Future directions for PTSD and parenting research
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There is lots of research on the impact of post-traumatic stress disorder (PTSD) on parenting and the parent-child relationship, but a few areas still need to be fleshed and further investigated. This article discussed the challenges of doing this research and reccomendations are made for the area of parenting and PTSD research.
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Research on parents with trauma is usually blocked off into specific trauma types, or no identified type at all.
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Researchers differ in the way they define “trauma” in their studies, and this makes it hard to combine findings and derive accurate conclusions about parenting with PTSD.
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Research in the future should use theory to help illuminate the mechanisms between PTSD and parenting.
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Many of these studies do not use a developmental perspective and more attention should be paid to how parents' PTSD impacts children at different ages.
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Research most often uses surveys that parents fill out about their past parenting behaviors, which could be inaccurate. Parents with PTSD may also struggle to recall parenting accurately or think about their parenting in overly negative ways, due to their PTSD.
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Daily cell-phone surveys can catch parenting behaviors more accurately as they occur in the moment.
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There is a lack of diversity in research samples relating to families of different ethnicities, socioeconomic classes, and family structures- so it is unclear how much we can derive conclusions from existing research.
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Researchers have long focused on the negatives of parents with PTSD and ignored the positives, which spreads and enhances negative feelings in the participants, while ignoring the resilience parents with PTSD have.
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Meijer, L., Franz, M. R., Deković, M., van Ee, E., Finkenauer, C., Kleber, R. J., ... & Thomaes, K. (2023). Towards a more comprehensive understanding of PTSD and parenting. Comprehensive Psychiatry, 127, 152423.
A Multi-family intervention can effectively decrease PTSD symptoms of caregivers with multiple traumas
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Impoverished families are more likely to be exposed to trauma and develop posttraumatic stress disorder (PTSD). PTSD is also associated with interpersonal problems including family dysfunction, parental challenges, and difficulties with intimate relationships.
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Strengthening Family Coping Resources (SFCR) is a multi-family group intervention designed to decrease PTSD symptoms and improve healthy coping for impoverished families
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SFCR is specifically designed for those who have experienced complex trauma, which consists of repeated and long-term traumatic events that are interpersonal in nature.
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This study recruited 42 caregivers with on average two children, withmost having yearly household income of $35,000 or less.
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The families participated in weekly group therapy sessions for 10 or 15 weeks (10 weeks fror those families who did not meet partial or full PTSD diagnosis and the 15-week SFCRwas designed specifically for families whose children who did meet partial/full criteria for PTSD).
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PTSD symptoms such as intrusions and avoidance, significantly decreased for caregivers in both the 10 week and 15 week groups.
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These findings show that SFCR could be helpful to economically disadvantaged families with caregivers of varying trauma types
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Franz, M. R., Savella, G. M., Salen, N., Contractor, A. A., & Kiser, L. J. (2022). The Effects of a Multi-Family Group Trauma Intervention on Caregiver Posttraumatic Stress Symptom Clusters. Violence and Victims.
Disengagment behaviors can predict intimate partner violence
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Intimate partner violence (IPV) is a major public health concern, leading to prevention efforts focused on identifying risk indicators of escalating conflict between partners.
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Research supports that relationships where one partner demands or pressures in conversation while the other withdraws or avoids confrontation are at an increased risk of IPV.
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Disengagement behaviors often overlap with other negative interaction patterns such as dyadic coercion or contempt, making it necessary to use multifaceted assessments to accurately measure disengagement.
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Therefore, more research is needed to see how various disengagment behaviors (listening, questions, eye contact) may predict emerging IPV.
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This study collected observational and questionnaire data from 83 heterosexual. The couples were observed in the laboratory for disengagment behaviors and then answered questions related to psychological and physical IPV perpetration and victimization, and romantic disengagement one year later.
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In this study, less question asking and higher eye contact by women were associated with greater psychological IPV and physical IPV perpetrated by women 1 year later. Additionally, less question asking and higher eye contact by women were associated with greater psychological IPV and physical IPV perpetrated by men 1 year later.
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Interventions and practitioners should screen for IPV and IPV risk first before working on communication patterns to determine if safety planning needs to be prioritized.
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Franz, M. R., Smethurst, M., Barry, R. A., Cole, H. E., & Taft, C. T. (2023). Women’s Disengagement Behaviors During Couple Conflict: Investigating Risk Indicators of Intimate Partner Violence. Journal of Interpersonal Violence, 38(15-16), 9239-9263.
