Abstract
Trauma exposure can lead to poor psychological health not only for those directly affected, but also for their children. Additional research is needed to understand mechanisms in the intergenerational sequelae of traumatic stress. The current study examined parenting stress as a moderator of the association between parents’ lifetime trauma exposure and school-aged children’s internalizing symptoms (N = 139 dyads). Results of multiple regression analyses showed that the relationships between parental trauma exposure and child separation anxiety and harm avoidance were significant when parenting stress was moderate to high, but not when parenting stress was low. Parental trauma exposure was not significantly associated with child depressive symptoms. Clinical implications include the importance of screening and addressing parents’ trauma exposure and parenting stress in the context of child and family mental health services. Further research is needed to explicate the mechanisms linking parents’ trauma exposure with child anxiety symptoms.
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References
Kilpatrick DG, Resnick HS, Milanak ME, Miller MW, Keyes KM, Friedman MJ (2013) National estimates of exposure to traumatic events and PTSD prevalence using DSM-IV and DSM-5 criteria: DSM-5 PTSD prevalence. J Trauma Stress 26:537–547. https://doi.org/10.1002/jts.21848
Anda RF, Felitti VJ, Bremner JD, Walker JD, Whitfield C, Perry BD, Dube SR, Giles WH (2006) The enduring effects of abuse and related adverse experiences in childhood: a convergence of evidence from neurobiology and epidemiology. Eur Arch Psychiatry Clin Neurosci 256:174–186. https://doi.org/10.1007/s00406-005-0624-4
Felitti VJ, Anda RF, Nordenberg D, Williamson DF, Spitz AM, Edwards V, Koss MP, Marks JS (1998) Relationship of childhood abuse and household dysfunction to many of the leading causes of death in adults. Am J Prev Med 14:245–258. https://doi.org/10.1016/S0749-3797(98)00017-8
McLaughlin KA (2016) Future directions in childhood adversity and youth psychopathology. J Clin Child Adolesc Psychol 45:361–382. https://doi.org/10.1080/15374416.2015.1110823
Magruder KM, Laughlin KA, Elmore Borbon DL (2017) Trauma is a public health issue. Eur J Psychotraumatol 8:1375338. https://doi.org/10.1080/20008198.2017.1375338
Randell KA, O’Malley D, Dowd MD (2015) Association of parental adverse childhood experiences and current child adversity. JAMA Pediatr 169:786–787. https://doi.org/10.1001/jamapediatrics.2015.0269
Dekel R, Goldblatt H (2008) Is there intergenerational transmission of trauma? The case of combat veterans’ children. Am J Orthopsychiatry 78:281–289. https://doi.org/10.1037/a0013955
Lambert JE, Holzer J, Hasbun A (2014) Association between parents’ PTSD severity and children’s psychological distress: a meta-analysis. J Trauma Stress 27:9–17. https://doi.org/10.1002/jts.21891
Yehuda R, Halligan SL, Grossman R (2001) Childhood trauma and risk for PTSD: relationship to intergenerational effects of trauma, parental PTSD, and cortisol excretion. Dev Psychopathol 13:733–753. https://doi.org/10.1017/S0954579401003170
van Ee E, Kleber RJ, Jongmans MJ, Mooren TTM, Out D (2016) Parental PTSD, adverse parenting and child attachment in a refugee sample. Attach Hum Dev 18:273–291. https://doi.org/10.1080/14616734.2016.1148748
Laurent J, Ettelson R (2001) An examination of the tripartite model of anxiety and depression and its application to youth. Clin Child Fam Psychol Rev 4:209–230. https://doi.org/10.1023/a:1017547014504
Lunkenheimer ES, Olson SL, Hollenstein T, Sameroff AJ, Winter C (2011) Dyadic flexibility and positive affect in parent–child coregulation and the development of child behavior problems. Dev Psychopathol 23:577–591. https://doi.org/10.1017/S095457941100006X
Fonagy P, Gergely G, Jurist E, Target M (2002) Affect regulation, mentalization, and the development of the self, Other Press
Chemtob CM, Nomura Y, Rajendran K, Yehuda R, Schwartz D, Abramovitz R (2010) Impact of maternal posttraumatic stress disorder and depression following exposure to the September 11 attacks on preschool children’s behavior: impact of PTSD and depression. Child Dev 81:1129–1141. https://doi.org/10.1111/j.1467-8624.2010.01458.x
Samuelson KW, Wilson CK, Padrón E, Lee S, Gavron L (2017) Maternal PTSD and children’s adjustment: parenting stress and emotional availability as proposed mediators: maternal PTSD and children’s adjustment. J Clin Psychol 73:693–706. https://doi.org/10.1002/jclp.22369
