Childhood experiences of maltreatment, reflective functioning and attachment in adolescent and young adult mothers: Effects on mother-infant interaction and emotion regulation

Evaluation of the relationship between childhood traumas and emotion regulation skills in terms of adult obesity

This study aims to reveal the relationship between childhood traumas and emotion regulation skills of obese and non-obese individuals. The research is a comparative-descriptive and correlational study. The obese group included 52 people with a BMI ≥ 30, and the non-obese group included 58 people with a BMI ≤ 25 kg/m2. Information Form, Childhood Trauma Questionnaire (CTQ), and Emotion Regulation Skills Questionnaire (ERSQ) were used in the study data. The rates of total childhood trauma and physical neglect were significantly higher in obese individuals (53.8 % vs. 32.8 %; 50 % vs. 22.4 %, respectively) than in non-obese individuals. Obese individuals were found to have lower emotion regulation skills. While a significant inverse relationship was found between childhood trauma and emotion regulation skills total and sub-dimension scores in obese individuals, no significant relationship was found in non-obese individuals. Psychiatric-mental health nurses can play an active role in the prevention and treatment of obesity by providing emotion regulation training to individuals in their roles as counselors and educators.

Childhood maltreatment and mentalizing capacity: A meta-analysis

BACKGROUND

The protective role of mentalizing capacity against the adverse effects of childhood maltreatment (CM) is acknowledged; however, empirical studies have yielded diverse conclusions regarding the relationship between childhood maltreatment and mentalizing capacity.

OBJECTIVE

This meta-analytic review aims to comprehensively summarize and quantify the association between childhood maltreatment and mentalizing capacity.

PARTICIPANTS AND SETTING

A total of 23 studies involving 3910 participants were included in the analysis.

METHODS

Systematic searches across eight bibliographic databases identified peer-reviewed publications describing empirical studies on the interplay between CM and mentalizing capacity. Effect sizes (r) were synthesized using random-effects models. A moderated effects analysis was conducted on five variables: participant gender, age group, mental health status, mentalizing capacity measurement, and childhood maltreatment measurement.

RESULTS

The findings showed a significant moderate negative correlation between childhood maltreatment and mentalizing capacity (r = -0.21, 95 % CI = [-0.26, -0.15]). This suggests that heightened severity of childhood maltreatment corresponds to lower mentalizing capacity. Moreover, the strength of this correlation was influenced by participant gender, age group, mental health status, mentalizing capacity measurement, and CM measurement.

CONCLUSIONS

The controversy surrounding the link between CM and mentalizing capacity gains clarity when considering significant moderating variables. The pooled effect provides a preliminary definition of the magnitude and direction of this correlation.

Maternal History of Adversity and Subsequent Mother-Child Interactions at Early Ages: A Systematic Review

Adverse childhood experiences (ACEs) can negatively impact physical, emotional, cognitive, and social development, consequently affecting the next generation. The aim of the present study was to systematically review evidence from empirical studies on the association between maternal history of adversity in childhood (maltreatment and household dysfunction) and subsequent mother-child interactions at an early age. A search was performed in the PubMed, Web of Science, PsycINFO, EMBASE, Scopus, LILACS, and SciELO databases to identify studies, including measures of maternal childhood adversities and mother-child interaction, published between 2016 and 2022. Twenty-nine studies met the inclusion criteria. The results showed that in 90% of the studies, maternal childhood adversities negatively impacted subsequent mother-child interactions in early childhood, reducing maternal displays of affection, emotional availability, sensitivity, mother-child communication, and bonding. Biological factors (e.g., genetic and hormonal) and maternal emotional recognition moderated these associations. In addition, biological factors (i.e., neurobiological and hormonal) and psychosocial factors (e.g., depression, executive functioning, and violence) acted as mediators. Preventive interventions should be implemented to break out of the intergenerational cycle of violence that impacts mother-child interactions.

A Scientometric Review of Infant Cry and Caregiver Responsiveness: Literature Trends and Research Gaps over 60 Years of Developmental Study

Infant cry is an adaptive signal of distress that elicits timely and mostly appropriate caring behaviors. Caregivers are typically able to decode the meaning of the cry and respond appropriately, but maladaptive caregiver responses are common and, in the worst cases, can lead to harmful events. To tackle the importance of studying cry patterns and caregivers' responses, this review aims to identify key documents and thematic trends in the literature as well as existing research gaps. To do so, we conducted a scientometric review of 723 documents downloaded from Scopus and performed a document co-citation analysis. The most impactful publication was authored by Barr in 1990, which describes typical developmental patterns of infant cry. Six major research thematic clusters emerged from the analysis of the literature. Clusters were renamed "Neonatal Pain Analyzer" (average year of publication = 2002), "Abusive Head Trauma" (average year of publication = 2007), "Oxytocin" (average year of publication = 2009), "Antecedents of Maternal Sensitivity" (average year of publication = 2010), "Neurobiology of Parental Responses" (average year of publication = 2011), and "Hormonal Changes & Cry Responsiveness" (average year of publication = 2016). Research clusters are discussed on the basis of a qualitative inspection of the manuscripts. Current trends in research focus on the neurobiology of caregiver responses and the identification of factors promoting maternal sensitivity. Recent studies have also developed evidence-based strategies for calming crying babies and preventing caregivers' maladaptive responses. From the clusters, two topics conspicuously call for future research: fathers' responsiveness to infant cry and the impact of caregiver relationship quality on cry responsiveness.

