PTSD and CPTSD amongst parents subject to child protection court proceedings: observed rates and associated demographic and clinical covariates.

Background

Substance misuse is a commonly cited reason for the initiation of child protection proceedings. Additionally, posttraumatic stress disorder (PTSD) shows a higher prevalence in both mothers and fathers involved in child protection services compared to the general population. Complex PTSD (CPTSD), recently included in the International Classification of Diseases 11th revision (ICD-11), has yet to be formally investigated in child protection systems using a validated tool.

Objective

We aimed to identify the observed rates of PTSD and CPTSD in parents subject to child protection proceedings using the International Trauma Questionnaire (ITQ) and to examine associated demographic (age, gender, ethnicity) and clinical (depression, anxiety, substance/alcohol misuse, and domestic abuse) factors.

Methods

As a cross-sectional, observational study, we used routinely collected ITQ data pertaining to 93 parents accessing a Family Drug and Alcohol Court service in England between August 2022 and June 2024. We used multivariable logistic regression models to explore associations between demographic and clinical variables and presence of PTSD or CPTSD.

Results

We found that over half of the parents met criteria for PTSD or CPTSD (N = 52, 55.9%), with CPTSD being more prevalent (N = 34, 36.6%) than PTSD (N = 18, 19.4%). Anxiety and depression were significantly associated with presence of PTSD or CPTSD, and 90.1% of parents assessed had histories of substance misuse.

Conclusion

These findings show high rates of CPTSD and high levels of trauma and substance misuse difficulties in CP contexts, highlighting the need for integrating trauma-informed treatments and whole person care services for parents subject to CP proceedings to produce better outcomes for families.