# I don’t know-responses in the international trauma questionnaire caregiver-version: caregivers’ knowledge about children’s mental health

## TL;DR

This study explores how caregivers' uncertainty about their child's mental health symptoms, using an 'I don't know' option, can help improve understanding and treatment in trauma cases.

## Contribution

The study introduces an 'I don’t know' response option in trauma questionnaires to better understand caregiver knowledge gaps in children's mental health.

## Key findings

- 43.49% of caregivers used at least one 'I don’t know' response in the questionnaire.
- Social anxiety and suicidal tendencies in children were significantly associated with caregivers' 'I don’t know' responses.
- A latent class analysis identified two distinct caregiver groups: 'Knowers' and 'Don’t Knowers'.

## Abstract

To assess psychological problems in children having experienced traumatic events, multiple sources of information are gathered, including the caregiver’s report. Caregiver and child reports rarely accord. As there is no consensus why reports differ, this study investigated the caregivers’ knowledge on their child’s psychological symptoms, implementing an “I don’t know” option (IDK) in a measure on (complex) posttraumatic stress disorder– (C)PTSD.

Data of 269 caregivers (including 70.19% biological parents and 11.15% other caregivers) and their children (Mage = 13.02, 55% female) were collected at entry assessments in a child psychiatry hospital. Standardized measures, including the International Trauma Questionnaire - Child and Adolescents Version (ITQ-CA), and a mirroring Caregivers’ Version (ITQ-CG) were used. Gender and age differences in IDK were investigated through Fisher’s Exact Tests and Mann-Whitney-U-Tests. Spearman correlations were computed between the total psychological outcomes as reported by children and caregivers. A Latent Class Analysis (LCA) was performed to identify different types of “Knowers” and “Don’t Knowers”.

43.49% of caregivers used at least one IDK response. IDK responses were unevenly distributed across (C)PTSD symptoms. There were no significant age or gender differences in children or caregivers regarding specific or total IDK. Social anxiety and suicidal tendencies were significantly associated with IDK. The LCA identified two caregiver-classes (“Knowers” vs. “Don’t Knowers”).

The patterns of IDK underline the necessity of implementing this response option to provide clinicians with insights on important areas of psychoeducation for caregivers.