Birth-related posttraumatic stress disorder and negative childbirth experience related to maternal functioning among adolescent mothers: a cross-sectional study

BACKGROUND

Adolescent pregnancy is an important issue in terms of reproductive health. Adolescent mothers have to overcome two crises at the same time: motherhood and maturity. Childbirth experience and posttraumatic stress disorder may influence the mother's perception of her infant and postpartum care behaviors.

METHODS

This cross-sectional study was conducted on 202 adolescent mothers referring to health centers in Tabriz and its suburbs between May and December, 2022. Data were collected by PTSD Symptom Scale, Childbirth Experience Questionnaire 2.0, and Barkin Index of Maternal Functioning. The association between childbirth experience, posttraumatic stress disorder and maternal functioning was assessed by multivariate analysis.

RESULTS

After adjusting the effect of socio-demographic and obstetric characteristics, the score of maternal functioning among mothers without posttraumatic stress disorder was statistically significantly higher than mothers with posttraumatic stress disorder diagnosis [β (95% CI) = 2.30 (0.39 to 4.20); p = 0.031]. The score of maternal functioning increased with the increase in the childbirth experience score [β (95% CI) = 7.34 (3.87 to 10.81); p < 0.001]. The score of maternal functioning among mothers with wanted sex of baby was statistically significantly higher than unwanted sex of baby [β (95% CI) = 2.70 (0.37 to 5.02); p = 0.023].

CONCLUSION

Healthcare professionals should pay special attention to improving maternal functioning among adolescent mothers. One of the important actions can be to create a positive experience of childbirth for avoiding of posttraumatic stress disorder following birth and counseling with mothers who stated sex of fetus is undesired.

The effect of childhood maltreatment on adult survivors' parental reflective function, and attachment of their children: A systematic review

BACKGROUND

Parental reflective function (PRF) is a candidate mechanism in the transmission of intergenerational trauma. This systematic review examined (1) the association between parental history of childhood maltreatment and PRF, (2) how PRF relates to attachment in children of parent survivors, and (3) whether PRF moderates the association between parental maltreatment history and child attachment.

METHODS

Ten databases were searched (from inception to 10^th November 2021). Inclusion criteria were primary study, quantitative, parent participants, measures of childhood maltreatment, and postnatal PRF. Exclusion criteria were qualitative, intervention follow-up, gray literature, or a review study. Risk of bias was assessed using recommended tools. Data were narratively synthesized.

RESULTS

One-thousand-and-two articles were retrieved, of which eleven met inclusion criteria (N = 974 participants). Four studies found a significant association between parental childhood maltreatment and disrupted PRF, six did not, one found mixed results. One study reported the association between childhood maltreatment and attachment (nonsignificant results).

DISCUSSION

There is no clear evidence PRF is routinely disrupted in parent survivors, though there is high heterogeneity in studies. Future research should standardize design to better understand whether PRF is a candidate mechanism in intergenerational trauma.

OTHER

PROSPERO CRD42020223594.

Parenting stress and competence among mothers of young children with substance use disorders: The roles of trauma and reflective functioning

Posttraumatic stress symptoms are prominent in the lives of parents of young children with substance use disorders (SUD). Parenting experiences, particularly stress and competence, impact parenting behaviors and concomitant child growth and development. Factors that promote positive experiences of parenting, such as parental reflective functioning (PRF), and protect the mother and child from negative outcomes are crucial to understand to develop effective therapeutic interventions. The current US study analyzed baseline data from a parenting intervention evaluation to examine how length of substance misuse, PRF, and trauma symptoms were associated with parenting stress and parenting sense of competence among mothers in treatment for SUDs. Measures included the Addiction Severity Index, PTSD Symptom Scale-Self Report, Parental Reflective Functioning Questionnaire, Parenting Stress Index/Short Form, and Parenting Sense of Competence Scale. The sample included 54 predominantly White mothers with SUDs who had young children. Two multivariate regression analyses found that (1) lower parental reflective functioning and higher posttraumatic stress symptoms were associated with higher parenting stress, and (2) only higher posttraumatic stress symptoms were associated with lower levels of parenting sense of competence. Findings underscore the importance of addressing trauma symptoms and PRF when aiming to improve parenting experiences for women with an SUD.

