Parent Emotional Reaction Questionnaire (PERQ)

Abstract

The Parent Emotional Reaction Questionnaire (PERQ) is a specialized psychometric properties instrument designed to assess the emotional and cognitive reactions experienced by parents following their child’s exposure to trauma. Originally developed in the context of child sexual abuse, the PERQ measures the extent of parental distress, guilt, shame, and intrusive thoughts, which are critical indicators of secondary traumatic stress. This 15-item self-report measure utilizes a 5-point Likert scale and is widely employed in clinical research to understand the systemic impact of childhood trauma on family functioning and treatment outcomes.

Keywords

Parent Emotional Reaction Questionnaire, PERQ, parental distress, secondary traumatic stress, childhood trauma, sexual abuse, guilt, shame, family function, psychological assessment.

Authors

Judith A. Cohen, Anthony P. Mannarino, Tonje Holt.

Purpose

The primary purpose of the PERQ is to quantify the specific psychological symptoms and emotional reactions experienced by primary caregivers in response to their child’s traumatic experience. Recognizing that parental distress significantly impacts a child’s recovery trajectory, the PERQ provides clinicians and researchers with a focused measure to identify parents at risk for developing significant mental health issues, such as symptoms related to secondary traumatic stress or vicarious traumatization.

This instrument helps in assessing the burden of care and the need for parental support interventions. Specifically, it gauges reactions like intrusive thoughts, avoidance behaviors, affective distress (sadness, anger), and self-blame (guilt, shame) related to the child’s victimization, which are crucial factors mediating the success of child trauma treatment.

Construct

The PERQ measures the overarching construct of parental emotional reaction and distress following a child’s trauma. While often highly correlated with general distress measures, the PERQ specifically targets reactions directly attributable to the child’s traumatic event, thereby capturing elements of secondary traumatization. The scale focuses on how the parent processes and internalizes the trauma experienced by the child.

The 15 items encompass several key dimensions of parental distress, including cognitive intrusion (e.g., thinking about the trauma while working), affective responses (upset, sadness, anger), somatic complaints (headaches, stomachaches), and self-conscious emotions (guilt, shame, responsibility). These dimensions are critical in understanding how a parent’s internal psychological processing of the trauma may affect their ability to provide a supportive and stable environment for the child’s healing.

Validity

Initial studies by Cohen and Mannarino (1996) established the scale’s content validity by ensuring items comprehensively covered the range of emotional reactions observed in parents of children who experienced sexual abuse. Subsequent validation studies, notably by Holt, Cohen, and Mannarino (2015), provided evidence for the instrument’s construct validity across various trauma populations.

The PERQ has demonstrated strong concurrent validity, showing significant correlations with established measures of parental psychological distress, such as general anxiety and depression scales. Furthermore, the scale exhibits predictive validity, as elevated PERQ scores are often associated with poorer outcomes for the child in treatment, highlighting the critical role of parental emotional regulation in therapeutic success.

Reliability

The PERQ generally exhibits good to excellent internal consistency. Research employing Cronbach’s alpha typically reports values in the range of 0.80 to 0.90 for the total scale score, indicating high reliability across the 15 items. This strong internal consistency suggests that the items are measuring a consistent underlying construct of parental emotional reaction following child trauma exposure.

While specific test-retest reliability data may vary across publications, the robust internal consistency confirms the scale’s utility as a stable and cohesive measure of parental psychological distress at a given point in time following the identification of the child’s trauma.

Factor Analysis

The factor structure of the PERQ was rigorously examined and validated in later research, particularly by Holt, Cohen, and Mannarino (2015). Their Factor Analysis typically supports a multi-dimensional structure, although the exact number of factors can vary depending on the specific demographic and clinical characteristics of the population studied.

Commonly identified factors include: 1) General Distress and Intrusion (items related to being upset, sad, afraid, and experiencing intrusive thoughts); 2) Self-Blame and Shame (items related to guilt, shame, feeling responsible, and feeling inadequate); and 3) Somatic and Avoidant Symptoms (items related to physical manifestations of stress and trouble sleeping). The confirmation of these distinct factors allows researchers to analyze specific facets of parental reaction rather than relying solely on a single total score, offering a more nuanced understanding of secondary traumatic stress.

Instrument

Test Type: Self-report questionnaire, Psychological assessment scale

Format: 15 items, rated on a 5-point Likert scale (1=never, 5=always)

Language Available: Primarily English (translations may exist in subsequent research)

Population Group: Parents or primary caregivers of children who have experienced trauma.

Age Group: Adults (Caregivers)

Population Details: Originally validated on parents of children who experienced sexual abuse, but applicable to parents reacting to various forms of childhood trauma or victimization.

Test Methodology: Summation of item scores yields a total parental distress score. Subscale scores can also be calculated based on the validated Factor Analysis structure.

Keywords

Parental accommodation, vicarious trauma, psychometrics, caregiver burden, child maltreatment, treatment mediation, guilt, shame.

Authors

Author ORCID Identifier: Not specified in source content (N/A)

Affiliation Email addresses: Not specified in source content (N/A)

Correspondence Address: Not specified in source content (N/A)

Permissions & Fee and Test Year

The PERQ was initially conceptualized and published in research dating back to 1996 (Cohen & Mannarino). The scale is generally considered available for non-commercial academic and research use, though permission should be sought directly from the primary authors (Judith A. Cohen or Anthony P. Mannarino) for clinical or large-scale academic applications.

The original PDF of the instrument, as referenced in the source material, can be downloaded here: http://citeseerx.ist.psu.edu/viewdoc/download?doi=10.1.1.452.2747&rep=rep1&type=pdf

Reference’s

Cohen, J. A., & Mannarino, A. P. (1996). Family-related variables and psychological symptom formation in sexually abused girls. Journal of Child Sexual Abuse, Vol 5(1), 105-120.

Cohen, J. A., & Mannarino, A. P. (1996). Factors that mediate treatment outcome of sexually abused preschool children. Journal of the American Academy of Child & Adolescent Psychiatry, 34(10), 1402-1410.

Holt, Tonje., Cohen, Judith A., and Mannarino, Anthony. (2015). Factor structure of the Parent Emotional Reaction Questionnaire: analysis and validation. European Journal Psych traumatology. Vol 6.

Items of the Parent Emotional Reaction Questionnaire (PERQ)

IMPORTANT: The following scale items must be preserved in their original language and must not be changed in any way.

1. I have felt upset about my child’s trauma.
2. I think about what happened to my child while I am working.
3. I have felt sad about my child’s traumatic experience.
4. I am afraid of what other people will think about my child’s traumatic experience.
5. I feel that I should have been able to keep the trauma from happening.
6. I have felt afraid since I learned about my child’s trauma.
7. I have trouble falling asleep at night because I think about what happened to my child.
8. I have felt angry about my child’s traumatic experience.
9. Since I learned about my child’s traumatic experience, I have been having headaches, stomachaches, etc.
10. I have felt embarrassed about my child’s traumatic experience.
11. I have cried about my child’s traumatic experience.
12. I have felt ashamed about my child’s traumatic experience.
13. I have felt responsible for my child experiencing trauma.
14. I have felt insecure since I learned that my child experienced trauma.
15. I feel guilty that I did not know about the trauma sooner.

Response Scale: 1=never, 2=rarely, 3=sometimes, 4=frequently, 5=always