Intergenerational Transmission of Trauma Among Veterans: Past Trauma, Posttraumatic Stress Disorder, and Parental Pre-Mentalization

Background: Parenting acts as the primary socialization system for young children. Attachment theory states that parents' appropriate interpretation of their children's internal states, e.g., parental mentalization, contributes to parental sensitivity to foster child self-regulation and child's own mentalization. Unfortunately, parents' traumatic experiences and symptoms may substantially limit their mentalizing capacities and transmit trauma to their offspring. Some parents developed pre-mentalization mode – a distorted way of interpreting their child's subjectivity as malevolent – to cause child maltreatment and child behavioral and emotional problems. Veterans have posttraumatic stress disorder (PTSD), but less research has examined how veteran parents' PTSD would influence their parenting. Neither did studies explore how the interaction between veteran parents' past trauma before joining the military and their current PTSD affect their parenting. To inform interventions to break the cycle of generational trauma in military families, this study examines the associations between veteran parents' past trauma before joining the military, PTSD, and parental pre-mentalization.

Methods: We collected data from 509 veteran parents with young children below the age of 10 via Qualtrics online research panel in 2021. Parents' past trauma before joining the military was assessed by the 11 items from the Deployment Risk & Resilience Inventory-2; parents' PTSD was measured by the 17 items from the PTSD Checklist-Military Version, and parental pre-mentalization was assessed by the 6-item pre-mentalization subscale of the Parental Reflective Functioning Questionnaire. A multiple regression analysis was conducted to examine the association between parental pre-mentalization and parents' PTSD, followed by a moderation analysis to test the hypothesis that the positive effect of parents' PTSD on parental pre-mentalization would be stronger among parents who had a higher level of past trauma. Relevant covariates included parents' age, gender, race, education, relationship status, household income, military rank, previous deployment status, and child age and gender.

Results: The sample was predominantly male (76.2%) with a mean age of 39 years. Veterans were parents to boys (60.6%) and girls (39.4%) at an average of 6.5 years. Participants were predominantly White/European American (78.6%) with at least a bachelor's degree (67.8%), and 64.4% of them experienced deployment when serving in the military. The annual household income was relatively high, with over 50% of the participants reporting above $70,000. Most participants (81.1%) were married. After controlling covariates, results suggested that parental PTSD was associated with parental pre-mentalization (β = 0.28, p <.001). In addition, a significant interaction effect was identified (β = 0.24, p =0.48), which suggested a stronger positive impact of parents' PTSD on parental pre-mentalization among veteran parents who experienced higher levels of past trauma before joining the military.

Conclusion and Implications: This study suggested that veterans' PTSD will significantly compromise their parental mentalization, which may later jeopardize their child's development. The impacts of parental PTSD would be aggravated for veterans who experienced past trauma before joining the military. The mentalization-based intervention can be tailored to decrease veterans' parental pre-mentalization to break the cycle of trauma among the veteran population.