Glaus Jennifer, Moser Dominik A, Rusconi Serpa Sandra, Jouabli Sondes, Turri Fiorella, Plessen Kerstin J, Schechter Daniel S
Division of Child and Adolescent Psychiatry, Department of Psychiatry, Lausanne University Hospital (CHUV) and University of Lausanne, Lausanne, Switzerland.
Faculty of Psychology, University of Geneva, Geneva, Switzerland.
Front Psychiatry. 2022 Feb 23;13:820652. doi: 10.3389/fpsyt.2022.820652. eCollection 2022.
Adults who have histories of childhood trauma have been noted to display greater somatization, dissociative symptoms and affect dysregulation. What happens in the parent-child relationship when those traumatized children become parents? A potential link to somatization in the child has been suggested by several prior studies. Children who have early attachment disturbances had more physical complaints if their mothers displayed less maternal sensitivity during observed parent-child interactions. Yet, the intergenerational link between maternal and child somatization has not been sufficiently explored in a longitudinal study in order to understand the potential impact of maternal trauma history and related psychopathology on subsequent child somatization and psychopathology.
This paper examined prospective, longitudinal data of 64 mother-toddler dyads (mean age = 2.4 years, SD = 0.7) who were later studied when children had a mean age of 7 years. Mothers with and without histories of interpersonal violence (IPV; physical/sexual abuse and/or family violence exposure) were included. Mothers with IPV histories were oversampled. Linear and Poisson regression models were used to test the associations between maternal IPV-related post-traumatic stress disorder (PTSD) with maternal somatization severity when children were toddlers, and between maternal somatization and maternal interactive behaviors with child somatization by maternal report and clinician-rated assessment at school-age.
Maternal PTSD severity was significantly associated with increased maternal somatization severity ( = 0.031). Maternal somatization severity during the child's early childhood predicted both maternal report of child somatization ( = 0.011) as well as child thought problems ( = 0.007) when children were school-aged. No association was found between maternal somatization and child-reported psychopathology. The study did not find that maternal alexithymia, caregiving behaviors or child exposure to violence contributed significantly to the model examining the association between maternal and child somatization.
The results are in line with the hypothesis of intergenerational transmission of somatization in the context of IPV and related maternal PTSD during formative early development. We interpret this as an expression of psychological distress from mother to child, as maternal trauma and pathology affect the caregiving environment and, thus, the parent-child relationship. The authors conclude with a discussion of implications for parent-infant and early childhood intervention.
有童年创伤史的成年人被发现表现出更多的躯体化症状、解离症状和情感失调。当那些受过创伤的孩子成为父母时，亲子关系中会发生什么？先前的几项研究表明，这与孩子的躯体化之间可能存在联系。如果母亲在观察到的亲子互动中表现出较低的母性敏感性，那么早期依恋关系紊乱的孩子会有更多的身体不适。然而，为了了解母亲的创伤史和相关精神病理学对随后孩子的躯体化和精神病理学的潜在影响，母儿躯体化之间的代际联系在纵向研究中尚未得到充分探索。
本文研究了64对母婴二元组（平均年龄 = 2.4岁，标准差 = 0.7）的前瞻性纵向数据，这些母婴在孩子平均年龄为7岁时进行了后续研究。纳入了有和没有人际暴力史（IPV；身体/性虐待和/或家庭暴力暴露）的母亲。有IPV史的母亲被过度抽样。线性回归模型和泊松回归模型用于检验母亲与IPV相关的创伤后应激障碍（PTSD）与孩子幼儿期时母亲的躯体化严重程度之间的关联，以及母亲的躯体化和母亲的互动行为与学龄期通过母亲报告和临床医生评定的孩子躯体化之间的关联。
母亲PTSD的严重程度与母亲躯体化严重程度的增加显著相关（ = 0.031）。孩子幼儿期时母亲的躯体化严重程度预测了孩子学龄期时母亲报告的孩子躯体化情况（ = 0.011）以及孩子的思维问题（ = 0.007）。未发现母亲的躯体化与孩子报告的精神病理学之间存在关联。该研究未发现母亲述情障碍、养育行为或孩子接触暴力对检验母儿躯体化关联的模型有显著贡献。
研究结果符合在早期发育形成期IPV及相关母亲PTSD背景下躯体化代际传递的假设。我们将此解释为心理困扰从母亲传递给孩子，因为母亲的创伤和病理状态会影响养育环境，进而影响亲子关系。作者最后讨论了对母婴和幼儿干预的启示。
