Abstract
Although concurrent associations between parent and child posttraumatic stress symptoms (PTSS) have been well-documented, few longitudinal studies have examined bidirectional influences by modeling the effects of both parent and child PTSS simultaneously over time. The current study examines patterns of PTSS in children and their mothers beginning in preschool and continuing through elementary school age (ages 4–9 years) in a large, heterogeneous sample (N = 331 mother-child dyads). Mothers reported on their own and their child’s posttraumatic stress symptoms. A random intercept cross-lagged panel model (RI-CLPM) was used to examine associations between symptoms across six time points. Results indicated that maternal and child symptoms were associated with each other at concurrent time points and tended to fluctuate in a synchronized manner relative to their overall mean symptom levels. Longitudinal cross-lagged paths were significant from mother to child, but non-significant from child to mother, suggesting that mothers’ symptom fluctuation at one time point predicted significant fluctuation in children’s symptoms at the subsequent time point. The concurrent co-variation of maternal and child symptoms and the predictive nature of maternal symptom flare-ups have important implications for both maternal and child mental health interventions and underscore the importance of attending to mothers’ symptomatology early in treatment.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Augusti, E. M., Baugerud, G. A., Sulutvedt, U., & Melinder, A. (2018). Maltreatment and trauma symptoms: Does type of maltreatment matter? Psychological Trauma: Theory Research Practice and Policy, 10(4), 396–401. https://doi.org/10.1037/tra0000315
Berry, D., & Willoughby, M. T. (2017). On the Practical Interpretability of Cross-Lagged Panel Models: Rethinking a Developmental Workhorse. Child Development, 88(4), 1186–1206. https://doi.org/10.1111/cdev.12660
Bornstein, M. H. (2016). Determinants of Parenting. In D. Ciccheti (Ed.), Developmental psychopathology: Risk, resilience, and intervention (pp. 180–270). John Wiley & Sons Inc. https://doi.org/10.1002/9781119125556.devpsy405
Briere, J., Johnson, K., Bissada, A., Damon, L., Crouch, J., Gil, E. … Ernst, V. (2001). The Trauma Symptom Checklist for Young Children (TSCYC): Reliability and association with abuse exposure in a multi-site study. Child Abuse and Neglect, 25(8), 1001–1014. https://doi.org/10.1016/S0145-2134(01)00253-8
Briggs-Gowan, M. J., Carter, A. S., Clark, R., Augustyn, M., McCarthy, K. J., & Ford, J. D. (2010). Exposure to potentially traumatic events in early childhood: differential links to emergent psychopathology. Journal of Child Psychology and Psychiatry, 51(10), 1132–1140. https://doi.org/10.1111/j.1469-7610.2010.02256.x
Briggs-Gowan, M. J., Carter, A. S., & Ford, J. D. (2012). Parsing the effects of violence exposure in early childhood: Modeling developmental pathways. Journal of Pediatric Psychology, 37(1), 11–22. https://doi.org/10.1093/jpepsy/jsr063
Briggs-Gowan, M. J., Godoy, L., Heberle, A., & Carter, A. S. (2016). Assessment of Psychopathology in Young Children. In D. Ciccheti (Ed.), Developmental Psychopathology: Theory and Method (3rd ed., 1 vol., pp. 1–93). Wiley
Bryant, R. A., O’Donnell, M. L., Creamer, M., McFarlane, A. C., & Silove, D. (2013). A multisite analysis of the fluctuating course of posttraumatic stress disorder. JAMA Psychiatry, 70(8), 839–846. https://doi.org/10.1001/jamapsychiatry.2013.1137
