Parenting and Child Wellbeing in Trauma-Exposed Families in China

Background: Prior research has demonstrated that exposure to traumatic events can cause psychological distress, and weaken resilience to future stressors.  Post-trauma functioning in adults affects other family members, particularly children, who may demonstrate emotional distress, particularly if parents are depressed. This study examines the wellbeing of parents and children in Chinese families who have been exposed to multigenerational trauma. Specifically, we hypothesized that children from families where trauma was reported in the parent and/or grandparent generations would have more physical, behavioral and emotional symptoms than children raised in trauma-free families. We further hypothesized that parents who experienced trauma and who were raised in families with parental trauma would report more difficulty parenting their children, and struggle in other areas of their lives.

Methods: We used a newly collected data on first-grade children in 2014, Shanghai, China. A convenience sampling strategy was used to select 7 out of 17 districts in Shanghai that represented diverse socioeconomic backgrounds between districts. Approximately one to five schools were conveniently sampled within each of the chosen 7 districts with a total of 73 classrooms. Questionnaires were disseminated to 17 school administrators, 73 classroom teachers, and 2,282 parents of children in the selected first-grade classrooms. The response rate for parents was 95% with 100% of response rate from school administrator and teachers. The questionnaire included assessment of exposure to traumatic events in the parent or grand-parenting generations (including divorce, untimely death of a parent or childhood sibling, witnessing violence or murder, or experiencing a natural disaster such as an earthquake).  Standardized measures were used to assess parental depression, somatic symptoms, marital relationship, and parental assessment of their relationship with their child.  The Chinese version of the Child Behavior Checklist was used to assess children’s behaviors. A rich set of demographic characteristics were also collected including parental income, education, and perceived social status. OLS regression analysis was conducted to control for socio-demographic characteristics, parental psychological well-being, health, marital conflict, parenting, and trauma exposure.

Results: Five percent of parents and 9% of the grandparents were identified as having had at least one trauma experience, and 11% of the parents reported trauma experiences in both generations (BOTH). Children in the BOTH group were evaluated by their parents as having significantly higher levels of externalizing, somatic, and internalizing symptoms than trauma-free peers.  Specifically, parental depressive symptoms, physical somatic symptoms, marital distress, and parental negative views of their children were all statistically significantly associated with their children’s behavioral scores.

Implications: Parents who had experienced trauma and were raised by parents who had experienced trauma had difficulty in several areas of their lives, including depression and health problems. They reported more marital conflict and more difficulty parenting their children. The children’s symptoms have all been theoretically and empirically linked to trauma, marital conflict and parental depression. We suggest that early intervention with families experiencing trauma might prevent or minimize trauma sequela that weaken parenting, and compromise children’s wellbeing.