First Nations parents’ experiences of COVID-19 and associations with symptoms of complex post-traumatic stress disorder

Purpose: To examine associations between First Nations parents’ experiences during the COVID-19 pandemic and symptoms of complex post-traumatic stress disorder (C-PTSD). Methods: First Nations parents (n = 110) completed a 90-minute telephone interview between October 2021 and July 2022. Parents self-reported their PTSD or C-PTSD symptoms using the International Trauma Questionnaire (categorised as no/low vs. high levels), COVID-19 events (e.g. testing, diagnosis, isolation) and perceived socioemotional changes in life situation (e.g. quality of relationships) compared with before the pandemic. Logistic regression analysed associations between C/PTSD symptoms (outcome) and demographic factors, COVID-19 events, perceived socioemotional changes since COVID-19 (exposures). Main findings: More than a quarter (27%) of parents reported high levels of C-PTSD/PTSD symptoms. Most (90%) reported at least one COVID-19 event. Parents who had experienced worsening racism and inequality since the pandemic (OR 0.29, 95% CI 0.11–0.79) or held a Health Care Card (OR 0.27, 95% CI 0.10–0.74) were significantly less likely to report no/low levels of C-PTSD/PTSD symptoms. Principal conclusions: Financial stress, racism and inequality were associated with increased trauma symptoms, highlighting the importance of implementing trauma-informed public health emergency responses during a pandemic. Those who had fewer disruptions to cultural practices were more likely to be resilient to the stressors of the pandemic, reinforcing the need for a culturally-responsive, trauma-informed public health emergency framework for First Nations communities. Emergency responses that address these factors while optimising safe opportunities to maintain cultural obligations and social connection are essential.