Eisenberg, N., Cumberland, A., & Spinrad, T. L. (1998). Parental Socialization of Emotion. Psychological Inquiry, 9(4), 241–273. https://doi.org/10.1207/s15327965pli0904_1
Goodman, S. H., Rouse, M. H., Connell, A. M., Broth, M. R., Hall, C. M., & Heyward, D. (2011). Maternal depression and child psychopathology: A meta-analytic review [Meta-Analysis]. Clinical Child and Family Psychology Review, 14(1), 1–27. https://doi.org/10.1007/s10567-010-0080-1
Grasso, D. J., Henry, D., Kestler, J., Nieto, R., Wakschlag, L. S., & Briggs-Gowan, M. J. (2016). Harsh parenting as a potential mediator of the association between intimate partner violence and child disruptive behavior in families with young children. Journal of Interpersonal Violence, 31(11), 2102–2126. https://doi.org/10.1177/0886260515572472
Greene, C. A., Haisley, L., Wallace, C., & Ford, J. D. (2020). Intergenerational effects of childhood maltreatment: A systematic review of the parenting practices of adult survivors of childhood abuse, neglect, and violence. Clinical Psychology Review, 80, 101891. https://doi.org/10.1016/j.cpr.2020.101891
Greene, C. A., McCarthy, K. J., Estabrook, R., Wakschlag, L. S., & Briggs-Gowan, M. J. (2020). Responsive Parenting Buffers the Impact of Maternal PTSD on Young Children [research-article]. Parenting: Science and Practice, 20(2), 141–165. https://doi.org/18-223
Hamaker, E. L., Kuiper, R. M., & Grasman, R. P. P. P. (2015). A critique of the cross-lagged panel model. Psychological Methods, 20(1), 102–116. https://doi.org/10.1037/a0038889
Hatfield, E., Rapson, R. L., & Le, Y. C. L. (2009). Emotional contagion and empathy. In J. Decety, & W. Ickes (Eds.), The Social Neuroscience of Empathy (pp. 19–30). The MIT Press
Juth, V., Silver, R. C., Seyle, D. C., Widyatmoko, C. S., & Tan, E. T. (2015). Post-Disaster Mental Health Among Parent-Child Dyads After a Major Earthquake in Indonesia. Journal Of Abnormal Child Psychology, 43(7), 1309–1318. https://doi.org/10.1007/s10802-015-0009-8
Keen, S. M., Kutter, C. J., Niles, B. L., & Krinsley, K. E. (2008). Psychometric properties of PTSD Checklist in sample of male veterans. Journal of Rehabilitation Research & Development, 45(3), 465–474
Koplewicz, H. S., Vogel, J. M., Solanto, M. V., Morrissey, R. F., Alonso, C. M., Abikoff, H. … Novick, R. M. (2002). Child and parent response to the 1993 World Trade Center bombing. Journal of Traumatic Stress, 15(1), 77–85. https://doi.org/10.1023/A:1014339513128
Kouros, C. D., & Garber, J. (2010). Dynamic Associations between Maternal Depressive Symptoms and Adolescents’ Depressive and Externalizing Symptoms. Journal of Abnormal Child Psychology, 38(8), 1069–1081. https://doi.org/10.1007/s10802-010-9433-y
Lambert, J. E., Holzer, J., & Hasbun, A. (2014). Association between parents’ PTSD severity and children’s psychological distress: A meta-analysis [Meta-Analysis]. Journal of Traumatic Stress, 27(1), 1–9. https://doi.org/10.1002/jts.21891
Landolt, M. A., Ystrom, E., Sennhauser, F. H., Gnehm, H. E., & Vollrath, M. E. (2012). The mutual prospective influence of child and parental post-traumatic stress symptoms in pediatric patients. Journal of Child Psychology and Psychiatry, 53(7), 767–774. https://doi.org/10.1111/j.1469-7610.2011.02520.x
Lang, A. J., Wilkins, K., Roy-Byrne, P. P., Golinelli, D., Chavira, D., Sherbourne, C. … Stein, M. B. (2012). Abbreviated PTSD Checklist (PCL) as a guide to clinical response. General Hospital Psychiatry, 34(4), 332–338. https://doi.org/10.1016/j.genhosppsych.2012.02.003
