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Impaired Caregiving, Trauma Exposure, and Psychosocial Functioning in a National Sample of Children and Adolescents

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Abstract

Impairments in Caregiving (ICG) secondary to mental illness and substance use have been linked to adverse outcomes in children. Little is known, however, about whether outcomes vary by type of ICG, exposure to co-occurring traumas, or mechanisms of maladaptive outcomes. Clinic-referred youth age 7–18 years (n = 3988) were compared on ICG history, demographics, trauma history, and mental health symptoms. Child trauma exposure was tested as a mediator of ICG and child symptoms. Youth with ICG were at heightened risk for trauma exposure, PTSD, internalizing symptoms, total behavioral problems, and attachment problems, particularly youth with multiple types of ICG. Effect sizes were moderate to large for PTSD, internalizing symptoms, and total behavioral problems. Number of trauma types mediated the relationship between ICG and child symptoms. ICG was related to trauma exposure within and outside the family context. Understanding these links has important implications for interrupting intergenerational trauma and psychopathology.

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Authors and Affiliations

  1. Department of Psychiatry, University of Maryland School of Medicine, 737 W. Lombard St., Baltimore, MD, 21201, USA

    Rebecca L. Vivrette & Laurel J. Kiser

  2. Department of Psychiatry, UCLA/Duke University National Center for Child Traumatic Stress, Duke University School of Medicine, 411 West Chapel Hill Street, Suite 200, Durham, NC, 27701, USA

    Ernestine C. Briggs, Robert C. Lee & Robert S. Pynoos

  3. Cone Health, 1200 N. Elm St., Greensboro, NC, 27401, USA

    Krista T. Kenney

  4. Fuller Theological Seminary, 180 North Oakland Ave., Pasadena, CA, 91101, USA

    Tina R. Houston-Armstrong

  5. Department of Psychiatry and Biobehavioral Sciences, UCLA/Duke University National Center for Child Traumatic Stress, University of California Los Angeles School of Medicine, 11150 W. Olympic Blvd., Suite 650, Los Angeles, CA, 90064, USA

    Robert S. Pynoos

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  1. Rebecca L. Vivrette
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  2. Ernestine C. Briggs
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Correspondence to Rebecca L. Vivrette.

Ethics declarations

This manuscript was developed (in part) under grant numbers 2U79SM054284 and SM061256 from the Center for Mental Health Services (CMHS), Substance Abuse and Mental Health Services Administration (SAMHSA), U.S. Department of Health and Human Services (HHS). The views, policies, and opinions expressed are those of the authors and do not necessarily reflect those of SAMHSA or HHS. We would like to acknowledge the 56 sites within the NCTSN that have contributed data to the Core Data Set as well as the children and families that have contributed to our growing understanding of child traumatic stress.

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent was obtained from all individual participants included in the study.

Conflict of Interest

Rebecca Vivrette declares that she has no conflict of interest. Ernestine Briggs declares that she has no conflict of interest. Robert Lee declares that he has no conflict of interest. Krista Kenney declares that she has no conflict of interest. Tina Houston-Armstrong declares that she has no conflict of interest. Robert Pynoos declares that he has no conflict of interest. Laurel Kiser declares that she has no conflict of interest.

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Vivrette, R.L., Briggs, E.C., Lee, R.C. et al. Impaired Caregiving, Trauma Exposure, and Psychosocial Functioning in a National Sample of Children and Adolescents. Journ Child Adol Trauma 11, 187–196 (2018). https://doi.org/10.1007/s40653-016-0105-0

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