Maternal Childhood Trauma, Mother-Child Interactions, and Developmental Course of Internalizing Behavior from Preschool to Preadolescence

Background: The intergenerational effects of MCT may be transmitted to children through exposure to suboptimal caregiving environments, including dysfunctional parent-child interactions. However, current understanding of the mechanisms underlying the intergenerational transmission is limited due to cross-sectional design of existing research. This study investigated the long-term association of MCT with the developmental course of their children’s internalizing behavior from preschool to preadolescence, while assessing the mediating role of dysfunctional mother-child interactions.

Methods: Participants were 307 mother-child (46% boys) dyads, who were urban, of low socioeconomic status, enrolled at childbirth for a prospective study of prenatal cocaine exposure. Internalizing behavior was assessed using caregiver-reported Child Behavior Checklist at ages 4, 6, 9, 10, 11, and 12. At offspring age of 4 years, the Childhood Trauma Questionnaire was used for a retrospective assessment of maternal experience of childhood trauma, and the Parenting Stress Index for mother-child dysfunctional interactions. Maternal psychological distress was assessed via the Brief Symptom Inventory at all time points. Using Mplus v.8.8 with full information maximum likelihood estimation, extended Latent Growth Curve Modeling (LGCM) combined with a path model was conducted to examine the association of MCT with children’s internalizing behavior trajectory, adjusting for time-varying (maternal psychological distress) and time-invariant covariates (child gender, race, prenatal cocaine exposure status, child-perceived life-time violence exposure assessed at age 12; caregiver age, education). Mother-child interactions, an intermediate variable, was modeled via linear regression in the extended LGCM.

Results: The unconditional LGCM fit the data, χ²(16)=21.367, p=.165; CFI=.988; TLI=.989; RMSEA=.033 (90%CI=.000-.066). At age 4, children had an average internalizing behavior raw score of 4.35 (p<.001), which increased over an 8-year period (mean slope=0.17, p<.001). The extended conditional LGCM fit the data, χ²(210)=1804.69, p<.001, CFI=.913, TLI=.911, RMSEA=.047 (90%CI=.038-.056). Higher MCT was associated with higher levels of dysfunctional mother-child interactions (β=0.337, p<.001), which in turn was associated with higher overall levels (intercept) of children’s internalizing behavior (β=0.447, p<.001), resulting in a significant indirect association (standardized estimate for the indirect effect=0.151, SE=0.037, p<.001). There were no associations of MCT with the intercept and the rate of change (slope) in internalizing behavior, either directly or indirectly through mother-child interactions. Maternal psychological distress was related to concurrent internalizing behavior across all ages (ps<.001). No other covariates were significant.

Conclusions and Implications: MCT was associated with higher overall levels of children’s internalizing behavior through dysfunctional mother-child interactions, suggesting a lasting effect of MCT on child internalizing behavior observed at 4 years and persisting until age 12, via parent-child relationships. Although the change of increase in internalizing behavior over time was not affected by the severity of MCT, children, who exhibited higher levels of internalizing behavior during preschool due to dysfunctional mother-child interactions associated with higher MCT, were likely to maintain these elevated levels throughout childhood. Trauma informed two-generations interventions, such as parent management training, may be helpful in mitigating the intergenerational transmission of violence. Research that expands knowledge of biological mechanisms, such as epigenetic modifications, and environmental protective factors as pathways underlying the intergenerational transmission of violence is warranted.