Child and caregiver concordance of potentially traumatic events experienced by orphaned and abandoned children

Abstract

Exposure to trauma is associated with significant emotional and behavioral difficulties among children (Perepletchikova & Kaufman, 2010). Overall, reports of trauma and violence experienced by children are discrepant from those of their caregivers (Lewis et al., 2012). Even less is known about the extent of concordance between orphans and their caregivers. This study examines the correlates of concordance in reported traumatic experiences between 1,269 orphaned and abandoned children (OAC) and their caregivers. The OAC lived in family-settings in 5 low and middle income countries and were part of a longitudinal study, “Positive Outcomes for Orphans” (POFO) that enrolled children aged 6 to 12 at baseline. By examining concordance with respect to specific types of trauma reported, this study expands the understanding of who reports which types of traumas experienced by orphaned and abandoned children, thereby improving the potential to provide targeted interventions for children who have experienced such events. In this study, children and caregivers were asked separately if the child had experienced different types of potentially traumatic events. Children were significantly more likely to report physical abuse, sexual abuse and family violence than were caregivers. Caregivers were significantly more likely than children to report natural disasters and accidents. High levels of concordance were found in the reporting of wars, riots, killings, and deaths in the family. The impacts of trauma on behavior and mental health are profound, and highly effective interventions targeting sequelae of childhood trauma are currently being developed for use in low resource areas. Findings from this study demonstrate that it is feasible to conduct screening for potentially traumatic events utilizing child self-report in resource limited settings and that child self-report is crucial in evaluating trauma, particularly family violence and physical or sexual assault.

Prevalence and Incidence of Traumatic Experiences Among Orphans in Institutional and Family-Based Settings in 5 Low- and Middle-Income Countries: A Longitudinal Study

“…This analysis uses self-reported trauma exposures because a prior study in this population showed discordance between self-report and caregiver report, with caregivers reporting significantly fewer potentially traumatic events. 23 This discordance is consistent with underreporting of child trauma exposure by parents and caregivers in other populations. 24 - 26 In most cases, caregivers of orphans have not been present for the orphan’s entire childhood and may have limited knowledge of the child’s trauma history and are also less likely to report violence and abuse within the current caregiving setting.…”

Gender (in) differences in prevalence and incidence of traumatic experiences among orphaned and separated children living in five low- and middle-income countries

“…We used self-reported trauma because a prior study in the POFO population showed that caregivers underreported PTEs experienced by OSC (Rajan et al . 2013). Trauma measures were not administered to children <10 years of age because pilot testing indicated that younger children could not be expected to reliably understand and answer such questions, and the local Institutional Review Boards (IRB) did not permit asking children under 10 about traumatic events.…”

Potentially traumatic experiences and sexual health among orphaned and separated adolescents in five low- and middle-income countries

“…Second, we used self-reported traumatic events and sexual health behaviors. However, a prior study in this population showed that caregiver reports under-reported traumatic experiences (Rajan et al, 2014 ). The sensitive nature of sexual behavior questions can result in reporting more socially desirable answers.…”