Child abuse history in teen mothers and parent–child risk processes for offspring externalizing problems
Introduction
Despite the steady decline in adolescent pregnancies, the US still has the highest teen birth rate among developed countries (Sedgh, Finer, Bankole, Eilers, & Singh, 2015). Many teen mothers have been exposed to multiple traumatic and stressful events during childhood that affect their psychological functioning and quality of life both before and after the birth of their child (Beers & Hollo, 2009). The same adverse childhood experiences that may have contributed to these mothers’ early pregnancy might also influence the health and well-being of their offspring (Hillis et al., 2004). For instance, higher rates of teen pregnancy are evident in mothers with a history of child maltreatment (Madigan, Wade, Tarabulsy, Jenkins, & Shouldice, 2014), and the negative psychological and social consequences of child abuse can extend across generations (e.g., Collishaw, Dunn, O’Connor, & Golding, 2007). Research suggests that mothers who have been exposed to child maltreatment may transfer risk for poor social, emotional, and physical well-being to their offspring (e.g., Brand et al., 2010, Noll et al., 2009).
Although the majority of mothers with a history of maltreatment do not victimize their own children (i.e., do not themselves become perpetrators) (e.g., Thornberry & Henry, 2013), offspring of teen mothers with an abuse history are at increased risk for being referred to authorities regarding child protection concerns (Dixon et al., 2005, Spieker et al., 1996). Child maltreatment is considered a major public health concern, and more recent intervention efforts focus on the prevention versus treatment of child abuse and neglect (Prinz, Sanders, Shapiro, Whitaker, & Lutzker, 2009). To better understand the prevention of child maltreatment, it is important to examine mechanisms implicated in intergenerational cycles of psychosocial risk for family adversity. Parents’ history of adverse childhood experiences, such as abuse, may operate as distal risk factors for similar adverse outcomes in their offspring, by way of impacting the quality of the parent–child relationship (Belsky, 1993). Indeed, disrupted patterns of parent–child interaction appear to be proximal risk factors associated with child maltreatment. Some of these factors include high-risk parenting (e.g., harsh discipline, criticism), a disconnected or dysfunctional parent–child relationship, and child externalizing problems (e.g., persistent noncompliance, aggression) (Belsky, 1993, Cummings and Berkowitz, 2014). Of significance for informing the design of targeted interventions for maltreatment prevention in high-risk families, this longitudinal study evaluated the impact of teen mothers’ abuse history on these family-level risk factors assessed at different developmental stages.
Adolescent mothers, in general, have a heightened risk for disrupted caregiving due to their young age and lower cognitive readiness for parenting (Beers & Hollo, 2009). Those that have survived child maltreatment, however, may face even greater challenges in parenting (de Paúl & Domenech, 2000). Early childhood is a stressful period for many parents as children strive for greater autonomy, yet require high levels of guidance and emotional support. Parents with a history of child abuse may be more likely to demonstrate hostile parenting (e.g., critical and abrasive behavior toward child) during this developmental stage, due to poor emotion regulation (Smith, Cross, Winkler, Jovanovic, & Bradley, 2014) and cognitive biases toward aggressive responding in relationships (Berlin, Appleyard, & Dodge, 2011). Although prior research supports an association between parents’ abuse history and hostile parenting, there are mixed findings with respect to whether a history of sexual or physical abuse in parents most strongly predicts elevated hostility toward their child (e.g., Banyard, 1997, Barrett, 2009). Considering the significant co-occurrence between these two types of abuse (Madigan et al., 2014), other studies have examined their combined effects. Past findings suggest that parents with a history of both sexual and physical abuse (i.e., dual abuse) are more likely to exhibit hostile parenting, compared with parents with a history of sexual or physical abuse only (Dubowitz et al., 2001, Ehrensaft et al., 2015). This finding is in line with the view that exposure to different types of abuse has stronger associations with adverse outcomes than repeated exposure to a single type of abuse (Finkelhor et al., 2007, Higgins and McCabe, 2001, Madigan et al., 2014).