Leen-Feldner, E. W., Feldner, M. T., Knapp, A., Bunaciu, L., Blumenthal, M., & Amstadter, A. B. (2013). Offspring psychological and biological correlates of parental posttraumatic stress: Review of the literature and research agenda [Review]. Clinical Psychology Review, 33(8), 1106–1133. https://doi.org/10.1016/j.cpr.2013.09.001
Milot, T., Éthier, L. S., St-Laurent, D., & Provost, M. A. (2010). The role of trauma symptoms in the development of behavioral problems in maltreated preschoolers. Child Abuse & Neglect, 34(4), 225–234. https://doi.org/10.1016/j.chiabu.2009.07.006
Morris, A. S., Gabert-Quillen, C., & Delahanty, D. (2012). The association between parent PTSD/Depression symptoms and child PTSD symptoms: A meta-analysis. Journal of Pediatric Psychology, 37, 1076–1088
Mulder, J. D., & Hamaker, E. L. (2020). Three Extensions of the Random Intercept Cross-Lagged Panel Model. Structural Equation Modeling, 00(00), 1–11. https://doi.org/10.1080/10705511.2020.1784738
Mund, M., & Nestler, S. (2019). Beyond the Cross-Lagged Panel Model: Next-generation statistical tools for analyzing interdependencies across the life course. Advances in Life Course Research, 41(November 2017), 100249–100249. https://doi.org/10.1016/j.alcr.2018.10.002
Muthén, L. K., & Muthén, B. O. (2017). Mplus user’s guide (version 8.0). Muthén & Muthén
Nichols, S. R., Briggs-Gowan, M. J., Estabrook, R., Burns, J. L., Kestler, J., Berman, G., Henry, D. B., Wakschlag, L. S. (2015). Punishment Insensitivity in Early Childhood: A Developmental Dimensional Approach. Journal of Abnormal Child Psychology, 43(6), 1011–1023. https://doi.org/10.1007/s10802-014-9950-1
Nugent, N. R., Ostrowski, S., Christopher, N. C., & Delahanty, D. L. (2006). Parental Posttraumatic Stress Symptoms as a Moderator of Child’s Acute Biological Response and Subsequent Posttraumatic Stress Symptoms in Pediatric Injury Patients. Journal of Pediatric Psychology, 32(3), 309–318. https://doi.org/10.1093/jpepsy/jsl005
Oh, Y., Greenberg, M. T., Willoughby, M. T., Vernon-Feagans, L., Blair, C. B., Burchinal, M. R. … Mills-Koonce, W. R. (2020). Examining Longitudinal Associations between Externalizing and Internalizing Behavior Problems at Within- and Between-Child Levels. Journal of Abnormal Child Psychology, 48(4), 467–480. https://doi.org/10.1007/s10802-019-00614-6
Olino, T. M., Michelini, G., Mennies, R. J., Kotov, R., & Klein, D. N. (2021). Does maternal psychopathology bias reports of offspring symptoms? A study using moderated non-linear factor analysis. Journal of Child Psychology and Psychiatry, 62(10), 1195–1201. https://doi.org/10.1111/jcpp.13394
Ordway, M. R. (2011). Depressed mothers as informants on child behavior: methodological issues. Research in nursing & health, 34(6), 520–532. https://doi.org/10.1002/nur.20463
Ostrowski, S. A., Christopher, N. C., & Delahanty, D. L. (2006). Brief Report: The Impact of Maternal Posttraumatic Stress Disorder Symptoms and Child Gender on Risk for Persistent Posttraumatic Stress Disorder Symptoms in Child Trauma Victims. Journal of Pediatric Psychology, 32(3), 338–342. https://doi.org/10.1093/jpepsy/jsl003
Richters, J. E. (1992). Depressed mothers as informants about their children: a critical review of the evidence for distortion. Psychological Bulletin, 112(3), 485–499. https://doi.org/10.1037/0033-2909.112.3.485
Satorra, A., & Bentler, P. M. (2010). Ensuring positiveness of the scaled difference chi-square test statistic. Psychometrika, 75(2), 243–248
