Exploring Longitudinal Relationships Among Maternal Trauma History, Attachment Security, and Parenting Behaviors with Infants

Background and Purpose: According to betrayal trauma theory, early traumatic events perpetrated by attachment figures lead to more severe outcomes over time than less interpersonal forms of trauma. Unresolved attachment trauma impacts maternal mental health and parenting behaviors, thereby perpetuating intergenerational cycles of adversity. Mothers’ unresolved trauma on the Adult Attachment Interview (AAI), predicts frightening maternal behavior with infants which, in turn, forecasts adverse mental health outcomes among school aged children. Although there is notable congruence between betrayal trauma theory and studies on unresolved attachment among mothers, a maternal history of betrayal trauma, adult attachment security, and parenting behaviors remain unexamined. The purpose of this study was to explore betrayal trauma as an antecedent of maternal unresolved adult attachment status and frightening behaviors with infants, and to investigate whether unresolved attachment mediates the relationship between betrayal trauma severity and maternal frightening behaviors.

Methods: A mixed-methods approach was used to analyze secondary data from a longitudinal study following mothers and their first-born children (N=125) from the third trimester of pregnancy until the children were seven years old. A socioeconomically diverse group of mothers (Mean age=29) in the original study were administered the AAI prenatally, which was coded for unresolved attachment stemming from loss or abuse. Mothers’ interactions with infants were videotaped at 8 and 24 months postpartum to assess their frightening behaviors with previously validated coding scales. In the current study, content analyses of the AAI transcripts were used to identify and numerically rank the severity of maternal histories of betrayal trauma. Multiple and logistic regression analysis were conducted to examine relationships among these severity rankings, levels of maternal unresolved states of mind, and frightening behaviors, controlling for annual household income. The mediation model was tested using a percentile bootstrap estimation approach with 5000 samples.

Results: Findings revealed that betrayal trauma severity was significantly related to maternal unresolved attachment (b=.122, p<.000). A one-unit increase in betrayal trauma severity was associated with 1.146 times the odds of displaying frightening behaviors with 24-month-old children (95% CI [1.032-1.272]). Betrayal trauma severity did not predict frightening behaviors assessed at 8 months, and annual household income was not significantly related to any of the outcomes. An indirect mediation effect was found; higher levels of maternal betrayal trauma severity were associated with a greater likelihood of demonstrating frightening behaviors assessed within the first two years of a child’s life, as mediated by maternal unresolved states of mind (b=.028, bootstrapped SE=.018, 95% bootstrapped CI [.001-.069]).

Conclusions and Implications: This study was the first to analyze and establish relationships between maternal betrayal trauma severity, attachment, and parenting behaviors. Results were consistent with previous studies indicating that consequences of maternal unresolved trauma worsen as infants approach toddlerhood. The mediating role of unresolved attachment has important practice implications; interventions focusing on reorienting towards attachment security may attenuate the likelihood that mothers with severe histories of betrayal trauma will display frightening behaviors with their children, which would reduce children’s risk of adverse mental health outcomes. Future studies in this area are recommended.