Development of trauma symptoms following adversity in childhood: The moderating role of protective factors

Background: Although the buffering effect of protective factors on children's outcomes following exposure to adverse childhood experiences has been well documented, research gaps remain as to whether this buffering effect differs based on the type of adversity experienced (i.e., maltreatment versus household dysfunction). Objective: To examine whether protective factors moderate the association between cumulative adversity, as well as adversity subtypes (i.e., maltreatment and household dysfunction) and child trauma-related distress in a clinical sample referred for treatment following exposure to adversity. Participants and setting: One-hundred and seventy-six children (aged 3-18) referred to a child abuse treatment clinic and who's files were opened between January 2016 and June 2017 were included. Methods: Data were collected, extracted, and coded from clinical files using a standardized data extraction protocol. Protective factors included: using individual coping strategies, peer support, individual social skills, caregiver physical caregiving, caregiver psychological caregiving, and educational involvement. Results: Cumulative childhood adversity (b = .16, p = .04) positively predicted child trauma-related distress. The link between exposure to cumulative adversity and child trauma-related distress varied as a function of protective factors: there was a positive association between adversity and child trauma-related distress for children who had low levels of protective factors, but not for those with high levels of protective factors (b = -0.56, p= < .001). Similar findings were observed when data was stratified by maltreatment and household dysfunction. Conclusions: Bolstering children's protective factors prior to, and during child abuse treatment, may reduce trauma-related distress following exposure to adversity.