Trauma from the Eye of the Beholder: Reporter Discordance in Child'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. This study investigated the impact of reporter, child versus caregiver, in assessing neurobiological correlates of trauma and PTSD in children.

Methods: Two independent samples of youth (Original n=76, 47%Female, M(SD)=9.39(.492); Replication: n=98, 51%Female, M(SD)=9.38(.089)) and their caregivers were interviewed regarding their child's trauma exposure and PTSD severity. Original sample youth were assessed for fear-potentiated startle (FPS) during fear conditioning, and bilateral amygdala reactivity during an emotional faces functional MRI task. To assess reporter effects, effect sizes and directions of associations between interview measures and neurobiological correlates were compared using multiple linear regression.

Results: Child's self-reported trauma exposure was associated with child's self-reported PTSD severity (Original: β=.55, p<.001; Replication: β=.37, p<.01), while caregivers' report of child's trauma exposure was not associated with child's self-reported PTSD severity (Original: β=-.01, p=.99; Replication: β=.07, p=.57). Child's self-report of PTSD severity was positively associated with FPS (Original: β=.29, p<.05) and amygdala reactivity (Original: β=.39, p<.05), while caregivers' report of child's PTSD were not (ps>.05).

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