Relationships between Parent Social Problem-Solving and Child and Parent Posttraumatic Stress Symptoms after Pediatric Injury
Authors:   , Nicholls Elizabeth Gray , Daly Brian P. 
Published: July 2021

Objective: Post-traumatic Stress Symptoms (PTSS) are common among injured children and their parents and can result in significant psychosocial impairment. Because parents can influence children's reactions to a traumatic event, potentially malleable factors associated with parents' development of PTSS may represent a key area for early risk assessment and intervention in both parents and children. Social Problem-Solving (SPS) theory posits that deficits in an individual's ability to identify, discover, and evaluate effective solutions for specific problems give rise to psychological morbidity, including PTSS. However, the role of parent SPS abilities in the development of PTSS symptomatology in injured children or the parents themselves has not been investigated. Therefore, the present study aimed to: 1) examine relationships between parent/guardian problem-solving abilities and level and change in parent/guardian PTSS at 6 and 12 weeks post-injury; 2) examine relationships between parent/guardian problem-solving abilities and level and change in child PTSS at 6 and 12 weeks post-injury; 3) investigate relationships between negative parent/guardian problem-solving orientation (NPO) at baseline and level and change in PTSS in children and parents/guardians over time; 4) investigate relationships between parent/guardian rational problem-solving (RPS) abilities at baseline and level and change in child PTSS over time; and 5) explore changes in parents/guardians' problem-solving abilities between baseline, 6, and 12 weeks post-injury. Participants (target): 48 injured children (ages 8-17) and their parents or legal guardians. Methods: Children and parents/guardians completed questionnaires at baseline (within two weeks of injury), 6 weeks post-injury, and 12 weeks post-injury. At each time point, parents completed a measure of Social Problem-Solving ability, while both children and parents completed assessments of PTSS. Results: Parents' baseline total Social Problem Solving-Revised-Short Form (SPSI-RSF) Scores and NPO scale scores were significantly related to parent PTSS at baseline and six weeks post-injury. Although parents with worse baseline SPS/NPO initially reported higher PTSS, they demonstrated a greater decrease in symptoms as compared to parents with better baseline SPS/NPO over the course of the study. By 12 weeks postinjury, parents' total scores on the SPSI-R-SF and the NPO subscale were no longer associated with parent PTSS. RPS scores were not significantly associated with parent PTSS at any time point. With respect to child PTSS, contrary to hypotheses, parents' baseline total scores on the SPSI-R-SF, NPO, and RPS scales were not associated with level and change in child-reported PTSS over time. Parents evidenced a small, but statistically significant, improvement in overall SPSI-R-SF scores over time. Conclusions: Results suggest that parents with poor problem-solving abilities may benefit from targeted problem-solving therapy during the peri-trauma period and immediate aftermath of a child's injury. This therapy may be most helpful if designed to specifically address negative problem orientation. Although no significant associations between parent SPS and child PTSS were identified, this may be due to the complex nature of relationships between these variables.