van Veen T, Wardenaar KJ, Carlier IVE, Spinhoven P, Penninx BWJH, Zitman FG (2013) Are childhood and adult life adversities differentially associated with specific symptom dimensions of depression and anxiety? Testing the tripartite model. J Affect Disord 146:238–245. https://doi.org/10.1016/j.jad.2012.09.011
Jacobvitz D, Leon K, Hazen N (2006) Does expectant mothers’ unresolved trauma predict frightened/frightening maternal behavior? Risk and protective factors. Dev Psychopathol. https://doi.org/10.1017/S0954579406060196
Hesse E, Main M (2000) Disorganized infant, child, and adult attachment: collapse in behavioral and attentional strategies. J Am Psychoanal Assoc 48:1097–1127. https://doi.org/10.1177/00030651000480041101
Schwerdtfeger KL, Goff BSN (2007) Intergenerational transmission of trauma: exploring mother–infant prenatal attachment. J Trauma Stress 20:39–51. https://doi.org/10.1002/jts.20179
Cicchetti D, Rogosch FA (1996) Equifinality and multifinality in developmental psychopathology. Dev Psychopathol 8:597–600. https://doi.org/10.1017/S0954579400007318
Deater-Deckard K (1998) Parenting stress and child adjustment: some old hypotheses and new questions. Clin Psychol Sci Pract 5:314–332. https://doi.org/10.1111/j.1468-2850.1998.tb00152.x
Ritchie KL, Holden GW (1998) Parenting stress in low income battered and community women: effects on parenting behavior. Early Educ Dev 9:97–112. https://doi.org/10.1207/s15566935eed0901_5
Qi CH, Kaiser AP (2003) Behavior problems of preschool children from low-income families: review of the literature. Topics Early Child Spec Educ 23:188–216. https://doi.org/10.1177/02711214030230040201
McKeever VM, Huff ME (2003) A diathesis-stress model of posttraumatic stress disorder: ecological, biological, and residual stress pathways. Rev General Psychol 7:237–250. https://doi.org/10.1037/1089-2680.7.3.237
Zuckerman M (1999) Vulnerability to psychopathology: a biosocial model. Am Psychol Assoc, Wash. https://doi.org/10.1037/10316-000
Raffaelli M, Crockett LJ, Shen Y-L (2005) Developmental stability and change in self-regulation from childhood to adolescence. J Genetic Psychol 166:54–76. https://doi.org/10.3200/GNTP.166.1.54-76
Costello EJ, Copeland W, Angold A (2011) Trends in psychopathology across the adolescent years: What changes when children become adolescents, and when adolescents become adults? Trends in psychopathology across the adolescent years. J Child Psychol Psychiatry 52:1015–1025. https://doi.org/10.1111/j.1469-7610.2011.02446.x
Hankin BL, Young JF, Abela JRZ, Smolen A, Jenness JL, Gulley LD, Technow JR, Gottlieb AB, Cohen JR, Oppenheimer CW (2015) Depression from childhood into late adolescence: Influence of gender, development, genetic susceptibility, and peer stress. J Abnorm Psychol 124:803–816. https://doi.org/10.1037/abn0000089
Kubany ES, Leisen MB, Kaplan AS, Watson SB, Haynes SN, Owens JA, Burns K (2000) Development and preliminary validation of a brief broad-spectrum measure of trauma exposure: the Traumatic Life Events Questionnaire. Psychol Assess 12:210–224. https://doi.org/10.1037/1040-3590.12.2.210
Abidin RR (1995) Parenting stress index, third edition: professional manual. Psychological Assessment Resources Inc, Odessa
March JS, Parker JDA, Sullivan K, Stallings P, Conners CK (1997) The Multidimensional Anxiety Scale for Children (MASC): factor structure, reliability, and validity. J Am Acad Child Adolesc Psychiatry 36:554–565. https://doi.org/10.1097/00004583-199704000-00019
Baldwin JS, Dadds MR (2007) Reliability and validity of parent and child versions of the multidimensional anxiety scale for children in community samples. J Am Acad Child Adolesc Psychiatry 46:252–260. https://doi.org/10.1097/01.chi.0000246065.93200.a1
Kovacs M (1992) The Children’s Depression Inventory (CDI) manual. Multi-Health Systems, New York
Saylor CF, Finch AJ, Spirito A, Bennett B (1984) The Children’s Depression Inventory: a systematic evaluation of psychometric properties. J Consult Clin Psychol 52:955–967. https://doi.org/10.1037/0022-006X.52.6.955
Hayes AF (2009) Beyond Baron and Kenny: statistical mediation analysis in the new millennium. Commun Monogr 76:408–420. https://doi.org/10.1080/03637750903310360
von Hippel PT, Bartlett JW (2019) Maximum likelihood multiple imputation: faster imputations and consistent standard errors without posterior draws. Statist Sci 38.