In addition to influencing parenting behavior, parents’ maltreatment history can impact the quality of the parent–child relationship. Prior maltreatment in childhood may contribute to negative mental representations (or internal working models) of attachment experiences with parents’ own caregivers, and consequently undermine their ability to sensitively attend and respond to the needs of their offspring (George, Solomon, Cassidy, & Shaver, 2008). Prior research shows that mothers who have been exposed to child sexual abuse tend to experience more difficulties bonding with their child (DiLillo and Damashek, 2003, Roberts et al., 2004, Wright et al., 2012), and one past study using a sample of teen mothers demonstrated an association between their physical abuse history and heightened difficulties in the mother–infant relationship (Milan, Lewis, Ethier, Kershaw, & Ickovics, 2004). Furthermore, exposure to child sexual abuse—both alone and in combination with physical abuse—is predictive of less parental availability in the parent–child relationship (Ehrensaft et al., 2015). Young children rely on caregivers to attend to their emotional needs for security and comfort; thus, a lack of parental availability and responsiveness contributes to patterns of attachment insecurity. Indeed, offspring of mothers with a history of child abuse are at elevated risk for developing ineffective and disrupted attachment strategies (Kwako et al., 2010, Lyons-Ruth and Block, 1996). Further research is needed, however, to evaluate relations between abuse history in teen mothers and attachment security in infancy. In sum, prior exposure to maltreatment in parents is a significant risk factor for problematic relations with their offspring in early childhood, including disruptions in the parent–child attachment relationship and hostile parenting.
The majority of survivors of child maltreatment do not victimize their own children; however, they may inadvertently transmit risk for psychopathology in their later offspring. For instance, results from longitudinal research demonstrate associations between mothers’ exposure to child maltreatment and offspring problem behavior in preschool and early elementary school (Collishaw et al., 2007, Madigan et al., 2015, Myhre et al., 2014, Rijlaarsdam et al., 2014, Roberts et al., 2004). Some of these studies also evaluated parenting mechanisms that may (partially) account for this association, considering that ineffective parenting is involved in the development of early-onset externalizing problems (Patterson, Reid, & Dishion, 1992). Results indicated that parental hostility (e.g., harsh discipline) and/or parental affective symptoms (e.g., distress and anxiety) were significant mediating factors in the relationship between parents’ self-reported maltreatment history and offspring behavior problems (Collishaw et al., 2007, Myhre et al., 2014, Rijlaarsdam et al., 2014, Roberts et al., 2004). Taken together, these findings support an indirect pathway linking parents’ own experiences of maltreatment to later child behavior problems via dysfunctional parenting processes.
The aforementioned studies have several significant limitations. Namely, these studies used general measures of child maltreatment (i.e., combined different forms of maltreatment) (Collishaw et al., 2007, Myhre et al., 2014, Rijlaarsdam et al., 2014), or focused solely on child sexual abuse (Roberts et al., 2004). Thus, we do not know whether offspring of mothers with exposure to sexual or physical abuse only, or a combination of these two types of abuse, are most at risk for negative developmental outcomes. Furthermore, the abovementioned studies have relied on self-reports of parental hostility, and attachment security is yet to be evaluated as a potential mediator (to our knowledge). Developmental theory and longitudinal research suggests differential effects of relational (e.g., lack of emotional connection) and coercive (e.g., harsh discipline) family processes on the emergence of problem behavior (Kochanska, 2002, Pasalich et al., 2015, Patterson et al., 1992). Prior results based on a subset of the sample included in this study showed that attachment security and maternal hostility were not significantly associated and independently predicted externalizing problems in Grade 1 (Vando, Rhule-Louie, McMahon, & Spieker, 2008). Finally, these past studies included low-risk community samples. We are unaware of research that has examined associations among parents’ abuse history, parent–child processes, and offspring outcomes in teen mother–child dyads. This is surprising given that adolescent mothers report higher rates of child maltreatment history, are at elevated risk for disrupted caregiving, and have children who exhibit poorer behavioral adjustment (Hillis et al., 2004, Madigan et al., 2014, Noll et al., 2009).
