In recent years, more and more attention has been placed on the concept that the psychological development of a child is the result of a combination of genetics and environmental factors, dating back from previous generations.
This means that the mental health of women in its entirety, not just during pregnancy or post-natal periods, is relevant to the future of the children.
In this blog, I explore the role of maternal stress, and especially of maternal experience of maltreatment, on the development of their offspring.
Typically, the word ‘maltreatment’ is associated with physical or sexual violence, however, the term also includes psychological violence and neglect.
Recent studies, including from our own research group, have shown that a history of such abuse and maltreatment in a mother can affect the offspring by increasing their risk of developing mental health problems as children and adolescents.
There are many mechanisms that could explain this transmission of risk from one generation to the next.
One explanation could be epigenetic modifications of DNA.
Epigenetic modifications are changes of the DNA chain determined by the environment. These modifications alter the expression of the genetic makeup of an individual, so that some piece of DNA, leading to specific proteins, tend to be produced in a more or less abundant way.
Epigenetic changes induced by the experience of maltreatment in mothers could be transmitted to the offspring by changes in the ‘utero’ environment.
For example, a history of child maltreatment can lead to permanently increased levels of stress hormones in the mothers’ body, subsequently affecting the intrauterine environment, where the fetus grows.
The change in the intrauterine environment, through such epigenetic mechanisms, can modify brain development, and therefore increase the child’s exposure to mental illness later in life.
Other studies show that children of abused mothers present an unsafe style of attachment, which could also explain the increased susceptibility to mental health problems.
But what is attachment?
Attachment theory is the result of work carried out between the 1960s and 1980s by psychoanalyst, John Bowlby.
Bowlby argued that “attachment is an integral part of cradle-to-grave human behavior”. The capacity of the human being to develop a harmonious personality depends mainly on having an adequate attachment to a mother figure (or to a similarly important figure).
A secure attachment style is therefore a reflection of a present and sensitive mother (or caregiver) who is able to respond to the needs of the child.
A child with a secure attachment style uses his or her parents as a base to explore the environment. Children appear stressed by separation and are reassured when reunited.
On the other hand, a child with an unsafe attachment style (technically defined as ‘anxious-avoidant, ambivalent or disorganized type’), is not able to use the caregiver as a basis for exploration, and shows less adaptive ability at the time of separation and reunion
An insecure style of attachment could make relationships in adolescence and adulthood harder. Difficulties with self-esteem, self-reflection and trusting peers, maybe at the heart of this issue.
Studies have shown that the style of attachment that most closely correlates with the history of maternal child maltreatment is the disorganized type.
Mothers with childhood abuse and a history of neglect have less ability to elaborate traumatic experiences and their own emotional experiences. This may results in an inability to respond to the child’s requests, and to attend to the child’s needs.
As a consequence, the child may also develop an ‘unsafe attachment style’.
These factors may contribute to the development of mental health problems in the child, such as conduct disorder or depression in adolescence and early adulthood, and also to perpetuating the problem from one generation to next.
Biological studies have explained this phenomenon by demonstrating that mothers who are exposed to maltreatment during childhood, especially if they later developed post-partum depression, show altered levels of oxytocin. Oxytocin is the hormone that is naturally produced during the postpartum, determining the mother’s ability to bond with her baby.
How can we help mothers who have suffered from childhood maltreatment?
In light of what we have discussed, it is clear that early identification of mothers with a history of maltreatment could be helpful in order to identify this vulnerability, and for putting in place a support framework for the mothers and for the mother-infant dyads. This could be fundamental not only for the well-being of the woman, but also for her child.
Maternal and mental health clinical services should aim to identify women at risk before, or at the beginning, of pregnancy. This would allow professionals to provide the necessary care and assistance early on, involving the whole family where possible.
Social support (a heathy network of family and friends) is essential, and, in the more severe cases, cognitive behavioural psychotherapies or family supportive psychotherapies are recommended. As we said before in a previous blog, in many countries psychological therapies are rarely available in the public health services — but in the UK, luckily, they are.
By embracing the psychological and social needs of mothers who have suffered from childhood maltreatment, we will able to stop this vicious cycle of transmission of mental health problems from one generation to the next, and from a mother to their children.
header image source: Valeria Zoncoll on Unsplash