Trauma From the Eye of the Beholder: Reporter Discordance in Children's Trauma, Psychopathology, and Neurobiology.

BACKGROUND

Childhood trauma is a risk factor for adolescent psychopathology, including posttraumatic stress disorder (PTSD). Most research has relied on caregiver (i.e., parent or legal guardian) reports of child trauma. In this study, we investigated the impact of reporter (child vs. caregiver) in assessing neurobiological correlates of trauma and PTSD in children.

METHODS

Two independent samples of youths (original sample: N = 76, 47% female, mean [SD] age = 9.39 [0.492] years; replication sample: N = 98, 51% female, mean [SD] age = 9.38 [0.089]) and their caregivers were interviewed regarding the children's trauma exposure and PTSD severity. Youths in the original sample were assessed for fear-potentiated startle (FPS) during fear conditioning and bilateral amygdala reactivity during an emotional faces functional magnetic resonance imaging task. To assess reporter effects, effect sizes and directions of associations between interview measures and neurobiological correlates were compared using multiple linear regression analysis.

RESULTS

Children's self-reported trauma exposure was associated with children's self-reported PTSD severity (original sample: β = 0.55, p < .001; replication sample: β = 0.37, p < .01), while caregivers' reports of child's trauma exposure were not associated with children's self-reported PTSD severity (original sample: β = -0.01, p = .99; replication sample: β = 0.07, p = .57). Children's self-report of PTSD severity was positively associated with FPS (original sample: β = 0.29, p < .05) and amygdala reactivity (original sample: β = 0.39, p < .05), while caregivers' reports of their children's PTSD were not (ps > .05).

CONCLUSIONS

These findings suggest that the reporter's perspective may influence associations between trauma, PTSD, and their neurobiological correlates. Child report rather than caregiver report may better align with the child's perceived experience and therefore better predict underlying neurobiology. These findings support the inclusion of children's self-reports of trauma and PTSD when investigating candidate biomarkers of PTSD vulnerability in trauma-exposed youth.