Parenting and child trauma- a mixed methods investigation

Abstract

Trauma exposure in children and young people (CYP) has been linked to a range of adverse outcomes, including the development of post-traumatic stress disorder (PTSD). Parenting may influence such outcomes in two relevant ways. Firstly, parenting throughout development, especially early parental behaviours, may centrally contribute to the formation of CYP’s abilities to deal with stressful experiences in later life. Secondly, parents pose a main source of social support after trauma exposure and may therefore further influence CYP’s coping. However, the role of pre-trauma parenting is currently understudied. More knowledge is also required on mechanisms relaying effects of post-trauma parenting on CYP outcomes, as well as how it interacts with other forms of social support. This thesis aimed to address such shortcomings using a variety of methods. Chapter 1 describes trauma-related data available for the ALSPAC sample, a large UK longitudinal cohort, in preparation for subsequent analyses in Chapter 2. It was found that sex differences in PTSS emerge between ages 10 and 13, but that this is not moderated by the onset of puberty. Chapter 2, using the same dataset, found limited evidence that early parental warmth, stimulation and conflict predict CYP post-traumatic stress symptoms (PTSS), though at different patterns for 8 and 15 years. Furthermore, there was no strong support for moderation effects of this association by early language and regulatory skills. Chapter 3 investigates similar associations in a South African high-risk sample, finding early parental intrusiveness and sensitivity observed during play predicted CYP PTSS at 13 years. No predictive effects were present however for parent-child attachment at 18 months or concurrent parenting and there was no evidence in favour of a vulnerability stress hypothesis. Together, both Chapters 2 and 3 support early parenting as a potential influential factor, but highlight a need for further studies applying higher quality measures of trauma exposure and potential mediators to elucidate risk and resilience pathways. Chapters 4 and 5 focused on post-trauma parenting, with Chapter 4 finding heart-rate measures taken during a narrative 1 month after trauma may pose a risk marker for concurrent, 3 and 6 months CYP PTSS. However, this association was not mediated by parental support behaviours. Chapter 5, using qualitative interviews to investigate CYP’s support systems, found that they received practical and warm support from a variety of sources, but that parents and peers were the main providers of emotional support and that CYP’s support needs changed over time. These chapters highlight a need to better understand mechanisms underlying the effects of post-trauma parenting and to embed its effects in those of the wider child support network. Further research will be required conceptualising pre- and post-trauma parenting and resilience as a continuum and establishing risk and resilience pathways for both PTSS and a broader range of outcomes after trauma.

Date of Award	14 Oct 2020
Original language	English
Awarding Institution	University of Bath
Supervisor	Sarah Halligan (Supervisor) & Rachel Hiller (Supervisor)