Living in a connected and supportive neighborhood can help single Black veterans with PTSD thrive as parents
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Military service is associated with posttraumatic stress disorder (PTSD), and PTSD is often connected to parenting challenges such as feeling less satisfied with being a parent, feeling more stressed about parenting, and having a lower quality relationship with one’s child.
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Single parents and Black veterans may be particularly vulnerable to PTSD and parenting challenges due to having less support, resources, and facing discrimination and systemic inequalities.
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Neighborhood cohesion is important to consider when understanding how veteran parents are coping. Neighborhood cohesion refers to how supportive one’s neighbors are such as how likely they are to help each other.
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This study collected questionnaire data from 563 veterans across the United States. The veterans answered questions about PTSD symptoms, parenting techniques, and how supportive they perceived their neighborhood to be.
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In this study, single Black veteran parents with higher PTSD living in unsupportive neighborhoods described more difficulty functioning as parents. However, those in more cohesive (supportive) neighborhoods had better parental functioning.
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Programs and initiatives to increase neighborhood supportiveness, connection, and resources can help minimize the negative impact of severe PTSD on parenting in single Black veteran households.
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Franz, M. R., Sanders, W., Nillni, Y. I., Vogt, D., Matteo, R., & Galovski, T. (2021). PTSD and parental functioning: The protective role of neighborhood cohesion among Black and White veterans. Psychological trauma: theory, research, practice, and policy.
When children misbehave, mothers with trauma symptoms may experience negative emotions and use permissive parenting techniques
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Parents who have experienced traumatic events and developed symptoms of posttraumatic stress disorder (PTSD) may have more difficulty using effective discipline with their children. Some previous research has shown that parents with PTSD are more likely to use harsh or overly permissive parenting techniques.
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Why would PTSD increase the likelihood that parents will have difficulty with child discipline? One possibility is that they experience increased levels of stress, which interferes with healthy cortisol levels in the body. Another possibility is that when parents with PTSD experience difficult interactions with their child, they may experience greater negative emotions which lead to problematic parenting techniques.
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After experiencing a traumatic event, some parents will meet criteria for a PTSD diagnosis while others experience significant distress but have “partial” PTSD. Even mothers with partial symptoms of PTSD might struggle with child discipline.
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78 mothers and their toddler-aged children participated in the study. 19 mothers were diagnosed with PTSD, 24 had partial PTSD, and the remaining mothers did not have PTSD.
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Mothers were videorecorded interacting with their children during a discipline encounter. Mothers provided saliva samples to test cortisol levels throughout the task. Afterward, mothers rated their emotions while watching a video of this interaction. Harsh and permissive parenting behaviors on the videos were coded by trained study staff.
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Results show that mothers with even partial symptoms of PTSD experienced more negative emotions during the discipline task, which was also associated with more permissive parenting behaviors.
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Mothers with PTSD did not use more harsh parenting techniques and cortisol levels did not impact parenting techniques.
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These findings suggest that mothers with even partial symptoms of PTSD may benefit from support in managing their negative emotions in response to child behavior which may lead to a reduction in permissive parenting techniques.
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Franz, M. R., Kumar, S. A., Brock, R. L., Calvi, J. L., & DiLillo, D. (2021). Parenting behaviors of mothers with posttraumatic stress: The roles of cortisol reactivity and negative emotion. Journal of Family Psychology.
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The negative psychological impacts of warzone deployment can extend beyond warzone veterans to adversely impact their intimate partners too.
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This study sought to understand the relationship between PTSD and depression diagnoses of warzone veterans and the mental health and relationship functioning of these veterans’ intimate partners.
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245 Iraq and Afghanistan warzone veterans and their partners were assessed for PTSD, depression, anxiety, alcohol use, family satisfaction, and relationship aggression.
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Intimate partners of warzone veterans with depression had a higher likelihood of suffering from depression or anxiety.
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Similarly, greater alcohol use among warzone veterans was associated with greater perpetration of intimate partner violence and greater alcohol use in their partners.
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Warzone veterans with PTSD and depression reported poorer family relationship adjustment and family communication, lower family satisfaction, and greater psychological intimate partner violence.
