Building child trauma theory from longitudinal studies: A meta-analysis

Many children are exposed to traumatic events, with potentially serious psychological and developmental consequences. Therefore, understanding development of long-term posttraumatic stress in children is essential. We aimed to contribute to child trauma theory by focusing on theory use and theory validation in longitudinal studies. Forty studies measuring short-term predictors and long-term posttraumatic stress symptoms were identified and coded for theoretical grounding, sample characteristics, and correlational effect sizes. Explicit theoretical frameworks were present in a minority of the studies. Important predictors of long-term posttraumatic stress were symptoms of acute and short-term posttraumatic stress, depression, anxiety, and parental posttraumatic stress. Female gender, injury severity, duration of hospitalization, and elevated heart rate shortly after hospitalization yielded small effect sizes. Age, minority status, and socioeconomic status were not significantly related to long-term posttraumatic stress reactions. Since many other variables were not studied frequently enough to compute effect sizes, existing theoretical frameworks could only be partially confirmed or falsified. Child trauma theory-building can be facilitated by development of encouraging journal policies, the use of comparable methods, and more intense collaboration.

Research highlights
► A minority of longitudinal child trauma studies is explicitly based on theory.
► General risk factor, biological, and cognitive models are used most often.
► Acute, short-term, and parental distress moderately to strongly predict long-term child posttraumatic stress while gender, injury severity, duration of hospitalization, and acute heart rate are weak predictors.
► Age, minority status, and SES do not predict long-term child posttraumatic stress.
► Child trauma theory-building can be facilitated in several ways.