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There are many children growing up without consistent parental care. Of course, the reasons for lack of consistent parental care vary greatly. Regardless of the causes, we all generally agree that lacking direct care from parents is not a good thing for children, particularly when it is prolonged. Children may experience a higher incidence of maladjustment, which may include attention deficit, anxiety, depression, or adult mental health (Crockenberg & Leerkes, 2000; Giannelli & Mangiavacchi, 2010; McLanahan, Tach, & Schneider, 2013). The nature of severity may depend on factors such as attachment bond with their mother or father earlier in life, the children’s sense of attachment to their current primary caregiver(s), the extent and duration of separation from their biological mother and father, or communication methods and frequency.

In our current study, we examined the relationships between parental absence and developmental trauma disorder (DTD) among a group of 13-year-old children in rural areas of China who lack direct care from their parents because the parents went to bigger cities for work. Our findings indicated that in comparison to the children who was not left-behind, left-behind children tended to show a higher level of developmental trauma disorder symptoms over time. This is not to say that these children developed developmental trauma disorder or we can’t be sure that potential DTD symptoms were due to parental absence, but it may just suggest that parental absence may be a chronic stressor for left-behind children because it decreases positive relationships and causes gaps in communication (Kwaka, Kim, & Yoonc, 2018). 

When interpreting the finding, we should bear in mind the following issues. First, the study was carried out in the context of the current economic development situation in China. Therefore, the finding may be unique to China. This culturally-specific reaction to prolonged separation from parents may not occur in cultures or communities where separation or alternative caregiving relationships are established as normative. Second, factors contributing to developmental trauma disorder may be complicated. Although it was found that impaired caregiving such as attachment trauma was related to higher levels of DTD symptoms (Spinazzola, van der Kolk, & Ford, 2018), nature of attachment process can be complex. For example, for some children attachment may have occurred, but for others parental absence may have prevented this or led to the development of a primary attachment bond with other caregivers. In addition, the children’s sense of attachment to their current primary caregiver may vary for those living with grandparents and is likely to be much lower for those in social service care or essentially living on their own. Therefore, we need to consider various aspects or processes of impaired caregiving system when investigating its association with DTD symptoms.
However, the study did in some sense highlight the point that the chronicity of a stressor can be traumatic in that it may be related to anxiety, attention deficits, or DTD in our current example, just as traditional posttraumatic stress disorder is related to anxiety or depression (Fan, Zhang, Yang, Mo , & Liu, 2011). So, in our opinion, we may want to further consider what is considered as a traumatic event or simply as a stress. Maybe concept of trauma should be considered on a continuum, in which low end is stress and high end is trauma. We just need to find the optimal cutoff point rather than categorize an event either as a trauma or not.    


Crockenberg, S., & Leerkes, E. (2000). Infant social and emotional development in family context. In C. H. Zeanah (Ed.), Handbook of infant mental health (pp. 60-90). New York: Guilford Press.

Fan, F., Zhang, Y., Yang, Y., Mo , L., & Liu, X. (2011). Symptoms of posttraumatic stress disorder, depression, and anxiety among adolescents following the 2008 Wenchuan earthquake in China Journal of Traumatic Stress, 24(1), 44-53.

Giannelli, G. C., & Mangiavacchi, L. (2010). Children’s schooling and parental migration: Empirical evidence on the ‘left-behind’ generation in Albania. Labour(Special Issue), 76-92.

Kwaka, J. Y., Kim, J. Y., & Yoonc, Y. W. (2018). Effect of parental neglect on smartphone addiction in adolescents in South Korea. Child Abuse and Neglect, 77, 75-84.

McLanahan, S., Tach, L., & Schneider, D. (2013). The causal effects of father absence. Annual Reivew of Sociology, 39, 399-427.

Spinazzola, J., van der Kolk, B., & Ford, J. D. (2018). When nowhere is safe: Trauma history antecedents of Posttraumatic Stress Disorder and Developmental Trauma Disorder in childhood. Journal of Traumatic Stress, 31(5), 631-642. doi: 10.1002/jts.22320

Reference Article

Zhang, Y. , Zhang, J. and Ding, C. (2019), Investigating the Association Between Parental Absence and Developmental Trauma Disorder Symptoms. JOURNAL OF TRAUMATIC STRESS. doi:10.1002/jts.22446

Questions for Discussion:

  1. To what extent can we to apply the concept of trauma used in medicine to social adversity individuals encounter in their daily life?
  2. Should the concept of trauma be limited to those events as defined in Diagnostic and Statistical Manual of Mental Disorders (DSM-5)?
  3. Can repeatedly-occurring negative events such as feeling being overlooked or discriminated, either real or perceived, be considered as a type of social trauma by individuals?

About the Author:

Cody Ding is a professor of measurement psychology in Department of Education Sciences & Professional Programs at University of Missouri-St. Louis. He has received his Ph.D. in educational psychology from University of Minnesota. His research interests include Multidimensional Scaling models for change and preference, psychosocial adaptation, learning, and neuroeducation.