Associations between Maternal Posttraumatic Stress Symptoms, Depressive Symptoms, and Their Children's Internalizing Symptomatology and Externalizing Behavior Problems

Background: Maternal mental health problems are risk factors for a host of negative psychosocial outcomes for children including both internalizing and externalizing behaviors. While the impact of maternal depressive symptoms on children’s development has been established within the literature much less is known about the impact of trauma and whether trauma and maternal depression interact to influence children’s outcome. The aims of the current study were two-fold. First, we sought to examine whether maternal posttraumatic stress symptoms were associated with their children’s internalizing symptomatology and externalizing behavior problems. Second, we sought to determine whether these associations were moderated by maternal depressive symptomatology.

Methods: The sample came from the first wave of an ongoing longitudinal study of maltreated and comparison children and consisted of 208 mothers and their biological children ages 9-12. Measures included the Brief Symptom Inventory (BSI), the Youth Symptom Survey Checklist parent report of their own symptoms (YSSC), the Children’s Depression Inventory (CDI), the Multidimensional Anxiety Scale for Children (MASC), the Youth Symptom Report Delinquency and Aggression subscales.   The trauma measure was categorized as 1) Posttraumatic Stress Disorder (PTSD: met all diagnostic criteria); 2) Partial PTSD (met all but one of the diagnostic criteria); and 3) No PTSD (met only one or no diagnostic criteria). Associations between the variables were examined using path analysis and multiple group strategies, controlling for maltreatment to examine whether mothers’ self-reported depressive symptoms moderated the associations.

Results: For the full sample, the analysis indicated that meeting PTSD criteria was positively and significantly related to both children’s internalizing symptomatology (B = 20.43, p < .001) and externalizing behavior problems (B = 4.73, p < .001). There were no significant associations for Partial PTSD and No PTSD. Results of multiple group models indicated that mothers’ depressive symptoms did not moderate the associations.

Conclusions: Results indicated that maternal trauma symptoms had deleterious impacts on children’s internalizing symptomatology and externalizing behavior problems when symptoms met criteria for a diagnosis of PTSD. Surprisingly, no evidence was found in the current study that maternal depression moderated the associations. This study adds to the sparse literature on maternal trauma and children’s outcomes indicating that trauma in mothers increases their children’s internalizing and externalizing problems.  Reasons for the lack of findings on depression will be explored.  Future research should focus on examining the longitudinal associations of maternal trauma symptoms and specific psychosocial outcomes for the children. Additionally, future research should examine the possible mediators in these associations, including parenting attitudes and behaviors, parenting stress, and family environment. Shedding light onto these associations could help identify possible avenues for effective interventions for traumatized mothers and their children.