Maternal History of Adverse Experiences and Posttraumatic Stress Disorder Symptoms Impact Toddlers’ Early Socioemotional Wellbeing: The Benefits of Infant Mental Health-Home Visiting

Abstract

BackgroundThe present study examined the efficacy of the Michigan Model of Infant Mental Health-Home Visiting (IMH-HV) infant mental health treatment to promote the socioemotional wellbeing of infants and young children. Science illuminates the role of parental “co-regulation” of infant emotion as a pathway to young children’s capacity for self-regulation. The synchrony of parent–infant interaction begins to shape the infant’s own nascent regulatory capacities. Parents with a history of childhood adversity, such as maltreatment or witnessing family violence, and who struggle with symptoms of post-traumatic stress may have greater challenges in co-regulating their infant, thus increasing the risk of their children exhibiting social and emotional problems such as anxiety, aggression, and depression. Early intervention that targets the infant–parent relationship may help buffer the effect of parental risk on child outcomes.MethodsParticipants were 58 mother–infant/toddler dyads enrolled in a longitudinal randomized control trial testing the efficacy of the relationship-based IMH-HV treatment model. Families were eligible based on child age (<24 months at enrollment) and endorsement of at least two of four socio-demographic factors commonly endorsed in community mental health settings: elevated depression symptoms, three or more Adverse Childhood Experiences (ACEs) parenting stress, and/or child behavior or development concerns. This study included dyads whose children were born at the time of study enrollment and completed 12-month post-baseline follow-up visits. Parents reported on their own history of ACEs and current posttraumatic stress disorder (PTSD) symptoms, as well as their toddler’s socioemotional development (e.g., empathy, prosocial skills, aggression, anxiety, prolonged tantrums).ResultsMaternal ACEs predicted more toddler emotional problems through their effect on maternal PTSD symptoms. Parents who received IMH-HV treatment reported more positive toddler socioemotional wellbeing at follow-up relative to the control condition. The most positive socioemotional outcomes were for toddlers of mothers with low to moderate PTSD symptoms who received IMH-HV treatment.ConclusionResults indicate the efficacy of IMH-HV services in promoting more optimal child socioemotional wellbeing even when mothers reported mild to moderate PTSD symptoms. Results also highlight the need to assess parental trauma when infants and young children present with socioemotional difficulties.

Enrollment and outcomes of home visiting for mothers with and without a history of out‐of‐home care

“…It may be that mothers with a history of out‐of‐home care who also experience poorer mental health and lower educational attainment face additional barriers to enrollment and engagement in home visiting. While previous research suggests that the children of mothers who have experienced maltreatment or trauma have high rates of developmental delay (Folger et al., 2018), there are several other contextual factors (e.g., parenting practices, access to early care, and education) that could contribute to why no significant differences in screening results between groups were detected in this study, as other home visiting research has shown improvement in the mental health of infants and children of mothers with a history of maltreatment (Ribaudo et al., 2022).…”

“…Those with a history of out-of-home care experience poorer mental health outcomes compared to the general population and, among those who become parents, face increased barriers to supporting the mental health and wellbeing of their infants (Larrieu et al, 2008;Shpiegel et al, 2017Shpiegel et al, , 2020. Early childhood home visiting programs for new mothers and their children could address some of these challenges (Ribaudo et al, 2022;Sama-Miller et al, 2019). The purpose of this study was to examine differences in engagement in home visiting for mothers with and without a history of out-of-home care.…”

“…For example, a strong interpersonal support network is known to lessen the effects of maternal depression on child outcomes (Goodman & Gotlib, 1999), and social support is an identified area of need for young adults with a history of out‐of‐home care (Greeson et al., 2015). Although some research has demonstrated positive effects of home visiting on the mental health of infants and children whose mothers have a self‐reported history of childhood maltreatment (Ribaudo et al., 2022; Shenk et al., 2017), there has been insufficient research to support the benefits of home visiting in women with a history of out‐of‐home care because no studies have specifically examined home visiting in this population. Separation from families of origin, experiences with child welfare system oversight, transiency in placement during childhood, and other characteristics unique to out‐of‐home care may also contribute to barriers to enrollment for these women compared to peers.…”

Symptoms of post-traumatic stress disorder in parents of preterm newborns: A systematic review of interventions and prevention strategies

“…However, given the higher prevalence of PTSD in parents of preterm newborns (up to 53% in mothers and 33% in fathers) ( 4 ) with respect to general postpartum population (20.7% in mothers, 7.2% in fathers at 1 month post-partum) ( 58 ), interventions for PTSD prevention could be offered to all parents of NICU-admitted infants. A further reason for offering interventions for PTSD prevention and treatment to all parents of preterm babies is that parents with PTSD have greater difficulties in co-regulating their infants, thus increasing the risk of their children exhibiting social and emotional problems such as anxiety, aggression, depression and disorganized behavior ( 59 , 60 ). Given other long-term consequences of parental PTSD on infants [e.g., poorer cognitive outcome ( 61 ), sleeping and eating difficulties ( 62 )], and the importance of the first months of life for brain and stress-system development, prevention and early treatment of parental PTSD is even more important ( 63 ).…”

Trajectories of parental posttraumatic stress disorder and children's mental health following Super Typhoon Lekima: The mediating role of feeling of safety

“…In the coping trajectory group, parents focus on actively coping with or fighting against the distressing psychological problems. However, this parental struggle itself may serve as a traumatic stimulus for children (Ribaudo et al, 2022). When children witness their parents struggling with trauma events, they may perceive the magnitude of their parents' traumatic experience, which could potentially result in higher levels of PTSD symptoms in children.…”