Understanding trauma symptoms in children and adolescents exposed to domestic abuse: a research portfolio

Abstract

Introduction: This thesis had two primary aims. The first aim was to systematically review the literature investigating trauma symptoms in children and adolescents aged five to eighteen years who had been exposed to domestic abuse. The second aim was to complete an empirical study investigating predictors of trauma symptoms and the relational nature of trauma in women and children aged five to eighteen years who had been exposed to domestic abuse. Method: For the first aim, a systematic literature search identified eligible studies that met predefined inclusion criteria. Following data extraction, the studies were rated against methodological quality criteria. For the second aim, using a quantitative, cross-sectional design, 84 women self-reported on experiences of domestic abuse, symptoms of depression, anxiety, stress and trauma and their child’s trauma symptoms. Analyses investigated the relationship between exposure to domestic abuse and trauma symptoms, predictors of trauma symptoms and whether maternal trauma symptoms moderated the relationship between exposure to domestic abuse and child trauma symptoms. Results: The systematic review identified 14 studies that were eligible for inclusion. Two studies were rated as high quality, ten as acceptable quality and two as low quality. A consistent relationship between exposure to DA and trauma symptoms in children and adolescents was reported, regardless of study quality. The empirical study found a significant relationship between exposure to physical and psychological abuse and trauma symptoms in children aged five to eighteen years. Maternal trauma symptoms were both significantly correlated with and a significant predictor of child trauma symptoms supporting the relational nature of trauma in this population. The interaction was not significant, indicating that maternal trauma symptoms was not a moderator, and the relationship between domestic abuse and child trauma symptoms was present at low, medium and high levels of maternal trauma symptom severity. Conclusion: Across included studies the systematic review found a consistent but variable prevalence of PTSD and trauma symptoms in children and adolescents exposed to domestic abuse, highlighting the importance of assessment and evidence based intervention in this population. Results should be interpreted whilst taking into account the strengths and limitations of individual studies and the overall review. The majority of children in the research study were experiencing trauma symptom severity within the range of clinical concern. The relational nature of trauma was supported in mothers and children exposed to domestic abuse highlighting that treatment should be family based and delivered concurrently to mothers and their children. Results are discussed and should be interpreted whilst considering the limitations discussed.