The Role of Family Factors in Child Post-Traumatic Stress Disorder (PTSD)

Student thesis: Doctoral ThesisDoctor of Clinical Psychology


There is a large body of evidence showing that children experience high levels of Post Traumatic Stress Disorder (PTSD) in the aftermath of a trauma. It is often assumed that the child’s response to the trauma is influenced by: i) the parents’ own symptomatology; ii) the family’s avoidance of trauma reminders and discussion; iii) the general parenting style (e.g. the degree of warmth,
criticism and emotional over- involvement); and iv) the general family environment. Given that few attempts have been made to test these hypotheses and research findings have been mixed, determining additional factors affecting children exposed to trauma was important.
Aims and Objectives
The purpose of the present study was to add to the existing literature by looking at family factors and their relation to post-traumatic responding in the child. To address this aim we explored the relationship between the child’s self-reported PTSD and: 1) parental expressed emotion; 2) the degree of cohesion, emotional expressiveness and conflict in the family environment; 3) the parent’s self-reported symptoms of PTSD, depression and anxiety; and 4) family post-trauma
Twenty-two children (aged 7 – 17 years) exposed to trauma, and their main care-giver, were recruited from child and adolescent mental health services across South-East London. All parents completed self-report measures of PTSD, anxiety and depression, as well as scales rating their child’s anxiety and depression. Parental expressed emotion was rated using a five-minute,
audio-taped interview where the parent was asked to talk about their child and their relationship. The parents completed the Family Environment Scale (FES) which measures family cohesion, emotional expressiveness, and conflict. The children completed self-report measures of PTSD, anxiety and
depression. Finally, children and parents completed a newly-developed questionnaire that assesses their view of the consequences of talking about the trauma in the family.
Contrary to expectations, parental expressed emotion, parental own symptomatology, and the parent’s ratings of the degree of family cohesion, conflict, emotional expressiveness encouraged in the family (measured by the FES) were unrelated to the child’s self-reported PTSD symptomatology. However, poor family communication was associated with PTSD symptoms in the child. Overall, the factors found to most strongly relate to the child’s PTSD
severity were the strength of their own negative trauma-related beliefs and comorbid anxiety and
Little support was found for the widely held view that parental expressed emotion and parenting/family style directly influence the child post-traumatic responding. The best predictor of the child’s response was their own trauma-related beliefs. On the other hand, family post-trauma communication directly influenced the child’s post-traumatic symptoms levels. Future studies should aim to confirm the findings from the present study and attempt to examine family post-trauma
coomunication using multi-method and multi-informant measures in longitudinal and experimental designs.
Date of Award1 Oct 2012
Original languageEnglish
Awarding Institution
  • King's College London
SupervisorPatrick Smith (Supervisor) & Sean Perrin (Supervisor)

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