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The study findings suggest that both individual and couples therapy should be used to address the mental health of warzone veterans and their intimate partners.
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Franz, M. R., Kaiser, A. P., Phillips, R. J., Lee, L. O., Lawrence, A. E., Taft, C. T., & Vasterling, J. J. (2020). Associations of warzone veteran mental health with partner mental health and family functioning: Family Foundations Study. Depression and Anxiety, 37(11), 1068-1078.
Your mood can impact how satisfied you feel with your relationship (and vice versa!)
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Dysfunction in romantic relationships may be a driving force in the onset and course of depressive disorders among individual partners.
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Many previous studies that have explored the relationship between individual mood and relationship satisfaction have been in college students or community samples without high levels of distress.
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The current study explored the relationship between depressed mood and relationship satisfaction among 53 low income individuals seeking help at outpatient mental health clinics.
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In the current study, participants completed short surveys every day over two weeks to report how their mood and relationship satisfaction changed daily.
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Results of the current study suggest that mood and relationship satisfaction are related. Specifically, decreases in relationship satisfaction predicted both increases in negative mood and decreases in positive mood. Additionally, increases in negative mood and decreases in positive mood predicted declines in relationship satisfaction.
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Individuals struggling with depression may benefit from therapy that addresses interpersonal problems and relationship dissatisfaction.
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Brock, R. L., Franz, M. R., O'Bleness, J. J., & Lawrence, E. (2019). The dynamic interplay between satisfaction with intimate relationship functioning and daily mood in low-income outpatients. Family process, 58(4), 891-907.
The mental health consequences of war affect not just warzone veterans, but also their intimate partners
PTSD may impact parenting by influencing emotion regulation
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PTSD is characterized by avoidance of experiences that could trigger strong emotions
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Mothers with PTSD may struggle to tolerate and respond to intense emotions in ways needed to effectively manage their children’s misbehavior.
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The purpose of this study was to see if mothers with PTSD reported greater struggles with managing their emotions and to see if this predicted more problematic parenting techniques, including harsh parenting or overly permissive parenting.
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Participants included 78 mothers (19 with PTSD and 59 without PTSD) who completed a diagnostic interview for PTSD, followed by self-report questionnaires about emotion regulation and parenting behaviors.
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Results showed that parents with PTSD reported more problems with emotion regulation, and that more problems in emotion regulation were linked to overly permissive (but not to overreactive) parenting behaviors.
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Consistent discipline requires parents to be able to cope with negative emotions, such as frustration, when dealing with misbehaving children. At times, mothers with PTSD may struggle to cope with their own emotional distress in ways helpful for managing child misbehavior.
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Findings suggest that interventions focused on improving emotion regulation in parents with PTSD and emotion regulation difficulties may contribute to improved management of child misbehavior and more consistent discipline.
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Kumar, S. A., Franz, M. R., Brock, R. L., & DiLillo, D. (2020). Posttraumatic stress and parenting behaviors: The mediating role of emotion regulation. Journal of family violence, 35(5), 417-426.
When women experiencing trauma symptoms receive high quality social support from their partners, they cope with their feelings better
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After experiencing an extremely stressful event (for example, experiencing violence in a relationship, being in a major car accident, learning about the sudden death of a loved one), it's not uncommon to experience distress, or trauma symptoms, related to that experience. Results from the Family Development Project, a longitudinal study of pregnant couples, suggest that women experiencing trauma symptoms related to a stressful experience cope better on a day-to-day basis when they receive above high-quality support from their partners. In fact, trauma symptoms over the past month no longer impacted day to day coping difficulties among women when support from their partners was above average quality or higher.
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Furthermore, when women reported higher levels of trauma symptoms, their partners were more likely to use unhealthy coping strategies (avoiding their thoughts and feelings) on a day-to-day basis as well.
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This was not the case for fathers. Fathers experiencing trauma symptoms did not cope better or worse on a day-to-day basis, based on the level of support their partners provided.
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It may be that women are more likely to reach out for support when they are distressed if they learn from a young age to rely on others for social support. Alternatively, men may experience greater benefit when they receive support less directly from their partners.
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Results have implications for the development of interventions. Prenatal interventions for women might be improved by adding in a focus on the couple’s health and wellbeing. Teaching partners to provide higher quality support during pregnancy, particularly among couples who are experiencing trauma-related distress, may help mothers cope better on a day-to-day basis.