Low socioeconomic status (SES) as a predictor of post-traumatic stress disorder (PTSD) in children and adolescents: a scoping review.

Abstract

Childhood trauma presents potential lifelong consequences for health and well-being. Research indicates that those with low socioeconomic status (SES) are disproportionately exposed to trauma and that childhood victimisation is associated with a higher risk for mental health problems. Existing literature in this field has predominantly focused on quantitative analysis and the adult population. There is a scarcity of research analysing the role low SES plays in the outcome of PTSD (Post-traumatic stress disorder) amongst children and adolescents within a low socioeconomic context. This study aimed to map and comprehensively analyse studies investigating low socioeconomic status as a predicting variable of PTSD among children and adolescents to generate insight and establish areas for future research. The present study was qualitative and utilised Kira’s taxonomy of trauma and assessment theory to support the objectives (Kira, 2001). A scoping review method was used guided by Arksey and O’Malley (2005). The search period was from 2012 to 2022. The search strategy for this scoping review used two electronic platforms, Ebscohost and Wiley, which provided access to the following databases: Academic search complete, APA Psychinfo, APA Psycharticles, Medline, and ERIC. The researcher screened all studies independently, and an external reviewer evaluated eligible articles. Charting the data involved synthesising and interpreting data according to key issues using a table format. Further analysis included descriptive statistics and thematic content analysis. Five prominent themes were developed: 1) structural risk/protective factors, 2) stages of development, 3) gender differences, 4) study design, and 5) study outcomes. The findings of this study illustrated a positive relationship between low SES and PTSD by identifying that low SES increased the chance of developing PTSD due to situational factors (early life exposure), negatively impacting he cognitive appraisals of a child. Contextual factors (types of SES indicators), such as parental instability, increased interpersonal violence, and scarce resources, further perpetuate the cycle of poverty and traumatic exposure. The study also identified crucial gaps in the literature, such as the need for qualitative/mixed methods and longitudinal research studies and the need for standardised low SES measures, among others, which could inform future research about the incremental validity of SES measures when determining a complete child or adolescent victimisation profile.