How a Legacy of Trauma Affects Parent-Child Relationships

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Since the landmark study of adverse childhood events (ACEs) in 1998, we have known that childhood trauma is common and has lasting effects. In that study, among a sample of around 10,000 individuals, over half of all the people surveyed experienced at least one traumatic childhood event, and one-quarter experienced multiple. Experiencing these traumatic childhood events increased the risk for mental and physical health problems.

The more traumatic the events, the higher the likelihood of poor outcomes as an adult. These poor outcomes include substance abuse, depression, risky sexual behavior, obesity, heart disease, cancer, lung disease, and others.

In the last two decades, researchers have unpacked these associations, trying to understand the role that trauma plays in many aspects of physical and mental health. Recently, researchers Danielle Roubinov, Linda Luecken, and colleagues have developed a new theory on how childhood trauma can be transmitted across generations.

They suggest that when a mother experiences childhood trauma, that can go on to influence her bond with her own child. In effect, the trauma reaches forward to disrupt the normal back-and-forth engagement of mothers with their newborns.

The evidence for this theory comes from a long-term, large-scale study of Mexican American women in Arizona called "Las Madres Nuevas." In this study, low-income Mexican women in Maricopa county were followed from the period when they were pregnant with a child until over a decade after the child was born. Assessments were conducted regularly throughout this time on psychological functioning, physical health, and physiology.

The physiological measures included influences of the sympathetic (fight-or-flight) and parasympathetic (rest-and-digest) systems on the heart and levels of stress hormones (cortisol). There were also recordings made of mothers and children during play to gauge how they respond to each other. This rich set of measurements has yielded several insights that helped the researchers come to this conclusion.

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First, having more adverse childhood events could predict a mother's stress and mental health before she delivered. Women with more childhood trauma had more depression (before childbirth), more family stress, more daily hassles, more economic hardships, and experienced more negative life events.

Stress and depression before childbirth are associated with worse postpartum depression symptoms—so childhood trauma is, in a sense, setting mothers up to fail. They are in a worse situation when they are about to have a child, and that appears to make their postpartum depression worse.

Postpartum depression, in turn, influences children. When their mothers have worse postpartum depression symptoms, children tend to have worse behavioral outcomes. Postpartum depression can also make it difficult for mothers to deal with "difficult" or less emotionally well-regulated babies. Thus, the difficult situations mothers dealing with childhood trauma are in during pregnancy may translate into a more difficult relationship with their children.

This can be seen in the way the mothers and children interacted with each other. Researchers coded for "give and take" play in the videos of parent-children interactions. More of this behavior is considered positive for building the relationship. They also coded for intense emotional periods and big swings in mood. More of this behavior is considered negative because it indicates difficulty regulating emotions.

Mothers who were higher risk at birth—that is, who had the kind of stress that might have resulted from childhood trauma—had less "give and take" play and more episodes of poor emotion regulation with their infants. Difficulty in this mother-child interaction was also related to higher levels of stress hormones in the infants.

These poor interaction patterns also predicted poorer self-regulation in children and more behavioral problems when the child was 3 years old. Poor interaction patterns also predicted depression in mothers after 3 years.

Putting all these findings together, Roubinov and colleagues were able to trace out a path by which childhood trauma is passed forward to the next generation:

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1. A woman experiences trauma as a child.
2. This trauma leads the woman to experience more stress and depression and to be at risk for other health problems.
3. When this woman becomes pregnant, these stressors affect how she will respond to childbirth.
4. Because she has more stress, the woman is more likely to experience postpartum depression.
5. This postpartum depression disrupts the bond she is trying to form with her child. She is less able to engage fully and positively with her child.
6. The poorer interaction and bonding end up harming both mother and child. The child is more likely to be stressed and have behavioral problems, and the mother is more likely to be depressed.

It's a long path, but there is now research on each link in this chain. Seeing it, we can begin to explore ways to disrupt this transmission of harm from one generation to the next. This may be through specialized maternal health or parent-child therapies.

What the evidence shows is that maternal mental health is not something that's isolated from the rest of the family. It's something that influences the entire family system, including the bond formed between mother and child. Healing needs to occur, then, for both the mother and the bond she forms with her child.

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