Differences in trauma exposure, PTSD and child well-being as a function of parental substance misuse in a child welfare sample

Abstract

Parental substance misuse can have multiplicative effects on children, from increased risk of trauma exposure (Sprang et al., 2008), greater likelihood of referral to child protective services (Stanton-Tindall et al., 2013), and negative long-term outcomes in psychological adjustment and well-being (e.g., Seay & Kohl, 2015). With the rise of the opiate crisis in the United States, many states have seen a dramatic increase in the number of children affected by parental substance misuse and referrals to child protective services. In a sample of children involved with child protective services (n = 436), we compared children with allegations and risk factors for parental substance misuse versus those without in terms of their trauma exposure, PTSD symptoms and child well-being. We also conducted a focus group with child welfare intake and assessment workers (n = 20) to provide context and increase understanding of the findings. Three-hundred and twenty-three of the 436 children (74%) had positive indicators for parental substance misuse, as identified by child welfare staff. Youth with parental substance misuse displayed poorer outcomes than those without, but only for those ages 11 to 20, not children under 11. The nuances of these data, as well as the implications, are discussed.