Children who witness mother-assault: An expanded posttraumatic stress disorder conceptualization

The impact on children who witness mother-assault was conceptualized as an expanded posttraumatic stress disorder (PTSD) and an exploratory research study testing this formulation was carried out. The current conceptualization was based in part on the work of V. Wolfe and associates who utilized a model whereby a number of mediating factors were thought to determine adjustment to traumatic. An important part of their model was the utilization of the Type I and II trauma typologies of Terr (1990, 1991). These typologies were used to measure the PTSD symptoms of children in response to the severity and course of mother-assault. In this study, a Type I sequelae consisted of the PTSD responses of reexperiencing, hyperarousal, and avoidance, and was related to the severity of mother-assault and child witnessing. The Type II sequelae consisted of the PTSD symptoms in addition to the coping responses of denial, rage, dissociation, sadness, and negative attributions. The Type II typology was related to the course of mother-assault which included the frequency of assaults and the duration of witnessing. Mediators included social support family disadvantage, and family functioning. Finally, this study tested the construct validity of two new instruments related to the child witness. The major questions posed for this exploratory research study were: a) would children who witness mother-assault exhibit Type I symptoms in response to the severity of mother-assault, b) would such children exhibit Type II symptoms in response to the course of mother-assault, and last, c) would the History Of Violence Witnessed By Child Questionnaire (HVWCQ) and the Children’s Impact of Traumatic Events Scale-Family Violence Form (CITES-FVF) be valid instruments. Eighty-four children and their mothers volunteered to be participants. Initial findings yielded a curvilinear relationship between the Type I and II responses and the severity and course of the mother-assault. Consequently, children were divided into a three group design whereby children in groups one and two reported gradual increases in symptoms. However, in the midst of the most severe mother-assault, the third group of children reported a decrease in all behaviours measuring the Type I and II PTSD typologies. A series of two factor group X age multivariate analyses of variance (MANOVA) were carried out. Mediating variables were not significant and were not added to the MANOVA models. There was no support for the research question that children would exhibit PTSD symptoms (Type I trauma) in response to the severity of mother-assault. Despite these findings, 56% (n=47) of the child population met the diagnostic criteria for PTSD. Also, there was no support for the research question that children would exhibit PTSD symptoms and maladaptive coping behaviours (Type II trauma) in response to the course of mother-assault. However, the PTSD responses of hyperarousal, avoidance, and assault anxiety were significant for age. As well, the only significant Type II coping responses were negative childhood attributions. Again, age not group was significant. Also, gender did not have an overall multivariate effect on Type I and Type II responses. Finally, two series of principal components factor analyses were conducted on the CITES-FVF and the HVWCQ. The first series of analyses did not support the research question that the CITES-FVF would be a valid measure. There were, however, similarities in the underlying structures of both instruments. The second series of factor analyses supported the question that the HVWCQ would be a valid instrument. At the same time reservations were raised given one of the factors had only a single variable. This exploratory study suggested a number of implications with respect to theory, clinical practice, and policy development. Primarily, it was argued that the current expanded PTSD conceptualization has some merit with respect to the child witness to mother-assault, and that furthermore, a broadened PTSD may also have some theoretical potential. In addition, the ramifications for group, individual, and family therapies were considered. Finally, policy developments by way of written protocols for shelter staff were highlighted