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. 2016 Nov;28(4pt1):947-969.
doi: 10.1017/S095457941600064X.

Parent-child relationship quality and family transmission of parent posttraumatic stress disorder symptoms and child externalizing and internalizing symptoms following fathers' exposure to combat trauma

James Snyder  1 , Abigail Gewirtz  2 , Lynn Schrepferman  1 , Suzanne R Gird  1 , Jamie Quattlebaum  1 , Michael R Pauldine  1 , Katie Elish  1 , Osnat Zamir  2 , Charles Hayes  1
Affiliations

Parent-child relationship quality and family transmission of parent posttraumatic stress disorder symptoms and child externalizing and internalizing symptoms following fathers' exposure to combat trauma

James Snyder et al. Dev Psychopathol. 2016 Nov.

Abstract

Transactional cascades among child internalizing and externalizing symptoms, and fathers' and mothers' posttraumatic stress disorder (PTSD) symptoms were examined in a sample of families with a male parent who had been deployed to recent military conflicts in the Middle East. The role of parents' positive engagement and coercive interaction with their child, and family members' emotion regulation were tested as processes linking cascades of parent and child symptoms. A subsample of 183 families with deployed fathers and nondeployed mothers and their 4- to 13-year-old children who participated in a randomized control trial intervention (After Deployment: Adaptive Parenting Tools) were assessed at baseline prior to intervention, and at 12 and 24 months after baseline, using parent reports of their own and their child's symptoms. Parents' observed behavior during interaction with their children was coded using a multimethod approach at each assessment point. Reciprocal cascades among fathers' and mothers' PTSD symptoms, and child internalizing and externalizing symptoms, were observed. Fathers' and mothers' positive engagement during parent-child interaction linked their PTSD symptoms and their child's internalizing symptoms. Fathers' and mothers' coercive behavior toward their child linked their PTSD symptoms and their child's externalizing symptoms. Each family member's capacity for emotion regulation was associated with his or her adjustment problems at baseline. Implications for intervention, and for research using longitudinal models and a family-systems perspective of co-occurrence and cascades of symptoms across family members are described.

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Figures

Figure 1
Figure 1
Co-occurrence and Relationship Between Child Externalizing and Internalizing Symptoms Males had more externalizing (r = .27, p = .005) and fewer internalizing (r = −.26, p < .001) symptoms at baseline. Child age was associated with more internalizing (r = .35, p < .001) and fewer externalizing (r = −.25, p = .012) symptoms at baseline X2(22) = 29.40, p = .13 X2/df = 1.34, CFI = .969, RMSEA = .038 (error terms are omitted for clarity)
Figure 2
Figure 2
Transmission Between Deployed Fathers’ and Non-deployed Mothers’ PTSD Symptoms X2(16) = 24.05, p = .12, X2/df = 1.42, CFI = .980, RMSEA = .042 (error terms are omitted for clarity)
Figure 3
Figure 3
Transmission Between Deployed Fathers’ PTSD Symptoms and Child Internalizing Symptoms Males had fewer internalizing (r = −.23, p = .008) symptoms at baseline, and child age was associated with more internalizing (r = .33, p = .028) symptoms at baseline X2(29) = 26.04, p = .63, X2/df = 0.90, CFI > .999, RMSEA < .001 (error terms are omitted for clarity)
Figure 4
Figure 4
Transmission Between Deployed Fathers’ PTSD Symptoms and Child Externalizing Symptoms Males had more externalizing (r = .16, p = .081) symptoms at baseline, and child age was associated with fewer externalizing (r = −.15, p = .085) symptoms at baseline. X2(32) = 53.05, p = .015, X2/df = 1.61, CFI = .945, RMSEA = .051 (error terms are omitted for clarity)
Figure 5
Figure 5
Transmission Between Non-deployed Mothers’ PTSD Symptoms and Child Internalizing Symptoms Males had fewer internalizing (r = −.23, p = .007) problems at baseline, and child age was associated with more internalizing (r = .22, p = .102) symptoms at baseline X2(32) = 24.93, p = .81, X2/df = 0.78, CFI > .999, RMSEA < .001 (error terms are omitted for clarity)
Figure 6
Figure 6
Transmission Between Non-deployed Mothers’ PTSD Symptoms and Child Externalizing Symptoms Males had more externalizing (r = .20, p = .022) and child age was associated with fewer externalizing (r = −.17, p = .057) symptoms at baseline X2(35) = 41.46, p = .21, X2/df = 1.18, CFI = .971, RMSEA = .028 (error terms are omitted for clarity)
Figure 7
Figure 7
Father Positive Engagement and Symptom Transmission Between Fathers’ PTSD Symptoms and Child Internalizing Symptoms Males had fewer internalizing (r = −.30, p < .001) symptoms at baseline, X2(79) = 74.72, p = .55, X2/df = 0.97, CFI = .987, RMSEA = .015 (error terms are omitted for clarity)
Figure 8
Figure 8
Father Coercion and Symptom Transmission Between Fathers’ PTSD Symptoms and Child Externalizing Symptoms Males had more externalizing (r = .16, p < .05) symptoms and child age (r = −.16, p < .05) was associated with fewer externalizing symptoms at baseline. ADAPT was associated with fewer child externalizing symptoms at 24 months (r = −.31, p < .05). X2(82) = 94.34, p = .10, X2/df = 1.15, CFI = .967, RMSEA = .033 (error terms are omitted for clarity)
Figure 9
Figure 9
Mother Positive Engagement and Symptom Transmission Between Non-deployed Mothers’ PTSD Symptoms and Child Internalizing Symptoms Males had fewer internalizing (r = −.29, p < .001) and child age (r = .18, p < .05) was associated more child internalizing symptoms X2(79) = 84.69, p = .31, X2/df = 1.07, = .954, RMSEA = .032 terms are omitted for clarity)
Figure 10
Figure 10
Mother Coercion Symptom Transmission Between Non-deployed Mothers’ PTSD Symptoms and Child Externalizing Symptoms Males had more externalizing (r = .17, p =.06) symptoms at baseline. X2(64) = 58.49, p = .67, X2/df = 0.87, CFI = .989, RMSEA = .020 (error terms are omitted for clarity)
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