Exploring Longitudinal Relations between Mother's Adult Attachment Security, Dissociation, and Children's Depressive Symptoms

Background and Purpose: Attachment disorganization in infancy has been shown to forecast later emotional and behavior problems. Processes underlying this association are less clear. Mothers’ unresolved trauma on the Adult Attachment Interview (AAI), assessed by lapses in the monitoring of discourse and/or reasoning, predicts frightening/anomalous maternal behavior with infants which, in turn, forecasts infant disorganization. Mothers classified as unresolved more often report dissociative experiences which are thought to underlie displays of frightening behavior with their child. Experiencing dissociative states on the part of the mother may increase the child’s risk of developing emotional problems since experiencing dissociation makes it more difficult for mothers to reliably support the child when needed. Thus, this study examined antecedents and correlates of maternal dissociative states. We hypothesized that 1) mothers’ unresolved trauma assessed prenatally will predict mothers’ dissociative states 7 years later, and 2) after controlling for mothers’ unresolved trauma (assessed prenatally), and frightening behaviors with their infants (assessed when the infant was 8 months old), mothers’ dissociative states would be related to their ratings of their children’s depressive symptoms at age 7.

Methods: Mothers (N=125) were recruited during third trimester of pregnancy and followed over time. Mothers (mean age=29 years old) were mostly white, and their socioeconomic status ranged from poverty to upper middle class. Mothers were administered the AAI prenatally, which was coded for unresolved trauma stemming from loss or abuse. Mother-infant interactions were videotaped during play, feeding and a clothes’ change at 8 months to assess their frightening behavior, using scales developed by Main & Hesse (1995). When their children were 7-year-old, mothers remaining in the study (N = 40) completed the Dissociative Experiences Scale (DES), a 28-item screening tool for dissociation with 3 subscales (depersonalization/derealization, dissociative amnesia, and absorption) and the Child Behavior Checklist (CBC) to assess their child’s mental health. 

Results: Mothers’ unresolved trauma assessed prenatally was predictive of mothers’ dissociative symptoms 7 years later (B = .77, p = .03).  Dissociative symptoms predicted mothers’ reports of their children’s depressive symptoms marked by anxiety when the children were 7 years old, after controlling for mothers’ unresolved trauma, and frightening behavior (B = .53, p = .01).  Also, mothers’ dissociative symptoms (B = .46, p = .03) and mothers’ frightening behaviors (B = 1.13, p = .04) were both significantly related to maternal reports of children’s withdrawn depression.

Conclusions and Implications: These findings are consistent with previous research establishing relations between maternal unresolved trauma, maternal dissociation, and adverse child mental health outcomes. Due to the connections found between maternal disorganized/unresolved attachment, dissociation, and mental health problems in children over time, identifying disorganized/unresolved attachment among pregnant women or during the early stages of a child’s life may provide an important window of opportunity for those specializing in preventative interventions.