Methods. This study included both quantitative and qualitative research components. The quantitative inquiry employed a cross-sectional survey design to examine the pathways of trauma transmission. The sample of parent participants (N=202) for the quantitative inquiry was recruited from an online data collection platform – Amazon Mechanical Turk. Structural equation modelling with Mplus 7 identified the mechanisms of trauma transmission. To enrich the understanding of the cycle of intergenerational trauma, 12 parent participants from low-income families recruited from a mental health agency answered corresponding questions regarding families’ lived experience during in-depth interviews. Participants shared their perceptions on helpful/unhelpful strategies about breaking the cycle of inter-generational trauma. Grounded theory was employed in the processes of data collection, coding, and analysis. ATLAS.Ti 8 was used for data management and coding. Strategies of expert consultation, audit trail, peer debriefing, and member checking were employed to ensure the trustworthiness.
Results. The quantitative inquiry showed parental childhood maltreatment ACEs was directly and indirectly associated with child behavioral problems and functioning with two important mediators, i.e., parental emotion regulation and mentalization (parents’ capacity to understand their child’s mental states). There was no direct or indirect effect of parental household dysfunction related ACEs on child outcomes. The qualitative inquiry revealed information to inform specific clinical strategies and facilitate the therapeutic process of breaking the trauma transmission: building an authentic therapeutic relationship, employing a strengths-based approach, and creating facilitating systems-level factors. Social service systems should ensure that services being delivered consistently and continuously in a mentally and physically safe environment. It is also necessary to facilitate inter-agency collaborations among social service systems to increase a continuum of care. Families’ lived experience also showed the influence of neighborhood environment on family lives, suggesting a commitment at the policy level to build community resilience to break family-level trauma transmission.
Conclusions and Implications. Study findings inform family-focused, trauma-informed care in terms of screening, prevention, and intervention at practice and policy levels. Considering that severer effects of trauma transmission may manifest among racial/ethnic groups and people of lower socioeconomic status (Metzler et al, 2017), the research findings can inform approaches to reduce racial and economic inequalities. By targeting parenting processes, including poverty and unemployment that could hinder effective parenting while providing services along with a policy commitment in a trauma-informed manner, practitioners and policy-makers can effectively alleviate negative effects of trauma to promote racial/social justice by breaking the cycle of inter-generational trauma and its correlates among the most vulnerable and marginalized groups.