Scheeringa, M. S., & Zeanah, C. H. (2001). A Relational Perspective on PTSD in Early Childhood. Journal of Traumatic Stress, 14(4), 799–815. https://doi.org/10.1023/A:1013002507972
Shi, X., Zhou, Y., Geng, F., Li, Y., Zhou, J., Lei, B. … Fan, F. (2018). Posttraumatic stress disorder symptoms in parents and adolescents after the Wenchuan earthquake: A longitudinal actor-partner interdependence model. Journal Of Affective Disorders, 226, 301–306. https://doi.org/10.1016/j.jad.2017.10.011
Shih, E. W., Quiñones-Camacho, L. E., & Davis, E. L. (2018). Parent emotion regulation socializes children’s adaptive physiological regulation. Developmental Psychobiology, 60(5), 615–623. https://doi.org/10.1002/dev.21621
Singer, J. D., & Willet, J. B. (2003). Applied Longitudinal Data Analysis: Modeling Change and Event Occurrence. Oxford University Press
Tierolf, B., Schuengel, C., & Lamers-Winkelman, F. (2018). Validation and Standardization of the Dutch Trauma Symptom Checklist for Young Children in a Normative and Clinical Sample. Journal of Aggression Maltreatment & Trauma, 27(1), 1–14. https://doi.org/10.1080/10926771.2017.1303012
van Ee, E., Kleber, R., & Jongmans, M. J. (2016). Relational patterns between caregivers with PTSD and their nonexposed children: A review. Trauma Violence & Abuse, 17(2), 186–203. https://doi.org/10.1177/1524838015584355
Weathers, F., Litz, B. T., Herman, D. S., Huska, J. A., & Keane, T. M. (1993, October). The PTSD checklist: reliability, validity, & diagnostic utility. Annual Meeting of the International Society for Traumatic Stress Studies, San Antonio, TX
Wherry, J. N., & Dunlop, C. E. (2018). TSCC and TSCYC Screening Forms in a Clinical Sample: Reliability, Validity, and Creating Local Clinical Norms. Child Maltreatment, 23(1), 74–84. https://doi.org/10.1177/1077559517725207
Wikman, A., Ljungman, L., Pingel, R., Hagedoorn, M., Sanderman, R., von Essen, L., & Cernvall, M. (2017). The interdependence of posttraumatic stress symptoms in parental dyads during and after their child’s treatment for cancer. Acta Oncologica, 56(12), 1698–1704. https://doi.org/10.1080/0284186X.2017.1355562
Wilkins, K. C., Lang, A. J., & Norman, S. B. (2011). Synthesis of the psychometric properties of the PTSD checklist (PCL) military, civilian, and specific versions. Depression And Anxiety, 28(7), 596–606. https://doi.org/10.1002/da.20837
Williamson, V., Creswell, C., Fearon, P., Hiller, R. M., Walker, J., & Halligan, S. L. (2017). The role of parenting behaviors in childhood post-traumatic stress disorder: A meta-analytic review. Clinical Psychology Review, 53, 1–13. https://doi.org/10.1016/j.cpr.2017.01.005
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Ethics approval
All procedures performed in this study were approved by the Northwestern Feinberg School of Medicine and UConn Health Institutional Review Boards and were in accordance with the principles of the 1964 Helsinki Declaration.
Consent to participate
Informed consent was obtained from all individual participants included in the study.
Additional information
Publisher’s note
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Electronic supplementary material
Below is the link to the electronic supplementary material.
Rights and permissions
About this article
Cite this article
Greene, C.A., Goldstein, B.L., McCarthy, K.J. et al. Maternal posttraumatic stress predicts Mother-Child Symptom Flare-Ups over Time. Res Child Adolesc Psychopathol 50, 1619–1628 (2022). https://doi.org/10.1007/s10802-022-00939-9
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s10802-022-00939-9