in co-recollection of the trauma with the child; the parent's own interpretations of the trauma, and the extent to which they communicate these to the child; and parental support for or discouragement of problematic coping styles in the child. More generally, the degree to which parenting is characterised by a restrictive style that limits child autonomy will be examined, as this has previously been linked problems with anxiety in children.

We will conduct a detailed study of children and their parents, which tracks their psychological adjustment in the months following trauma. Children aged 7-12 years will be recruited through hospital accident and emergency departments, and will complete assessments with their parents immediately following the trauma, and 3- and 6-months later. Detailed assessments of how parents interact with children following trauma will be completed, and child PTSD symptoms will be assessed. In this way, we will identify parental behaviours that contribute to later child adjustment, even once initial child reactions to the trauma are taken into account. In addition to this intensive, observational study we will also conducted a larger study based on parent and child questionnaires, which will provide additional evidence regarding key parental processes, and will also allow specific links between parental and child processes to be identified. Based on the preceding studies, we will develop preliminary guidance for parents on how to support their child following trauma

It is relatively common for children to experience potentially traumatic events, and to develop PTSD symptoms as a consequence. Potentially, parents of traumatised children may play an important role in facilitating child psychological adjustment. Despite this, at present, there is no systematic psychological advice or support given to families following the experience of trauma. This may represent a significant missed opportunity, as providing parents with guidance on how best to help their child post-trauma has the potential to improve child outcomes. At the same time, systematic investigation of the role of parents in influencing child psychological adjustment following trauma has not been conducted, and therefore there isn't an adequate evidence base to support the development of empirically-driven intervention targeting parental factors.

The proposed research comprises a comprehensive examination of parental influences in relation to child psychological adjustment post-trauma. In the event that significant parental influences are identified, preliminary work will be completed in relation to drafting guidance for parents of traumatised children. Consquently, there is clear potential for impact at multiple levels. Academically, the research is likely to be of immediate benefit to other researchers who are working to understand child psychological difficulties post-trauma; and may be of particular importance to those who are working to develop more effective psychological treatments for PTSD in children. In the longer term, the proposed work may have impact for policy makers, hospitals and other agencies who deal with child trauma, and for children and families who themselves experience traumatic events. Specifically, if the output from our research ultimately allows for a more informed approach to supporting traumatised children and their families it may: a) at a policy level, result in the routine provision of information for families affected by child trauma; b) provide guidance for professionals who routinely interact with child trauma populations; c) contribute to the development of psychological interventions for child PTSD that target parental behaviours of importance; and d) through each of these routes, be of value in aiding traumatised children in their psychological recovery.

PTSD, and other psychological reactions to trauma, can be both highly persistent and extremely disabling. Child sufferers may experience broader adjustment problems, including school failure and social problems, in addition to the severe distress associated with their psychological difficulties. As such, our research has the potential for longer term positive impact on wellbeing in children experiencing trauma.