A systematic literature review of the relationship between parenting responses and child post-traumatic stress symptoms

<b>Background:</b> Parents are a key source of support for children exposed to single-incident/acute traumas and can thereby play a potentially significant role in children’s post-trauma psychological adjustment. However, the evidence base examining parental responses to child trauma and child posttraumatic stress symptoms (PTSS) has yielded mixed findings. <b>Objective:</b> We conducted a systematic review examining domains of parental responding in relation to child PTSS outcomes. <b>Method:</b> Studies were included if they (1) assessed children (6-19 years) exposed to a potentially traumatic event, (2) assessed parental responses to a child’s trauma, and (3) quantitatively assessed the relationship between parental responses and child PTSS outcomes. A systematic search of three databases (APAPsycNet, PTSDpubs, and Web of Science) yielded 27 manuscripts. <b>Results:</b> Parental overprotection, trauma communication, avoidance of trauma discussion and of trauma reminders, and distraction were consistently related to child PTSS. There was more limited evidence of a role for trauma-related appraisals, harsh parenting, and positive parenting in influencing child outcomes. Significant limitations to the evidence base were identified, including limited longitudinal evidence, single informant bias and small effect sizes. <b>Conclusion:</b> We conclude that key domains of parental responses could be potential intervention targets, but further research must validate the relationship between these parental responses and child PTSS outcomes. Child post-traumatic stress symptoms following acute trauma are consistently related to post-trauma parental overprotection, avoidance of trauma discussion and of trauma reminders, and promotion of distraction from trauma-related thoughts and stimuli.The findings from this review provide a potential rationale for targeting these parental domains in clinical interventions addressing children’s post-traumatic stress symptoms.Future research is needed to validate the longitudinal relationship between parental response domains following children’s traumatic exposure and child post-traumatic stress symptoms. Child post-traumatic stress symptoms following acute trauma are consistently related to post-trauma parental overprotection, avoidance of trauma discussion and of trauma reminders, and promotion of distraction from trauma-related thoughts and stimuli. The findings from this review provide a potential rationale for targeting these parental domains in clinical interventions addressing children’s post-traumatic stress symptoms. Future research is needed to validate the longitudinal relationship between parental response domains following children’s traumatic exposure and child post-traumatic stress symptoms.