Evidence suggests parents of children who experience a trauma may develop Post-Traumatic Stress Disorder (PTSD), which can have significant consequences for their own and their child’s functioning. As such, identifying the rates and possible correlates for the development of PTSD in parents is of clinical and theoretical importance, and would enhance our understanding of how best to support families in the aftermath of trauma. This meta-analysis of 41 studies (n = 4370) estimated the rate of PTSD in parents following their child’s single-incident trauma to be 17.0% (95% CI 14.1–20.0%); when removing samples which were mixed, or not exclusively single-incident traumas the prevalence estimate dropped to 14.4% (95% CI 10.8–18.5%). Pooled effect sizes of 32 potential correlates for parents developing PTSD were also identified. Medium-to-large effects were found for factors relating to the parent’s post-traumatic cognition, psychological functioning and coping strategies alongside child PTSD. Small effects were found for pre-trauma factors, objective trauma-related variables and demographic factors for both parent and child. Results are consistent with cognitive models of PTSD, suggesting peri- and post-trauma factors are likely to play a substantial role in its development. These findings indicate the clinical need for screening parents most vulnerable to adverse post-traumatic reactions within the context of child trauma and tailoring interventions to include the family where necessary.

Indirect exposure to trauma, such as learning that a loved one has been exposed to trauma, can lead to post-traumatic stress disorder (PTSD). 1 According to diagnostic manuals, traumatic events include chronic conditions, such as cancer and type 1 diabetes, and being admitted to a paediatric intensive care unit. 1 Parents can develop PTSD after their child receives a medical diagnosis or undergoes invasive medical procedures.Research has shown that when parents are traumatised by paediatric medical events this can increase the risk of their child developing PTSD or experiencing trauma responses without a psychiatric diagnosis. 2 In addition, most children rely on their parents as primary caregivers to meet their basic care needs. This is particularly important if the child is recovering from trauma exposure, as this can lead to PTSD and many other difficulties, such as depression, anxiety and self-harm. 3 PTSD can impede family functioning 4 and qualitative research has suggested that parental PTSD can have an

Objectives: To identify the risks of developing posttraumatic stress disorder (PTSD) and/or depression in parents following their child's Pediatric Intensive Care Unit (PICU) admission using a brief screening instrument and to examine the associations with these risks. Design:A cross-sectional parental survey.Setting and Subjects: One hundred and seven parents of 75 children consecutively admitted to a general 13-bed PICU at a large teaching hospital.Measurements: All parents completed the 10-item Posttraumatic Adjustment Screen (PAS) before discharge. The PAS assesses risk factors known to be associated with poorer psychological outcome, including psychosocial variables pre-trauma and peri-trauma, and acute stress.Main Results: Parents' scores on the PAS indicated that 64 (60%) were at risk of developing PTSD and 80 (75%) were at risk of developing depression following their child's admission.Univariate analyses suggested that psychosocial variables, such as pre-existing stressors and a history of previous mental health problems, were more strongly associated with PAS risk scores for PTSD and depression than medical or socio-demographic factors. In logistic regression analyses a history of previous mental health problems was significantly associated with risk of developing PTSD and depression (p<0.001) explaining 28% and 43% of the variance in these outcomes. Conclusions:This study suggests that a significant number of parents on PICU are potentially at risk of developing PTSD and/or depression post-discharge and that psychosocial factors, pre-trauma and peri-trauma, are stronger determinants of this risk, and of acute distress, than other variables. Identification of vulnerable parents during admission, using a measure such as the PAS, could facilitate the targeting of support and monitoring, acutely and post-discharge, at those who might be most likely to benefit. • A significant minority of parents report persistent symptoms of Post-traumatic Stress Disorder (PTSD) after their child's admission to PICU • The wider research literature on risk factors associated with the development of PTSD has consistently shown that pre-existing trauma history and mental health problems are more predictive than objective indices of trauma severity • This study suggests that the use of a brief validated screening instrument such as the Posttraumatic Adjustment Screen (PAS) can be used to identify parents at risk of developing psychological problems following their child's PICU admission