Caregiver Problem Drinking and Trajectories of Post-Traumatic Stress Among Child Welfare Involved Youth

Background: Negative consequences associated with alcohol use (problem drinking) by caregivers has a negative impact on outcomes for child welfare involved youth, including increased risk for child maltreatment and future mental health problems. One such mental health problem includes post-traumatic stress, or adverse reactions to experiencing events that threaten a sense of safety, which occur in about 30% of child-welfare involved youth. While youth involved with the child welfare system are at an increased risk for having a caregiver with problem drinking, there is little knowledge on how caregiver problem drinking relates to the development post-traumatic stress and whether trajectories of post-traumatic stress are different based on caregiver problem drinking. This study seeks to increase our knowledge in this area by using nationally representative longitudinal data on caregivers and child welfare involved youth.

Methods: Data are from the Longitudinal Studies on Child Abuse and Neglect (LONGCAN). Participants included in this study were youth whose caregiver reported consuming any alcohol in the past year (N = 402) at the baseline assessment (age 4). Information on caregiver problem drinking was assessed by the CAGE. Children’s post-traumatic stress related symptoms were assessed at ages 8, 12 and 16 through the post-traumatic stress clinical subscale of the Trauma Symptom Checklist (TSC). Additional measures on caregiver demographics were included in the current study (major depression, gender, education, income, marital status, and race/ethnicity). A multilevel mixed-effects regression model examined whether trajectories of post-traumatic stress symptoms between the ages of 8 and 16 were different for youth with a caregiver who reported problem drinking compared to youth with a caregiver who reported no problem drinking, controlling for additional caregiver factors.

Results: About 23% of youth had a caregiver who reported problem drinking. Post-traumatic stress scores declined significantly over time for all youth. However, there was a caregiver problem drinking by time interaction which showed that at age 8, children with a caregiver who reported problem drinking showed significantly lower post-traumatic stress scores, compared to children with a caregiver who reported no problem drinking. However, by age 16, children with a caregiver who reported problem drinking showed significantly higher post-traumatic stress subscale scores, compared to children with a caregiver who reported no problem drinking.

Conclusions: Among child welfare involved youth, the relationship between post-traumatic stress and caregiver problem drinking tends to emerge at older ages, compared to child welfare involved youth with caregivers who report no problem drinking. While additional research is needed to clarify mechanisms that link caregiver problem drinking to post-traumatic stress among child welfare involved youth, these results can assist social work practitioners in identifying specific time points where tailored trauma-informed, collaborative systems interventions can be developed to reduce the risk for problems associated with childhood traumatic stress. These time-specific interventions may be beneficial to the field of child welfare as they may assist in the time-limited effort to address caregiver problem drinking as well as decreasing childhood vulnerability, and improving healthy family functioning, child safety, and parental capacity to protect.