Complex Trauma and Sexual Abuse: Relations to Caregiver-Child Symptom Disagreement

Trauma-exposed children and their caregivers often differ with regards to how the child is faring following trauma exposure, and this symptom discordance is related to negative clinical outcomes. Even though this symptom disagreement is common, it remains less clear if it is universal across trauma types and there may be sub-groups of trauma-exposed children and their caregivers who are at greater risk for discordance. At this time, prior work has not investigated how more severe traumatic events, such as childhood sexual abuse (CSA) and complex trauma (i.e. chronic/multiple interpersonal traumas prior to age 10), may correspond with caregiver-child symptom concordance. The study objectives were to examine: 1) the level and direction of children's symptom discordance and 2) whether CSA and complex trauma were associated with higher levels of caregiver-child symptom disagreement. Two hundred and sixty-nine treatment-seeking children ages 8-12 (M = 9.91, SD = 2.31; 64.7% female; 51.7% Black) and their caregivers participated in the study. Rates of symptom agreement were in the low range, and caregivers endorsed higher levels of symptoms than children. Complex trauma was only tied to greater posttraumatic stress symptoms (PTSS) disagreement, with caregivers of complex trauma survivors being more likely to acknowledge higher levels of symptoms than children. CSA was not associated with symptom concordance across difficulties. Aspects of the complex trauma definition were also not linked with symptom agreement. Caregivers and trauma-exposed children may have divergent symptom reports and children who have experienced more severe traumatic events may present with greater discordance for PTSS.