Psychopathological and Psychosocial Risk Profile, Styles of Interaction and Mentalization of Adolescent and Young Mother-Infant Dyads

This study examined the psychopathological and psychosocial risk profile and the quality of mother-infant interaction in 98 adolescent and young mother-infant dyads. At their infant's age of 3 months, mothers filled in a socio-demographic form and completed a test battery: EPDS for depression, STAY-I for anxiety, PSI-SF for parenting stress, MPSS for social support, AAI for maternal attachment and reflective functioning, CECA for adverse childhood experiences, Care-Index and Mind-mindedness coding system for mother-infant interaction. Results showed that motherhood in adolescence was associated with several psychosocial risk factors. Adolescent and young mothers have depression (25%), anxiety (29%) and insecure attachment (65%), with low reflective functioning, of whom 18% have disorganized attachment. A total of 54% of the mothers had at least one adverse childhood experience. Furthermore, adolescent mothers had low sensitivity and mind-mindedness and high intrusiveness, and their infant had low responsiveness and high passive behaviors. Mothers under 18 have experienced more sexual abuse, are more likely to be single and have been followed by child social services more than mothers aged 18-21. Adolescent mothers have a high-risk psychopathological and psychosocial profile that affects their ability to mentalize and build an adequate relationship with the child. It appears to be important to support the adolescent mother-child relationship.

How does adolescent motherhood affect mother-infant/toddler relationship and emotional availability

BACKGROUND

The present study examined the different aspects of infant-mother relationships in adolescent mothers and compared them in adult mothers.

METHODS

Children aged 18-40 months who were referred to our outpatient Infant Mental Health Department were analysed retrospectively. Sociodemographic data, Parent-Infant Relationship Global Assessment Scale (PIR-GAS) scores, and Emotional Availability (EA) Scales scores were analysed. Twenty-nine adolescent mothers being younger than 20 years at the beginning of pregnancy and thirty mothers who were aged at least 25 years were enrolled the same data as adult mother group.

RESULTS

In the adolescent mothers group, the education years of the mothers, the ratio of mothers having professions were significantly lower (p < 0.001); the spousal age gap was significantly higher than among the adult mothers (p < 0.001). It was also found that an underinvolved relationship pattern was seen more frequently among the mother-infant dyads in the adolescent mothers' group than in the adult mothers group (p = 0.002).

CONCLUSIONS

Although there were not found many problems in terms of the relationship of adolescent mothers with their infants/toddlers in the current study this may have been due to a small sample, we would like to emphasise that the problems should be detected and appropriate interventions should be made for adolescent mothers.Key pointsOur main aim for this study was assesment of the effect of adolescent motherhood in terms of infant\toddler-mother relationshipOur findings showed that lower education level and being unemployed were higher in adolescent mothers group.Higher age gap between spouses was found to be associated with adolescent motherhood. Underinvolved relationship was highly prevalent among adolescent mothersOur findings suggest that early motherhood is a risk factor for mother-infant\toddler-relationship and parenthood.Intervention and education programs during and after pregnancy for adolescent girls may help them to prepare for motherhood more consciously and form established relationships with their infants.

Emotional Availability as a Moderator of Stress for Young Children and Parents in Two Diverse Early Head Start Samples

Positive parent-child relationship quality is critical for buffering children from the effects of stress on development. It is thus vital to develop interventions that target parent-child relationship quality for families experiencing stress. We examined the moderating role of parent-child relationship quality (as measured by parental emotional availability [EA]) in the intergenerational association between parental adverse childhood experiences (ACEs) and their young children's hair cortisol concentrations (HCCs)-a physiological marker of cumulative hypothalamic pituitary adrenal (HPA)-axis activity. Using data from 127 parent-child dyads collected by two of six ACF-funded Buffering Toxic Stress consortium sites, we tested interaction effects of parental ACEs with parental EA on young children's (Mage = 18.38, SDage = 7.10) HCC. Results revealed curvilinear main effects such that higher parental ACEs were significantly associated with greater HCC and stronger associations occurred at higher levels of parental ACEs. However, this association was moderated by parental EA. Thus, among children with higher parental history of ACEs, children of parents with higher EA had lower HCC compared to children of parents with lower EA. These findings provide support for the risk-buffering and risk-exacerbating role of parent-child relationship quality (e.g., EA) for the transmission of parents' early life adversity on their children's HPA-axis activity, documented here in a racially and ethnically diverse sample of children and parents served by Early Head Start. Findings suggest that intervention and prevention efforts targeting stress response in children of mothers with childhood adversity should also support parents in building an emotionally available relationship with their children.