This study aimed to examine whether a history of child abuse in teen mothers indirectly impacts offspring externalizing problems, through its effects on attachment security in infancy and maternal hostility in preschool. Although both insecure and disorganized attachment are associated with externalizing problems (Fearon, Bakermans-Kranenburg, Van Ijzendoorn, Lapsley, & Roisman, 2010), we focused on secure versus insecure patterns more broadly as an important first step in examining how the emotional quality of the parent–child relationship may account for the effect of maternal abuse history on offspring externalizing problems. Existing gaps in the literature were addressed in four ways. First, we included a high-risk sample of teen mother–child dyads. Second, the effects of mothers’ exposure to a single form of abuse (i.e., sexual or physical) and dual abuse (i.e., sexual and physical) were evaluated in the same model. Some prior results suggest relationships between mothers’ history of sexual or physical abuse and attachment and parental hostility; however, there is more consistent evidence for associations between these parent–child processes and mothers’ prior exposure to dual abuse. These findings led us to predict that dual abuse history would show stronger effects on attachment and maternal hostility than a history of sexual or physical abuse only.
Third, we simultaneously examined attachment and maternal hostility as possible underlying mechanisms for the maladaptive developmental cascade. In theory, a poorer quality of parent–child relationship associated with insecure attachment may heighten risk for coercive parent–child exchanges and harsh parenting (Shaw, Bell, & Gilliom, 2000). However, attachment and parental hostility have not demonstrated significant associations in prior studies (Kochanska and Kim, 2012, Vando et al., 2008). Given that we were unsure whether these parent–child factors would be involved in the same pathway, or distinct pathways, from mothers’ abuse history to offspring externalizing problems, we examined both possibilities in the model. Finally, attachment and maternal hostility were assessed via “gold standard” direct observations of parent–child interaction. In sum, we hypothesized that dual abuse history would be negatively associated with attachment security and positively associated with maternal hostility, and that these effects, in turn, would predict higher levels of externalizing problems.
Section snippets
Sample
The sample was drawn from a longitudinal study of 115 adolescent mothers and their children in the Puget Sound region of Washington State. Mothers were less than 20 years old (M = 17.3 years; SD = 1.26; range 14.5–19.5) when they delivered the study child, and were recruited through high schools, public health clinics, and social services programs for young single mothers. In the final analyzed sample (N = 112), mothers identified as White (n = 88), African American (n = 11), Native American (n = 6),
Preliminary analyses
Forty-six mothers (41%) reported a history of child sexual (n = 32) and/or physical (n = 31) abuse. These mothers could be categorized into one of the three following groups: sexual abuse only (n = 15), physical abuse only (n = 14), or sexual AND physical abuse (n = 17). None of these abuse history groups were significantly associated with child (sex, birthweight, age at attachment assessment) and mother/family (race, age at study child's birth, years of education, welfare status) demographic variables
Discussion
Previous research suggests that children of parents who have experienced child maltreatment face increased risk for problem behavior; however, there is limited understanding of relational mechanisms underlying this risk. This study's findings demonstrate how abuse history in teen mothers has an indirect impact on their offspring's externalizing problems, through its effects on distinct parent–child risk processes. As hypothesized, compared to teen mothers reporting no abuse history, teen
Acknowledgments
This study was supported by Grants MCJ-550535 and MCJ-530589 from the Maternal and Child Health Bureau (Title V, Social Security Act), Health Resources and Services Administration, Department of Health and Human Services, awarded to Susan J. Spieker and Robert J. McMahon. Additional support for this study was provided by a Michael Smith Foundation for Health Research Postdoctoral Fellowship to Dave S. Pasalich.
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