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 and Joseph, 1996, Ehlers and 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 reappraising 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