Developmental Trauma Disorder: A Legacy of Attachment Trauma in Victimized Children

Developmental trauma disorder (DTD) and posttraumatic stress disorder (PTSD) have been found to have both shared and unique traumatic antecedents. The present study was an independent replication, with the DTD Structured Interview and the Traumatic Events Screening Instrument administered to 271 children in mental health treatment in six U.S. sites. On an unadjusted basis, DTD (27.3% prevalence, N = 74) and PTSD (40.2% prevalence, N = 109) both were associated with traumatic physical assault or abuse, family violence, emotional abuse, caregiver separation or impairment, and polyvictimization. After controlling for PTSD, DTD was associated emotional abuse, OR = 2.9, 95% CI [1.19, 6.95], and traumatic separation from a primary caregiver, OR = 2.2, 95% CI [1.04. 4.60], both of which also were associated with caregiver impairment, physical assault/abuse, and witnessing family/community violence. Three traumatic antecedents associated with PTSD were not associated with DTD: noninterpersonal trauma, sexual trauma, and traumatic loss. Children exposed to both traumatic victimization and attachment trauma (36.2%) or attachment trauma alone (32.5%) were more likely than children exposed only to victimization (17.5%) or those with no history of victimization or attachment trauma (8.1%) to meet the symptom criteria for DTD, χ²(3, N = 271) = 17.68, p < .001. Study findings replicate and extend prior DTD field trial study results, showing that, although PTSD and DTD share traumatic antecedents, DTD is uniquely associated with traumatic emotional abuse and caregiver separation. Further research is needed to examine how specific trauma types contribute to the risk, course, and severity of DTD.

Different Types of Childhood Experience with Mothers and Caregiving Outcomes in Adulthood

OBJECTIVE AND BACKGROUND

The current study examines the types of childhood experiences with mothers (i.e., maternal abuse, affection, discipline) among caregivers of aging mothers, and investigates whether membership in specific latent classes, particularly maternal maltreatment, is associated with psychological functioning among caregivers.

METHOD

Using data from the Midlife in the United States (MIDUS), we used the Bolck, Croon, and Hagenaars (BCH) approach of latent class analysis (LCA) to predict distal outcomes.

RESULTS

We identified four latent classes (prevalence rate noted): "Affectionate and authoritative" (65%), "affectionate and permissive" (11%), "emotionally abusive and neglectful" (8%), and "emotionally/physically abusive and authoritative" (16%). Caregivers in the "emotionally/physically abusive and authoritative" class endorsed high probabilities of both maternal affection and abuse and were most negatively affected across the three psychological functioning outcomes (i.e., self-rated mental health, psychological distress, and psychological well-being).

CONCLUSION AND IMPLICATIONS

In support of the life course perspective, our findings emphasized the importance of examining adult children caregivers' early life experiences with aging mothers and how those experiences can impact the psychological effects of caregiving. This study suggests specific practice implications; for example, assessment tools for evaluating caregiver burden should consider life course factors such as caregivers' childhood experiences with aging parents.

Impact of intimate partner violence and childhood maltreatment on maternal-infant maltreatment: A longitudinal study

AIM

This study identifies the impact of intimate partner violence (IPV) during pregnancy, and childhood maltreatment on mothers' perpetration of child maltreatment on 1-month postnatal infants.

METHODS

A longitudinal study was conducted on women in the third trimester of pregnancy in two obstetric hospitals in Tokyo, Japan, from June 2016 to September 2017. Participants were asked to complete online self-reported questionnaires during their pregnancy period and at 1 month postnatal. The relationship between suffering from IPV during pregnancy, experiencing childhood maltreatment before the age of 18 years, and perpetration of child maltreatment toward infants was measured among mothers using the Violence Against Women Screen and a survey of four and 14 ad hoc questions. To identify the impact of poly-victimizations of IPV and childhood maltreatment on maternal-infant maltreatment, the study implemented logistic regression models.

RESULTS

The data from 533 respondents to the first and second surveys were analyzed. Maternal-infant maltreatment at 1 month postnatal was strongly associated with poly-victimizations of IPV during pregnancy and childhood maltreatment (adjusted odds ratio [AOR] = 5.17; p < .001; 95% CI = 2.39-11.20), single victimization of IPV (AOR = 3.43, p < .001, 95% CI = 1.76-6.72), and single victimization of childhood maltreatment (AOR = 1.75, p = .03, 95% CI = 1.04-2.93; neither = reference).

CONCLUSION

The results emphasize the importance of individuating pregnant women with poly-victimizations of IPV during pregnancy and childhood maltreatment and providing intensive and continuous support for such women to prevent maternal-infant maltreatment after childbirth.