Change in preschoolers' PTSD symptom severity predicted by caregivers' emotional flooding and aggression.

Young children who experience symptoms of posttraumatic stress disorder (PTSD) rely heavily on caregivers for emotional support. Yet, caregivers who are overwhelmed (or "flooded") by children's emotional expressions may not provide effective responses, particularly if they also engage in parent-to-child aggression (PCA). Over 12 months, partnered caregivers (N = 448, Mage = 33.80, 52.5% female, 62.7% non-Hispanic White) of a child age 3-5 years who was eligible for Head Start completed surveys and interviews to assess parental emotional flooding, PCA, and children's trauma exposure and PTSD symptoms. Most children (89%) were exposed to potentially traumatic events, including 74% during the study. Male caregivers' emotional flooding predicted maintenance of children's PTSD symptoms over time, regardless of the degree of PCA engaged in. Female caregivers' emotional flooding predicted maintenance of children's PTSD symptoms only among those who engaged in high levels of PCA. Caregivers' experience of emotional flooding may impact children in ways that maintain their PTSD symptoms, including modeling of ineffective emotion regulatory processes or children's internalization of emotions to avoid negative parenting behaviors. Even at low levels of PCA, men's emotional flooding may be impactful, potentially via parental withdrawal. Interventions addressing caregivers' distress when managing children's PTSD-related emotions are indicated.