Molina AP, Negriff S, Monro W, Mennen FE (2018) Exploring the relationships between maternal mental health symptoms and young children’s functioning in a low-income, Minority Sample. J Child Fam Stud 27:3975–3985. https://doi.org/10.1007/s10826-018-1225-y
Hoven CW, Duarte CS, Lucas CP, Wu P, Mandell DJ, Goodwin RD, Cohen M, Balaban V, Woodruff BA, Bin F, Musa GJ, Mei L, Cantor PA, Aber JL, Cohen P, Susser E (2005) Psychopathology among New York City Public school children 6 months after September 11. Arch Gen Psychiatry 62:545. https://doi.org/10.1001/archpsyc.62.5.545
Kim HK, Pears KC, Capaldi DM, Owen LD (2009) Emotion dysregulation in the intergenerational transmission of romantic relationship conflict. J Fam Psychol 23:585–595. https://doi.org/10.1037/a0015935
Wood JJ (2006) Parental intrusiveness and children’s separation anxiety in a clinical sample. Child Psychiatry Hum Dev 37:73–87. https://doi.org/10.1007/s10578-006-0021-x
Lyons-Ruth K, Block D (1996) The disturbed caregiving system: relations among childhood trauma, maternal caregiving, and infant affect and attachment. Infant Ment Health J 17:257–275. https://doi.org/10.1002/(SICI)1097-0355(199623)17:3%3c257::AID-IMHJ5%3e3.0.CO;2-L
Moehler E, Biringen Z, Poustka L (2007) Emotional availability in a sample of mothers with a history of abuse. Am J Orthopsychiatry 77:624–628. https://doi.org/10.1037/0002-9432.77.4.624
Barlow DH, Farchione TJ, Bullis JR, Gallagher MW, Murray-Latin H, Sauer-Zavala S, Bentley KH, Thompson-Hollands J, Conklin LR, Boswell JF, Ametaj A, Carl JR, Boettcher HT, Cassiello-Robbins C (2017) The unified protocol for transdiagnostic treatment of emotional disorders compared with diagnosis-specific protocols for anxiety disorders: a randomized clinical trial. JAMA Psychiatry 74:875. https://doi.org/10.1001/jamapsychiatry.2017.2164
Caspi A, Moffitt TE (2018) All for one and one for all: mental disorders in one dimension. Am J Psychiatry 175:831–844. https://doi.org/10.1176/appi.ajp.2018.17121383
Cole DA, Peeke LG, Martin JM, Truglio R, Seroczynski AD (1998) A longitudinal look at the relation between depression and anxiety in children and adolescents. J Consult Clin Psychol 66:451–460. https://doi.org/10.1037/0022-006X.66.3.451
Thompson RA (2001) Childhood anxiety disorders from the perspective of emotion regulation and attachment. In: Vasey MW, Dadds MR (eds) The developmental psychopathology of anxiety. Oxford University Press, Oxford, pp 160–182. https://doi.org/10.1093/med:psych/9780195123630.003.0008
Reitman D, Currier RO, Stickle TR (2002) A critical evaluation of the Parenting Stress Index-Short Form (PSI-SF) in a Head Start Population. J Clin Child Adolesc Psychol 31:384–392. https://doi.org/10.1207/153744202760082649
Morris AS, Robinson LR, Hays-Grudo J, Claussen AH, Hartwig SA, Treat AE (2017) Targeting parenting in early childhood: a public health approach to improve outcomes for children living in poverty. Child Dev 88:388–397. https://doi.org/10.1111/cdev.12743
Lupien SJ, McEwen BS, Gunnar MR, Heim C (2009) Effects of stress throughout the lifespan on the brain, behaviour and cognition. Nat Rev Neurosci 10:434–445. https://doi.org/10.1038/nrn2639
Wahler RG, Dumas JE (1989) Attentional problems in dysfunctional mother-child interactions: an interbehavioral model. Psychol Bull 105:116–130. https://doi.org/10.1037/0033-2909.105.1.116
Ammerman RT, Putnam FW, Chard KM, Stevens J, Van Ginkel JB (2012) PTSD in depressed mothers in home visitation. Psychol Trauma Theory Res Prac Policy 4:186–195. https://doi.org/10.1037/a0023062
Gardner F, Hutchings J, Bywater T, Whitaker C (2010) Who benefits and how does it work? Moderators and mediators of outcome in an effectiveness trial of a parenting intervention. J Clin Child Adolesc Psychol 39:568–580. https://doi.org/10.1080/15374416.2010.486315
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The researchers would like to acknowledge the families who participated in this investigation as well as the research team from the Pomona CARE Lab who carried out the project.
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Cho, B., Woods-Jaeger, B. & Borelli, J.L. Parenting Stress Moderates the Relation between Parental Trauma Exposure and Child Anxiety Symptoms. Child Psychiatry Hum Dev 52, 1050–1059 (2021). https://doi.org/10.1007/s10578-020-01087-1
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DOI: https://doi.org/10.1007/s10578-020-01087-1