Exploratory Analysis of Trauma Symptomology Among Substance-Affected, Child Welfare Involved Caregivers after Receipt of Short-Term Parenting Intervention

Introduction

Caregiver-risk factors for intergenerational transmission of child maltreatment (ITCM) include mental health and substance use concerns. Understanding ITCM and caregivers' trauma profiles, especially among substance-affected (SA) families in the child welfare system (CWS), is vital for preventing child maltreatment. To investigate trauma symptomology among CWS-involved SA caregivers, the authors examined three longitudinal Regional Partnership Grant (RPG) cohorts funded by the Children’s Bureau, ACF. Each cohort was comprised of SA caregivers in the CWS receiving a short-term, evidence-informed parenting intervention and CWS services as usual. Authors utilized an exploratory, longitudinal approach to estimate caregiver subgroups, examining trauma symptomology over time and the impact of participation in parenting interventions. The research sought to answer these questions:

1. Are there qualitatively distinct subgroups of CWS-SA affected caregivers based on trauma symptoms?
2. What is the probability that caregivers will be in a different subgroup at Time 2?
3. Does intervention type predict transition probabilities.

Methods

Each RPG cohort received an evidence-based parenting intervention and completed the Trauma Symptom Checklist-40 (TSC-40) at baseline (T1) and program exit (T2). In total, 349 caregivers were included in the study; LTA examined each RPG cohort by parenting intervention. TSC-40 subdomain scores were the primary independent variable; and subgroup membership was the outcome variable of interest. A multi-step analytic process was implemented. Latent class analysis models using data from T1 and T2 resulted in a 2-class solution across both timepoints. Following the initial LTA model, a predictor (treatment type) was introduced.

Results

RPG caregivers were primarily White (77%), non-Hispanic/Latino (78%), females (84%). Mean T1 TSC-40 total trauma scores ranged from 0-104 with a median of 23; Mean T2 TSC-40 total trauma scores ranged from 0-95 with a median of 16. LTA Results revealed two distinct caregiver trauma symptomology subgroups at both timepoints, labeled: low-symptomology (T1 n= 296; T2 = 314); and high-symptomology (T1 n=201; T2 n=183). Mean scores at both times points for the low- symptomology subgroup was 11.49; while the high- symptomology subgroup had mean scores of 48.56. Caregivers in the low-symptomology subgroup exhibited high probabilities of remaining within that subgroup overtime. Positive changes in trauma symptomology were found among caregivers initially categorized in the high-symptomology subgroup. Individuals within the high-symptomology subgroup demonstrated a .20 probability score of transitioning into the low-symptomology group at Time 2. Type of intervention did not significantly predict transition probabilities.

Discussion

Findings showed caregivers initially classified as high-symptomology had an increased probability of shifting symptomology statuses at program exit, suggesting potential trajectories of recovery or stabilization after participation in any parenting intervention. Additionally, findings indicate a short-term evidence-informed parenting intervention may offer protective effects on caregivers’ trauma symptomology, though specific intervention type was not significant. These insights emphasize the need for tailored interventions and support for caregivers grappling with trauma within the CWS. More investigation is required to explore how these trauma symptom profiles impact repeat child maltreatment and ITCM. Additionally, further examination is needed on the "fit" of the parenting intervention meeting the trauma needs of the SA, CWS-involved caregiver.