Post-Traumatic Stress Disorder (PTSD) In Parents

Is This a Significant Problem?

Bernice D. Mowery, PhD, PNP, RN

Disclosures

Pediatr Nurs. 2011;37(2):89-92. 

In This Article

Effects of PTSD

Ignored and untreated, PTSD affects individuals both physically and psychosocially. PTSD is associated with higher catecholamine levels (Young & Breslau, 2004), which may cause inflammation and eventual damage to the cardiovascular system (Boscarino, 2008), resulting in hypertension and atherosclerotic heart disease, as well as abnormalities in thyroid and hormone functions, increased susceptibility to infections and immunologic disorders, and arthritis. Increased risk of developing other physiological problems has also been reported, including those of the nervous system, musculoskeletal system, circulatory system, digestive system, and signs and ill-defined disease (Andersen, Wade, Possemato, & Ouimette, 2010).

Additionally, PTSD in a parent can have an impact on the child's development (Murray & Cooper, 1997) physically and psychosocially. A strong linear relationship has been reported between maternal PTSD symptoms and severity of eating and sleeping issues at 18 months in prematurely born infants (Pierrehumbert, Nicole, Muller-Nix, Forcada-Guex, & Ansermet, 2003). Higher parent PTSD scores have also been associated with elevated HbA1c in children with type 1 diabetes mellitus (Landolt, Vollrath, Laimbacher et al., 2005). Parental PTSD has even been reported to increase the length of hospital stay after meningococcal disease (Shears et al., 2005). Parents with PTSD report more behavioral problems in their children compared to ratings of other informants or non-symptomatic parents (Rabineau, Mabe, & Vega, 2008). The connection between parent PTSD and the emotional health of the sick child has been extensively reported. Correlations between mother and child PTSD have been reported for children with meningococcal disease (Shears et al., 2005), cancer (Rabineau et al., 2008), and after pediatric trauma (Daviss et al., 2000; Schreier, Landakakos, Morabito, Chapman, & Knudson, 2005). Landolt, Vollrath, Timm, Gnehm, and Sennhauser (2005) found that the father's (but not the mother's) PTSD scores predicted the child's PTSD score after motor vehicle accident.

A parent experiencing PTSD can also present challenging symptoms for the health care team. Because of the painful response to hospital triggers, parents may avoid visiting. They may also avoid bringing their child for needed follow-up care and testing, resulting in being labeled as uncaring and non-adherent. Conversely, parents experiencing hyper-vigilance may refuse to leave their child at all during the entire hospitalization. Others may insist that only certain staff care for their child. The health care team must respond to parental persistent and sometimes irrational fears that their child might die or become critically ill again (Holditch-Davis, Barlett, Blickman, & Miles, 2003). Additionally, symptoms of anger or irritability that are part of PTSD may be directed toward the health care team and can strain relationships.

Some parents may deal with the re-experiencing phenomena of PTSD by telling the story of the traumatic event repeatedly. This obsession with the traumatic event can make it challenging for health care providers to efficiently obtain a history or other pertinent current information. PTSD can also interfere with a parent's ability to concentrate, making it difficult to learn new skills required for his or her child's care. Poor adherence with treatment regimens associated with parental PTSD has been reported for children with diabetes mellitus (Landolt et al., 2002), cystic fibrosis (Eddy et al., 1998), and liver or kidney transplants (Rabineau et al., 2008; Shemesh, 2004).

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