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April 2016 | Volume 4, Issue 2

EVIDENCE IN ACTION
A quarterly research brief from the
Center on Trauma and Children

The Pathway to Grandparenting Stress:

Trauma, Relational Conflict and Emotional Well-Being

The following is a study conducted by the Center on Trauma and Children. Sprang, G., Choi, M., Eslinger, J., & Whitt-Woosley, A. (2015). The pathway to grandparenting stress: Trauma, relational conflict and emotional well-being. Aging and Mental Health 19(4), 315-324.

Why is it important to use a trauma framework when understanding parenting stress for grandparents who are raising their grandchildren?

The number of grandparents raising their grandchildren has been steadily increasing over the last two decades. This trend has changed over time with an increase in grandparent headed households stemming from adverse life events, including parental substance abuse, incarceration, intimate partner violence, abuse and neglect (Crewe, 2007; Goodman & Rao, 2007; Kropf & Robinson, 2004; Dellman-Jenkins, Blankemeyer, & Olesh, 2002; Hirshorn, VanMeter & Brown, 2000). The prevalence of trauma exposure within

grandfamilies encourages the use of a conceptual framework grounded in the trauma and attachment literature (Strong, Bean, & Feinauer, 2009). Although exposure to such events can lead to traumatic stress-related symptoms and destabilization of relationships within the family, there are few resources and services available to grandfamilies to address trauma-related needs.

What did we study?

Surveys were conducted with 251 grandparents across Kentucky raising at least one grandchild through kinship care or other caregiving programs. In order to better understand the needs of Eastern Kentucky grandfamilies, this part of the state was purposefully oversampled resulting in 36.1% of respondents living in the eastern part of the state. The 96 question survey consisted of the Parenting Stress Scale (Berry & Jones, 1995) modified for grandparents, the conflicts scale from the Child-Parent Relationship Scale (Pianta, 1992), the RAND 36-Item Short Form Health Survey (Hays, Sherbourne, & Mazel, 1993), and other items including demographics, child trauma exposure, and trauma diagnoses. A structural equation model (SEM) was used to examine the mediating effect of grandchild-grandparent conflict on the relationship between child trauma exposure, grandparenting stress and emotional well-being.

What were the significant findings?

High levels of trauma exposure were found within grandparent-headed households; approximately three-fourths (72%) of respondents identified caring for a grandchild with one or more trauma exposures.
16% of the sample identified caring for a grandchild with four or more trauma exposures placing these children at elevated risk for adverse lifetime outcomes consistent with the Adverse Childhood Events Study (ACES) (Felitti et al., 1998).
16.3% of grandparents reported caring for a grandchild with a traumatic stress disorder.
The number of different types of trauma exposures for the grandchild was found to indirectly affect both overall grandparenting stress and emotional well-being by way of the degree of conflict within the child-grandparent relationship.
A higher number of trauma exposures for the child were associated with greater child-grandparent conflict, greater overall parenting stress, and lower ratings of emotional well-being among parenting grandparents.

Implications for Practice

High rates of trauma exposure for grandfamilies reinforce the importance of trauma screening for these families.
A trauma framework is necessary to understand the impact a grandchild's trauma exposure may have on caregiving stress and well-being.
Cumulative trauma exposure may serve to destabilize intra and interpersonal functioning within grandfamilies.
There is a need for expanded trauma-informed services for grandfamilies that include interventions that focus on decreasing conflict in the grandchild-grandparent relationship.
Trauma-informed strategies, such as psychoeducation about

trauma and its effects on the child and family, can be integrated into evidence-supported training programs (Smith, 2003; Kern, 2003) and other existing services.

REFERENCES

Berry, J.O., & Jones, W.H. (1995). The Parental Stress Scale: Initial psychometric evidence. Journal of Social and Personal Relationships, 12, 463-472.

Crewe, S.E. (2007). Different pathways to a common destiny: grandparent caregivers in the District of Columbia. Journal of health and Social Policy, 22(3-4), 199-214.

Dellman-Jenkins, M., Blankemeyer, M., & Olesh, M. (2002). Adults in expanded grandparents roles: Considerations for practice, policy and research. Educational Gerontology, 28, 219-235.

Felitti, V.J., Anda, R.F., Nordenberg, D., Williamson, D.F., Spitz, A.M., Edwards, V., ... Marks, J.S. (1998). Relationships of child abuse and household dysfunction to many of the leading causes of death in adults: Adverse Childhood Experiences (ACE) study. American Journal of Preventative Medicine, 14(4), 245-258.

Goodman, M.R., & Rao, S.P. (2007). Grandparents raising grandchildren in a US-Mexico border community. Qualitative Health Research, 17, 1117-1136.

Hays, R.D., Sherbourne, C.D., & Mazel, R.M. (1993). The RAND 36-item health survey 1.0. Health Economics, 2, 217-227.

Hirshorn, B., Van Meter, J.V., & Brown, D.R. (2000). When grandparents raise grandchildren due to substance abuse: Responding to a uniquely destabilizing factor. New York: NY: Springer.

Kern, C.W. (2003). Grandparents who are parenting again: Building parenting skills. In B. Hayslip, Jr., & J.H. Patrick (Eds.), Working with custodial grandparents (pp. 179-193), New York: Springer.

Kropf, N.P., & Robinson, M.M. (2004). Pathways into caregiving for rural custodial grandparents. Journal of Intergenerational Relationships, 2(1), 63-77.

Pianta, R.C. (1992). The child-parent relationship scale. Charlottesville, VA: University of Virginia Press.

Smith, G.C. (2003). How caregiving grandparents view support groups: An exploratory study. In B. Hayslip, Jr., & J. Hicks Patrick (Eds.), Working with custodial grandparents (pp. 69-91). New York: Springer.

Strong, D.D., Bean, R.A., & Feinauer, L.L. (2010). Trauma, attachment, and family therapy with grandfamilies: A model for treatment. Children and Youth Services Review, 21(1), 44-50.

This project was funded in part by the Eastern Kentucky United Methodist Health, Education, & Welfare Fund (Sprang, PI).

University of Kentucky Center on Trauma and Children
859-218-6901 | alwhit4@uky.edu | http://www.uky.edu/ctac