Posttraumatic Symptoms in 3-7 Year Old Trauma-Exposed Children: Links to Impairment, Other Mental Health Symptoms, Caregiver PTSD, and Caregiver Stress

Abstract

Few studies have examined how PTSD symptoms in young children are associated with other mental health symptoms and mood and functioning in caregivers. This is an important gap in the literature as such knowledge may be important for assessment and treatment. This study used network analysis to identify how the major symptom domains of PTSD in young trauma-exposed children were related to impairment, internalizing and externalizing symptoms, caregiver PTSD, and caregiver stress. Caregivers of 75 trauma-exposed 3-7 year old children reported on their child's symptoms and impairment and their own PTSD symptoms and caregiver stress. A strong association between the child PTSD domains of intrusions and avoidance emerged, which is in line with theoretical notions of how PTSD onsets and is maintained in adolescents and adults. Externalizing child symptoms were strongly linked to PTSD-related impairment and caregiver stress, highlighting the need to carefully assess and address such symptoms when working with young trauma-exposed children. Internalizing symptoms were uniquely associated with all three of the major childhood PTSD symptom domains with further implications for assessment and treatment.

Keywords: Caregiver; Children; Network analysis; PTSD; Parent; Stress.

Fig. 1

Zero-order polychoric correlations among study variables. Correlations marked with a circle are statistically significant at a p < .01 level

Fig. 2

The network structure of the study variables and the partial correlation matrix. Each variable is depicted as a node (a circle). Lines (edges) between nodes are unique associations (partial rs). Blue edges depict a positive association. Red edges depict a negative association. Wider and more saturated edges depict a stronger association. The coloring of nodes is based on pre-defined groups of nodes (Color figure online)

Fig. 3

Statistically significant differences between edge weights. Black boxes indicate that there is a statistically significant different between the strength of two edges. Edges are listed according to their strength with the strongest each at the top of the y-axis

Fig. 4

Networks estimated using caregiver-reported (top) and clinician-rated (bottom) child PTSD domains. Each variable is depicted as a node (a circle). Lines (edges) between nodes are unique associations (partial rs). Blue edges depict a positive association. Red edges depict a negative association. Wider and more saturated edges depict a stronger association. The coloring of nodes is based on pre-defined groups of nodes (Color figure online)